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IME's and Diagnostic Testing Procedures

The Pennsylvania Supreme Court recently addressed the issue of the necessity of an employee's submission to diagnostic testing procedures, in conjunction with an insurer's independent medical examination (IME) request.

In Coleman, Claimant suffered a work injury to her right shoulder and was treated with two surgeries. She previously, voluntarily submitted to an MRI and triphasic bone scan, with no real complications (a bone scan involves injection of a radiotracer into a vein and as it decays, emits gamma radiation that is detected by a camera).

An IME was performed, and the doctor requested that Claimant undergo an updated MRI and triphasic bone scan, which she refused. Employer filed a Petition to Compel Claimant's cooperation, which the WCJ granted. Claimant eventually underwent the tests, but filed a Review Petition to address the issue.

The Supreme Court noted that physical examinations are used to assess the extent of a Claimant's injuries. Therefore, 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.

However, the Court tempered this determination by noting a Claimant's right to be free from nonconsensual contact, and the right to be free of bodily invasion and to refuse medical treatment. Thus, the Court created three standards for determining whether diagnostic tests fall under the definition of "physical examination" under section 314, 77 P.S. 651(a):

  1. tests must be necessary,
  2. involve no more than minimal risk, and
  3. are not unreasonably intrusive.

In the case at bar, the issue was moot, as Claimant already submitted to the requested tests. However, the Court did provide some discussion on the subject. It noted that the bone scan requested of Claimant, while arguably involving minimal risk based on her experience with a prior scan, required the use of a tracer, which is undeniably an intrusion upon Claimant. The question of whether the intrusion was reasonable remained, but was not addressed. The Court also noted that injections are generally not unreasonably intrusive, especially given the fact that vaccinations and immunizations are often performed outside of clinical environments, such as schools. Whether the risk was minimal was also left for another day, given that the matter was technically moot.