General requirement
The employer shall furnish such medical, surgical, and other attendance or treatment, nurse and hospital service, medicine, crutches, and apparatus, for such period as the nature of the injury or the process of recovery may require.
Physician selection; administrative supervision; change of physicians and hospitals
The employee shall have the right to choose an attending physician authorized by the Secretary to provide medical care under this chapter as hereinafter provided. If, due to the nature of the injury, the employee is unable to select his physician and the nature of the injury requires immediate medical treatment and care, the employer shall select a physician for him. The Secretary shall actively supervise the medical care rendered to injured employees, shall require periodic reports as to the medical care being rendered to injured employees, shall have authority to determine the necessity, character, and sufficiency of any medical aid furnished or to be furnished, and may, on his own initiative or at the request of the employer, order a change of physicians or hospitals when in his judgment such change is desirable or necessary in the interest of the employee or where the charges exceed those prevailing within the community for the same or similar services or exceed the provider’s customary charges. Change of physicians at the request of employees shall be permitted in accordance with regulations of the Secretary.
Physicians and health care providers not authorized to render medical care or provide medical services
Request of treatment or services prerequisite to recovery of expenses; formal report of injury and treatment; suspension of compensation for refusal of treatment or examination; justification
Physical examination; medical questions; report of physical impairment; review or reexamination; costs
section 944 of this titleIn the event that medical questions are raised in any case, the Secretary shall have the power to cause the employee to be examined by a physician employed or selected by the Secretary and to obtain from such physician a report containing his estimate of the employee’s physical impairment and such other information as may be appropriate. Any party who is dissatisfied with such report may request a review or reexamination of the employee by one or more different physicians employed or selected by the Secretary. The Secretary shall order such review or reexamination unless he finds that it is clearly unwarranted. Such review or reexamination shall be completed within two weeks from the date ordered unless the Secretary finds that because of extraordinary circumstances a longer period is required. The Secretary shall have the power in his discretion to charge the cost of examination or review under this subsection to the employer, if he is a self-insurer, or to the insurance company which is carrying the risk, in appropriate cases, or to the special fund in .
Place of examination; exclusion of physicians other than examining physician of Secretary; good cause for conclusions of other physicians respecting impairment; examination by employer’s physician; suspension of proceedings and compensation for refusal of examination
An employee shall submit to a physical examination under subsection (e) at such place as the Secretary may require. The place, or places, shall be designated by the Secretary and shall be reasonably convenient for the employee. No physician selected by the employer, carrier, or employee shall be present at or participate in any manner in such examination, nor shall conclusions of such physicians as to the nature or extent of impairment or the cause of impairment be available to the examining physician unless otherwise ordered, for good cause, by the Secretary. Such employer or carrier shall, upon request, be entitled to have the employee examined immediately thereafter and upon the same premises by a qualified physician or physicians in the presence of such physician as the employee may select, if any. Proceedings shall be suspended and no compensation shall be payable for any period during which the employee may refuse to submit to examination.
Fees and charges for examinations, treatment, or service; limitation; regulations
All fees and other charges for medical examinations, treatment, or service shall be limited to such charges as prevail in the community for such treatment, and shall be subject to regulation by the Secretary. The Secretary shall issue regulations limiting the nature and extent of medical expenses chargeable against the employer without authorization by the employer or the Secretary.
Third party liability
section 933(b) of this titleThe liability of an employer for medical treatment as herein provided shall not be affected by the fact that his employee was injured through the fault or negligence of a third party not in the same employ, or that suit has been brought against such third party. The employer shall, however, have a cause of action against such third party to recover any amounts paid by him for such medical treatment in like manner as provided in .
Physicians’ ineligibility for subsection (e) physical examinations and reviews because of workmen’s compensation claim employment or fee acceptance or participation
Unless the parties to the claim agree, the Secretary shall not employ or select any physician for the purpose of making examinations or reviews under subsection (e) of this section who, during such employment, or during the period of two years prior to such employment, has been employed by, or accepted or participated in any fee relating to a workmen’s compensation claim from any insurance carrier or any self-insurer.
Procedure; judicial review
Refusal of treatment on religious grounds
Mar. 4, 1927, ch. 509, § 744 Stat. 1427May 26, 1934, ch. 354, § 148 Stat. 806June 25, 1938, ch. 68552 Stat. 1165Pub. L. 86–75774 Stat. 900Pub. L. 92–576, § 686 Stat. 1254Pub. L. 98–426, § 798 Stat. 1642(, ; , ; , §§ 2, 3, ; , , ; , , ; , , .)
Editorial Notes
Amendments
Pub. L. 98–426, § 7(a)1984—Subsec. (b). , inserted “or where the charges exceed those prevailing within the community for the same or similar services or exceed the provider’s customary charges”.
Pub. L. 98–426, § 7(b)Subsec. (c). , substituted provisions respecting physicians and health care providers not authorized to render medical care or services under this chapter for former provision respecting physicians designated by the Secretary as authorized to render such care and whose names shall be available to employees through posting or in such other form as the Secretary may prescribe.
Pub. L. 98–426, § 7(c)Subsec. (d). , substituted provisions for the recovery by the employee of amounts spent on medical services which the employer failed to provide; for the procedure to be followed for recovery; and for suspension of any payments made if the employee unreasonably refuses to submit to treatment or examination for former provisions which required a request for treatment or services and the filing of a physician’s report for recovery, and permitted the Secretary to excuse a failure to file a report when justified and to suspend payment if the employee unreasonably refuses treatment or examination.
