LAURIE S EDGE V PROVIDENCE ALASKA MEDICAL CENTER ALASKA

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LAURIE S EDGE V PROVIDENCE ALASKA MEDICAL CENTER ALASKA

ALASKA WORKERS' COMPENSATION BOARD

LAURIE S. EDGE v. PROVIDENCE ALASKA MEDICAL CENTER

LAURIE S EDGE V PROVIDENCE ALASKA MEDICAL CENTER ALASKA

ALASKA WORKERS' COMPENSATION BOARD




P.O. Box 25512 Juneau, Alaska 99802-5512




LAURIE S. EDGE,

Employee,

Applicant,

v.

PROVIDENCE ALASKA MEDICAL CENTER,

Employer,

and

PROVIDENCE HEALTH SYSTEM - WASHINGTON,

Insurer,

Defendants.

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INTERLOCUTORY

DECISION AND ORDER


AWCB Case No. 200016660


AWCB Decision No. 01-0257


Filed with AWCB Anchorage, Alaska

on December 19, 2001


We heard this matter at Anchorage, Alaska on December 12, 2001. Attorney Michael Jensen represents the employee. Attorney Rebecca Hyatt represents the employer. We closed the record at the hearing’s conclusion. We proceeded as a two-member panel which constitutes a quorum. AS 23.30.005(f).


ISSUE

Which medical specialties shall perform the second independent medical evaluation (SIME).


SUMMARY OF THE EVIDENCE

The employee was injured while trying to restrain a patient on August 20, 2000. The employee sustained injuries to her neck and back after being kicked by a patient. The employee has continuing complaints of neck pain and headaches. In their November 29, 2001 joint request for an SIME the parties agreed on the need for an SIME on the issues of causation, recommended treatment, degree of impairment, functional capacity, and date of medical stability. The parties agreed that the SIME panel shall consist of a psychiatrist and a neurologist. The employee believes we should also have an orthopedist or other specialist in physical medicine.

The employee argues that she continues to work, but the employer has denied payment of the physical component of her medical treatment. The employee argues that several bills remain unpaid, including bills for her steroid injections. The employer argues that there is not a physical component; that the employee has normal x-rays and MRI scans. The employer argues that it should not be expected to pay for an orthopedist as well.


FINDINGS OF FACT AND CONCLUSIONS OF LAW

AS 23.30.095(k) provides in pertinent part:

In the event of a medical dispute . . . between the employee’s attending physician and the employer’s independent medical evaluation, the board may require that a second independent medical evaluation be conducted by a physician or physicians selected by the board from a list established and maintained by the board.

We find the parties agree that the SIME should include a psychiatric and neurologic examination. We also find that the employer is resisting payment of the employee’s orthopedic component to her claim. We find an orthopedic / physical medicine opinion would assist us in deciding this component to the employee’s claim. Accordingly, we conclude the SIME shall also include an orthopedist as well as the specialties the parties agree on. We acknowledge the employer’s concerns regarding the cost of seeing multiple physicians. We note Walter Ling is on our list with specialties listed in Neurology and psychiatry. We suggest Dr. Ling be selected for these specialties in an effort to save costs.


ORDER

The SIME panel shall also include a physician with an orthopedic / physical medicine specialty.


Dated at Anchorage, Alaska this 19th day of December, 2001.


ALASKA WORKERS' COMPENSATION BOARD




____________________________

Darryl Jacquot,

Designated Chairman




____________________________

S. T. Hagedorn, Member


RECONSIDERATION

A party may ask the Board to reconsider this decision by filing a petition for reconsideration under AS 44.62.540 and in accordance with 8 AAC 45.050. The petition requesting reconsideration must be filed with the Board within 15 days after delivery or mailing of this decision.


MODIFICATION

Within one year after the rejection of a claim or within one year after the last payment of benefits under AS 23.30.180, 23.30.185, 23.30.190, 23.30.200 or 23.30.215 a party may ask the Board to modify this decision under AS 23.30.130 by filing a petition in accordance with 8 AAC 45.150 and 8 AAC 45.050.



CERTIFICATION

I hereby certify that the foregoing is a full, true and correct copy of the Interlocutory Decision and Order in the matter of LAURIE S. EDGE employee / applicant; v. PROVIDENCE ALASKA MEDICAL CENTER, employer; PROVIDENCE HEALTH SYSTEM, insurer / defendants; Case No. 200016660; dated and filed in the office of the Alaska Workers' Compensation Board in Anchorage, Alaska, this 19th day of December, 2001.



_________________________________

Shirley A. DeBose, Clerk





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