- A. Within seven (7) days of actual knowledge of an injury, the employer shall provide the employee reasonable and necessary medical care with a physician of the employer's choice. The providing of medical care shall not be construed as an admission of compensability of an injury or illness. The physician selected by the employer shall become the treating physician.
- B. If the employer fails or neglects to provide medical treatment within seven (7) days after actual knowledge is received of an injury, the injured employee may select a physician to provide medical treatment at the expense of the employer; provided, however, that the injured employee, or another in the employee's behalf, may obtain emergency treatment at the expense of the employer where such emergency treatment is not provided by the employer.
- C. If a self-insured employer, group self-insurance association plan, an employer's workers' compensation insurance carrier or an insured has previously contracted with a certified workplace medical plan, the employer shall select for the injured employee a treating physician from the physicians listed within the network of the certified workplace medical plan. The claimant may apply for a change of physician by utilizing the dispute resolution process set out in the certified workplace medical plan on file with the State Department of Health. If the dispute resolution process has been exhausted, the Workers' Compensation Court may appoint an independent medical examiner to determine the nature of medical treatment needed by the injured worker.
- D. The term "physician" as used in this section shall mean any person licensed in this state as a medical doctor, chiropractor, podiatrist, dentist, osteopathic physician or optometrist. The Court may accept testimony from a psychologist if the testimony is requested by the Court.
- E. Where the employee is not covered by a certified workplace medical plan, the employer shall select the treating physician as provided in subsection A of this section. The Court on application of the employee shall order one change of treating physician for any affected body part. If the employer objects, the Court shall set the request for change of treating physician for hearing within ten (10) days. Provided, that no change of treating physician can be authorized for a part of the body if no authorized medical care has been provided for that part of the body for one hundred eighty (180) days prior to the date of the filing of the application for change of treating physician. Provided further, regardless of the number of parts of the body injured, a maximum of two (2) changes of physician may be allowed in a claim. In the event the employee makes application for such a change, the employee shall list on such application three (3) proposed physicians who are qualified to treat the body part affected. The employer may agree to one of the physicians listed by the employee or submit its own list of three (3) physicians. If the employer and employee do not agree on the physician, the Court may select a physician who is qualified to treat the body part affected and who can see the employee within a reasonable time, with preference given to physicians who are qualified independent medical examiners.
- F. Diagnostic tests shall not be repeated sooner than six (6) months from the date of the test unless agreed to by the parties or ordered by the Court.
- G. Effective March 1, 2012, the scope and duration of medical treatment shall be provided in accordance with the current edition of the "Official Disability Guidelines", as published by the Work Loss Data Institute. For medical treatment not addressed by the Official Disability Guidelines or addressed but not recommended in the ODG section in regard to injuries to the cervical, thoracic, or lumbar spine, the Physician Advisory Committee shall adopt the Oklahoma Treatment Guidelines as provided in Section 73 of this act. Medical treatment provided by or at the direction of the treating physician in accordance with the current edition of the Official Disability Guidelines or Oklahoma Treatment Guidelines is presumed to be reasonable and necessary medical care. The employer or insurance carrier shall not be responsible for charges for medical treatment not provided in accordance with the current edition of the Official Disability Guidelines or Oklahoma Treatment Guidelines unless the medical treatment was provided in a medical emergency, the medical treatment was preauthorized by the employer or insurance carrier, or the medical treatment is approved by the Court upon a finding based on clear and convincing evidence provided by a qualified independent medical examiner that medical treatment provided according to either ODG or OTG is not in the best interest of the employee.
- H. Unless recommended by the treating doctor at the time claimant reaches maximum medical improvement or by an independent medical examiner, continuing medical maintenance shall not be awarded by the Court. At the request of any party, the judge shall appoint an independent medical examiner to determine the nature and extent of continuing medical maintenance. The issue of continuing medical maintenance may be reviewed by the Court at any time. The employer or insurance carrier shall not be responsible for continuing medical maintenance or pain management treatment that is outside the parameters established by the Physician Advisory Committee. The employer or insurance carrier shall not be responsible for continuing medical maintenance or pain management treatment not previously ordered by the Court or approved in advance by the employer or insurance carrier.
- I. An employee claiming or entitled to benefits under the Workers' Compensation Code, shall, if ordered by the Court or requested by the employer or insurance carrier, submit himself or herself for medical examination. If an employee refuses to submit himself or herself to examination, his or her right to prosecute any proceeding under the Workers' Compensation Code shall be suspended, and no compensation shall be payable for the period of such refusal.
- J. For compensable injuries resulting in the use of a medical device, ongoing service for the medical device would be provided in situations including, but not limited to, medical device battery replacement, ongoing medication refills related to the medical device, medical device repair or medical device replacement.
- K. The employer shall reimburse the employee for the actual mileage in excess of twenty (20) miles round-trip to and from the employee's home to the location of a medical service provider for all reasonable and necessary treatment, for an evaluation of an independent medical examiner and for any evaluation made at the request of the employer or insurance carrier. The rate of reimbursement for such travel expense shall be the official reimbursement rate as established by the State Travel Reimbursement Act. In no event shall the reimbursement of travel for medical treatment or evaluation exceed six hundred (600) miles round trip.
Added by Laws 2011, SB 878, c. 318, § 26.