Tuesday, February 24, 2004

Supreme Court Gives Standard for Ordering Diagnostic Testing With Physical Examination

In Coleman, Aplt v. WCAB (Indiana Hospital, et al.) the Claimant sought review of a WCJ's Order that she undergo a triphasic bone scan and MRI. The WCJ found the unrebutted medical evidence was that the tests were required; there was no medical evidence suggesting the tests would not have diagnostic value or place the Claimant at risk.

The Board dismissed the Claimant's appeal because she underwent the test, but the Commonwealth Court agreed to hear the issue and affirmed the WCJ as did the Supreme Court.

The Supreme Court held the term "physical examination" includes all reasonable medical procedures and tests necessary to permit a provider to determine the extent of a Claimant's disability. Furthermore, the test must meet the standard for suspension for refusal of care, e.g. it must involve only a minimal risk and offer a high probability of success. The fact that a test or procedure is invasive is not relevant; the Court said injections are commonplace in medical diagnosis and treatment. However, a reasonableness standard will be applied to the intrusiveness of the test or procedure. A minimally invasive test may be unreasonably intrusive, such as genetic testing, and introduction of a contrast agent into the body will not be unreasonably intrusive in most cases.

The Court concluded diagnostic testing to evaluate the extent of the Claimant's injuries falls under the definition of a physical examination when it is necessary, involves no more than minimal risk and is not unreasonably intrusive.

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