Idaho Worker Seeking Disability Benefits May Not Avoid Independent Medical Exam

Once an Idaho claimant has filed a complaint seeking disability benefits, the employer may require her to attend a medical examination under Idaho Code § 72-433, held the Supreme Court of Idaho [Moser v. Rosauers Supermarkets, 2019 Ida. LEXIS 86 (May 15, 2019)]. Declaring that the statute was not ambiguous in its requirements, the Court cast aside the claimant’s contention that she could only be required to submit to such an examination if she was actually receiving benefits at the time the employer sought the exam.

Background

Moser dislocated her right shoulder on October 9, 2016, while working as a cashier for Rosauers Supermarkets, Inc. (“Rosauers”). Rosauers accepted the claim even though Moser had a pre-existing history of recurrent instability of her right shoulder. Moser underwent surgery in November 2016. After surgery, she continued to suffer issues related to her shoulder and her surgeon recommended she receive a second opinion. Rather than authorizing the request for referral, Rosauers arranged for Moser to be evaluated by Dr. Michael Ludwig who opined that Moser’s shoulder dislocation likely resulted from her pre-existing condition. On September 8, 2017, Dr. Ludwig concluded that Moser had returned to her pre-injury baseline and that she did not require any further medical care. Moser was given an 11 percent upper extremity impairment apportioned entirely to Moser’s documented pre-injury condition.

Complaint Seeking Benefits

On January 3, 2018, Moser filed a workers’ compensation complaint seeking, in pertinent part, medical care, temporary total disability benefits, and potential permanent disability benefits. Rosauers filed a notice of medical exam, to which Moser objected, seeking a protective order. Her request for the protective order was eventually denied by the Commission. While the Commission found that § 72-433 was ambiguous, it concluded that following the claim of an accident, injury, or occupational disease, an employer may require a claimant’s attendance at a medical exam.

Supreme Court’s Opinion

The Supreme Court said the statute was not ambiguous. Under the wording of the statute, two issues were at stake:

  1. Whether Moser had (or claimed to have had) an injury or contracted an occupational disease, and
  2. Whether Moser was within the “period of disability” at the time Rosauers requested the medical examination.

The Court said the answer to both was “yes.” By filing a claim for disability benefits Moser had asserted that she suffered a decrease in wage-earning capacity and was within a “period of disability” as required by the statute. It made no difference that she was not receiving income benefits at the time.

The Court agreed, to an extent with Moser. It noted that after Moser’s injury, Rosauers initially accepted the claim and paid benefits until September 2017, when Dr. Ludwig examined Moser and opined that she had reached MMI. After that time, Moser had legitimate grounds to object to any request by Rosauers that she attend a medical examination. Even so, by filing her worker’s compensation complaint seeking benefits for disability in January 2018, Moser’s allegations placed her within a “period of disability” and she was therefore required to submit to Rosauers’ request that she attend a medical examination so long as it was at a “reasonable time and place.”

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