Torres v. Costco Wholesale Corp
38 FLW D1444
Employer/carrier filed Motion to Compel an IME of the claimant. It was the employer/carrier's burden to establish the factual and legal basis for this examination.
In order to obtain an independent medical examination (IME) as requested by the employer/carrier in this instance, there must be a "dispute" wich is a condition precedent. Because no petition for benefits had been filed, there was no dispute and accordingly, the employer/carrier was not entitled to an IME.
The employer/carrier had alleged that there was a need for an IME in order to determine if there was overutilization of care. The employer/carrier in this instance had alleged that the claimant had been provided treatment by the doctor under utilization review who had prescribed eight different medications at the same time. Court determined that this did not constitute a prima facie case for overutilization. In addition, the employer/carrier's assertion of concern for the claimant's lack of progress of care from the physician was insufficient to demonstrate a dispute authorizing an IME. The employer/carrier must present some evidence to demonstrate that it is in fact engaged in the statutory utilization review process. Argument and assertions by counsel are not evidence sufficient to demonstrate the existence of a dispute. Simply expressing unilateral speculative concern over a claimant's progress with an authorized physician is insufficient to create a medical dispute warranting an IME.
Based on Petition for Writ of Certiorari filed by the claimant, court determined that the JCC departed from the essential requirements of law in compelling the claimant to attend a physical exmination without evidence of a dispute.