Opinion ID: 1150782
Heading Depth: 2
Heading Rank: 2

Heading: Pre-hearing Communications Appropriateness

Text: The fact that the statutes and rules do not provide for the physician-patient privilege in workers' compensation contested cases does not resolve entirely the second question of the appropriateness of pre-hearing communications between claimant's treating physicians and employer's lawyer. Claimant argues also (1) that even if the privilege is inapplicable, other areas of the law recognize and protect the special relationship between a patient and her physician, and (2) that the workers' compensation statutes and agency rules do not contemplate this type of communication.
Claimant and amicus Oregon Trial Lawyers Association (OTLA) cite many sources recognizing the special relationship between patient and physician outside the context of the evidentiary privilege. These include: (1) The Hippocratic Oath; (2) willful or negligent disclosure of a professional secret as grounds for suspension of, or refusal to grant, a license to practice medicine, ORS 677.190(5); (3) the existence of tort liability for a physician's breach of the confidential relationship under Humphers v. First Interstate Bank, 298 Or. 706, 696 P.2d 527 (1985); (4) the constitutional right to privacy, see Roe v. Wade, 410 U.S. 113, 219, 93 S.Ct. 705, 761, 35 L.Ed.2d 147 (1973) (Douglas, J., concurring) ([t]he right to privacy has no more conspicuous place than in the physician-patient relationship, unless it be in the priest-penitent relationship); and (5) ethical obligations of lawyers when approaching a plaintiff's physicians in personal injury cases. [7] The respect accorded the physician-patient relationship in other contexts does not govern the status of the relationship in workers' compensation cases. This is especially true, as discussed earlier, when there is no evidentiary privilege connected with that relationship in Workers' Compensation Law. Thus, these reasons supporting prohibition of such communications are, regardless of their wisdom, no more than policy arguments. Weighing of policy arguments in the administrative law context is within the purview of the legislature, not the courts. The legislature delegated authority to the agency to define policy in this area by promulgating rules regarding physician reporting. ORS 656.252. This court's review of such delegative rules is largely deferential, especially when the agency has special expertise and has made a statutory interpretation at least as plausible as any challenger's. As this court has stated: All legislative decisions involve value judgments of a political nature and so do delegated legislative decisions.    The delegation of responsibility for policy refinement under such a [policy-delegating] statute is to the agency, not to the court. The discretionary function of the agency is to make the choice and the review function of the court is to see that the agency's decision is within the range of discretion allowed by the more general policy of the statute. Springfield Education Assn. v. School Dist. No. 19, 290 Or. 217, 229, 621 P.2d 547 (1980). See Branscomb v. LCDC, 297 Or. 142, 681 P.2d 124 (1984) (court will give deference to agency's interpretation of its rule adopted pursuant to a policy-delegating statute). The Board is permitted, as it did in Alan W. Hayes, Jr., supra, to adopt a general policy interpreting one of its rules that will be applicable to future cases. ORS 183.355(2); Marbet v. Portland Gen. Elect., 277 Or. 447, 461, 561 P.2d 154 (1977). The Board, in its interpretation permitting the communications, relied upon the express policy of the Workers' Compensation Law that seeks to avoid the delay and excessive costs caused by litigation and the adversarial system. ORS 656.012(2)(b); OAR 438-05-035. [8] The Board's interpretation is not inconsistent with this express policy, and it is not our task on judicial review to evaluate these competing interests and substitute our judgment for the judgment of the Board on what policy provisions should prevail; this would be beyond our scope of review. ORS 656.298(6) and 183.482(8)(a).
Claimant next argues that the workers' compensation statutes and the rules, themselves, do not envision these types of communications. Moreover, claimant asserts that the existence of numerous detailed workers' compensation provisions governing written reports by physicians [9] manifests an intent to make written reports the exclusive mode of communication between an employer's lawyer and a claimant's treating physicians. We find this argument unpersuasive. ORS 656.252(1) authorizes promulgation of rules regarding physician reporting. [10] Subsection (1) does not refer to writing, but only to reports. We find no reason to presume a legislative intent to require all reports to be written or to restrict verbal communication between employers or their agents and injured workers' physicians. We note, in fact, that subsection (2) of ORS 656.252 explicitly requires physicians to advise insurers and self-insured employers within five days of a worker's anticipated release to return to work or the reopening of a claimant's closed claim and subsection (5) requires physicians to notify insurers or self-insured employers within five days of changes in physicians or referrals to new physicians. Nothing in the statute addresses how physicians are to report to, advise, or notify insurers or self-insured employers so long as the relay of information is prompt and correct. Claimant further argues that repeated references to written reports in administrative rules reflect a policy of preventing unnecessary intrusion into the confidentiality of the physician/patient relationship. This argument, however, also is belied by ORS 656.252(1), which provides that the purpose of the written report requirement is to insure the prompt and correct reporting and payment of compensation in compensable injuries. The legislative history reveals considerable concern about promptness, but no discussion of protecting claimant confidentiality. See, e.g., Minutes, House Committee on Labor and Management, March 22, 1967, pp. 1-3. ORS 656.252 goes on to absolve complying physicians from legal liability for disclosure of medical confidences. [11] We conclude that physician-patient confidentiality was of scant concern to the legislature in this context, especially in the face of competing concerns for promptness and accuracy. ORS 656.252 is a non-exclusive outline of the types of communications physicians are required to initiate with insurers or self-insured employers. It is not an outline of any particular or exclusive mode for such communications. Therefore, the Board was free to interpret the statute in its rules to define permissible modes of communication. The Board, in its opinion in Alan W. Hayes, Jr., supra, interpreted the rules consistent with the stated purpose of the written reports. The Board stated: We find nothing in the statutes or rules requiring an insurer to give claimant prior notice of its intent to contact his or her physician. Further, we find such a requirement is inconsistent with our stated policy of full, fair and expeditious disclosure of information between the parties. It is also inconsistent with the legislature's intent to create a compensation system that reduces litigation and minimizes the adversarial process. 37 Van Natta at 1182. The Board was within its statutory power in so construing the statute. [12]
In essence, claimant argues that the lack of a specific reference to communications of the type involved in this case within the statutes and rules means that such communications are not permitted. The Board takes the opposite view: it interprets the absence of specific references prohibiting this type of communication to mean that such communications are permitted. Although claimant's interpretation is a plausible one, and may be supported by the policy reasons stated above, the Board's interpretation of the rules also is reasonable and is not inconsistent with the Workers' Compensation Law and rules made pursuant to that law.