Pub. L. 98–426, § 7(d)Subsec. (j). , added subsec. (j).
Pub. L. 98–426, § 7(e)Subsec. (k). , added subsec. (k).
Pub. L. 92–5761972—Subsec. (a). reenacted provisions without change.
Pub. L. 92–576Subsec. (b). , substituted provisions for employee’s choosing of an attending physician authorized by the Secretary, for prior provisions for such a choosing from a panel of physicians named by the employer and employer’s selection of a physician for an employee when nature of injury requires immediate medical treatment and care for prior provisions for employer’s selection of a physician from the panel; required Secretary’s supervision of medical care rendered and periodic reports of medical care furnished; provided for initiative of the Secretary or the request of the employer for making change of hospitals or physicians and that the change be in the interest of the employee; provided for change of physicians pursuant to regulations of the Secretary; and deleted prior provision authorizing a second choice of a physician from the panel and for selection of physicians for specialized services.
Pub. L. 92–576Subsec. (c). substituted provisions respecting Secretary’s designation of physicians in community authorized to render medical care and posting of their names for prior provisions respecting deputy commissioner’s determination of size of panel of physicians (named by employer) following statutory criteria and approval of their qualifications, and requirement of posting of names and addresses of physicians so as to afford reasonable notice.
Pub. L. 92–576Subsec. (d). substituted the Secretary for the deputy commissioner as the person to exercise the various authorities, struck out introductory provisions respecting employer’s failure to maintain a panel of physicians for examination purposes or to permit the employee to choose an attending physician from the panel and employee’s procurement of treatment and services and selection of a physician at expense of employer, decreased from twenty to ten days the period within which to make the formal report of injury and treatment, and authorized suspension of compensation for refusal to submit to an examination by a physician of the employer.
Pub. L. 92–576Subsec. (e). substituted provisions respecting physical examination to determine medical questions by a physician employed or selected by the Secretary, such physician’s report of the physical impairment, review or reexamination of the employee, and the charging of costs to an employer, who is a self-insurer, or the insurance company carrying the risk or the special fund for prior provisions respecting examination of employee by a physician selected by the deputy commissioner (who shall submit a report of the disability) whenever the deputy commissioner was of the opinion that the employer’s physician was partial in his estimate of the degree of permanent disability or the extent of temporary disability and charging cost of examination to the employer, if he was a self-insurer, or to the insurance company which was carrying the risk when the physician’s estimate was not impartial.
Pub. L. 92–576Subsec. (f). added subsec. (f). Former subsec. (f) redesignated (g).
Pub. L. 92–576Subsec. (g). redesignated former subsec. (f) as (g) and substituted “medical examinations, treatment, or service” for “such treatment or service”, “charges as prevail in the community for such treatment” for “charges as prevail in the same community for similar treatment of injured persons of like standard of living”, “regulation by the Secretary” for “regulation by the deputy commissioner”, and prescribed issuance of regulations respecting medical expenses chargeable against employer. Former subsec. (g) redesignated (h).
Pub. L. 92–576Subsec. (h). redesignated former subsec. (g) as (h) and inserted “that” before “suit”.
Pub. L. 92–576Subsec. (i). added subsec. (i).
Pub. L. 86–7571960—Subsec. (a). designated first sentence as subsec. (a). Remainder of former subsec. (a) redesignated (d).
Pub. L. 86–757Subsecs. (b), (c). added subsecs. (b) and (c). Former subsecs. (b) and (c) redesignated (e) and (f).
Pub. L. 86–757Subsec. (d). redesignated all but first sentence of former subsec. (a) as (d), substituting “If the employer fails to provide the medical or other treatment, services, and supplies required to be furnished by subsection (a), after request by the injured employee, or fails to maintain a panel of physicians as required by subsection (c), or fails to permit the employee to choose an attending physician from such panel, such injured employee may procure such medical or other treatment, services, and supplies and select a physician to render treatment and services at the expense of the employer” for “If the employer fails to provide the same, after request by the injured employee, such injured employee may do so at the expense of the employer.” Former subsec. (d) redesignated (g).
Pub. L. 86–757section 933(a) of this titleSubsecs. (e) to (g). redesignated former subsecs. (b) to (d) as (e) to (g), striking out “unless and until notice of election to sue has been given as required by ” and “without the giving of such notice” before and after “or suit has been brought against such third party” in subsec. (g).
1938—Subsec. (a). Act , § 2, authorized deputy commissioner to excuse failure to furnish prescribed medical report.
Subsec. (d). Act , § 3, added subsec. (d).
1934—Subsec. (a). Act , authorized deputy commissioner to suspend payment of compensation for refusal, without justification, to submit to medical or surgical treatment.
Statutory Notes and Related Subsidiaries
Effective Date of 1984 Amendment
Pub. L. 98–426Pub. L. 98–426Pub. L. 98–426section 901 of this titleAmendment by section 7(a), (e) of effective 90 days after , and applicable both with respect to claims filed after such 90th day and to claims pending on such 90th day, and amendment by section 7(b)–(d) of effective 90 days after , see section 28(b), (e)(2) of , set out as a note under .
Effective Date of 1972 Amendment
Pub. L. 92–576section 22 of Pub. L. 92–576section 902 of this titleAmendment by effective 30 days after , see , set out as a note under .
Claims Filed Under Black Lung Benefits Act
Pub. L. 98–426, § 28(h)(1)98 Stat. 1655