Missouri: Employer Penalized for Lapses in Prescription Payments

Missouri: Employer Penalized for Lapses in Prescription Payments

The employer’s failure to provide medical treatment for several months did not waive its right to designate a medical provider, according to the Commission, which rejected an argument that 287.140 allowed prospective waiver to designate medical providers. The employer in Missouri has the right to designate a medical provider. Previous cases that found a waiver and ordered payment of “unauthorized” treatment involved past medical care. In this case, the employer had disagreed with claimant on several instances about providing medical services but it had tendered more than 1/2 million dollars in medical treatment. 

The claimant remained entitled to medical care even if he was not an ideal patient, not accommodating or engaged in some unacceptable behavior that alienated his doctors. The employer’s failure to pay benefits for several months in 2007 supported an award for sanctions that included attorney’s fees. The adjustor’s records lacked any notes for about 8 months in 2007. The claimant sustained a paralyzing injury when he fell from a platform in 2002. The employer stipulated claimant was totally disabled and entitled to future care, although the parties disputed the scope of the medical care. The ALJ awarded van modifications, home modification and home cleaning but concluded claimant had not preserved his claim for a washer and dryer and other services. The commission case is Deane v Elder Custom Homes, 2012 MOWCLR LEXIS 20 (Feb. 16, 2012). 

Source: Martin Klug, Huck, Howe & Tobin. Read Martin Klug's Mo. Workers' Comp Alerts.

For more information about LexisNexis products and solutions connect with us through our corporate site.