South Dakota Medical Direction of Care

2013 South Dakota Codified Laws Title 62 - WORKERS' COMPENSATION Chapter 04 - Compensation For Injury Or Death § 62-4-43 Selection of medical practitioner or surgeon by employee.

Content below from - https://law.justia.com/codes/south-dakota/2013/title-62/chapter-04/section-62-4-43/

62-4-43. Selection of medical practitioner or surgeon by employee. The employee may make the initial selection of the employee's medical practitioner or surgeon from among all licensed medical practitioners or surgeons in the state. The employee shall, prior to treatment, notify the employer of the choice of medical practitioner or surgeon or as soon as reasonably possible after treatment has been provided. The medical practitioner or surgeon selected may arrange for any consultation, referral, or extraordinary or other specialized medical services as the nature of the injury shall require. The employer is not responsible for medical services furnished or ordered by any medical practitioner or surgeon or other person selected by the employee in disregard of this section. If the employee is unable to make the selection, the selection requirements of this section do not apply as long as the inability to make a selection persists. If the injured employee unreasonably refuses or neglects to avail himself or herself of medical or surgical treatment, the employer is not liable for an aggravation of the injury due to the refusal and neglect and the Department of Labor and Regulation may suspend, reduce, or limit the compensation otherwise payable. If the employee desires to change the employee's choice of medical practitioner or surgeon, the employee shall obtain approval in writing from the employer. An employee may seek a second opinion without the employer's approval at the employee's expense.

South Dakota Case Management Plan

Content below from - http://dlr.sd.gov/workers_compensation/case_management.aspx

  • All workers' compensation insurers (including self-insured employers) in South Dakota are required to provide case management services in their policies. Therefore, workers' compensation insurance companies are required to contract with one or more case management plans.
  • All plans must be certified by the Department of Labor. A self-insured employer may also have its plan certified by the department.
  • While some insurance plans work with rehabilitation specialists and case managers, insurers and self-insurers often contract with such people separately.

Injured workers have the right to choose the first physician they see. (Seeking emergency room treatment does not count as their choice.) Employees are required to tell the treating physician which plan covers them before treatment is provided.

Employers must report the injury to the plan within 24 hours of the time it is reported to them. The plan must then contact the physician and inform him or her of its rules. All physicians must follow the rules of the plan. The plan also has control over subsequent consultations or referrals.

 

For additional information regarding Gallagher Bassett's South Dakota Case Management Plan offering, please contact your Gallagher Bassett Account Executive.

 

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The information provided throughout this Web site is provided from a general insurance/risk management perspective and is NOT legal advice. Gallagher Bassett Services, Inc. (GB) does not provide legal advice as it is not qualified to do so. GB recommends that you seek the advice of legal counsel in order to become fully apprised of the legal implications related to the information provided above as such implications are highly dependent on the unique facts and circumstances applicable to an individual situation.