Physicians: Treatment: Specialized Evaluation or Treatment

Wright v. Ace American Ins. Co. [05/24/10] 2010 MTWCC 11 Where a doctor's opinion persuaded the Court that the claimant may be suffering from a cervical condition, the Court concluded that the claimant should be allowed to seek further medical treatment. However, the Court will not order the insurer to pay for the claimant to "doctor shop" until he finds a surgeon willing to perform cervical surgery. The claimant may seek the opinions of two qualified orthopedic surgeons at the insurer's expense. If neither agrees to treat the alleged cervical condition, the insurer shall not be liable for further treatment of the alleged condition.

Montana State Fund v. Pardis [05/10/06] 2006 MTWCC 21 Although an IME doctor strongly recommended that a patient, whose treating physician is a chiropractor, see a medical doctor to “monitor [the patient’s] progress,” the insurer cannot compel the patient to change treating physicians. Monitoring progress does not equate to the type of specialized evaluation or treatment contemplated by § 39-71-1101(3), MCA.