Worker's Comp follow-up medical exams argued

The facts are pretty straightforward.

Donnice Hartgrove, now 57, was a registered nurse at St. Mary's Health Center who sustained a work-related back injury and had surgery in November 2001.

After a Worker's Compensation hearing, she was determined to be permanently and totally disabled, and her employer - now known as SSM Health - was ordered to pay her weekly benefits.

But last December, SSM told Hartgrove they had scheduled an independent medical exam with a board certified neurosurgeon, and that they would stop paying her benefits if she failed to appear at the Jan. 21, 2014 appointment.

She didn't go to the appointment, and SSM stopped the payments.

The Labor and Industrial Relations Commission determined that SSM wrongfully terminated Hartgrove's benefits, and the hospital appealed.

Before explaining its legal case to the three-judge appeals court panel visiting at Lincoln University Thursday afternoon, SSM Health attorney Kevin M. Leahy explained the basic case to students and faculty in the audience.

"The issue in this case," he said, "is whether or not the employer/insurer is entitled to exercise its right to an independent medical examination," to determine whether she's had a change in her medical condition.

Leahy then told the judges a state law is clear: the employer is "entitled to, from time to time, a reasonable medical examination" and that state law also requires the files to be kept open in a permanent, total disability case.

"In this case, the individual is receiving $491.80 per week, for life," Leahy noted, repeating the argument the employer has the right to require the injured employee to submit to an examination and "if the employee refuses ... his right to compensation shall be forfeited."

But Hartgrove's attorney, Dewey Crepeau of Columbia, told the judges he is asking the court to "create a totally new process to require an employee to submit to a medical examination after a final award has been issued."

Crepeau said the section of law SSM cited was intended to be used as "a pre-hearing statute" while a disability case still is being determined.

He also argued: "Missouri law already has two ways to suspend permanent benefits - (how) you compute benefits and suspending life payments if the employee is able to go back to work."

But Leahy asked the court to find that the employer has a right to get an independent medical exam, to see if things have changed in the case.