SOUTH CAROLINA A Brief History of the Form 14B, Physician’s Statement
A Brief History of the Form 14B, Physician’s Statement
As part of the sweeping legislative reform that took place on July 1, 2007, Section 42-15-60, the statute dealing with a claimant’s entitlement to medical treatment, was amended in part to add a provision stating that, “When a claim is settled on the Commission’s Agreement for Permanent Disability/Disfigurement Compensation form [i.e. – Form 16], the employer is not required to provide further medical treatment or medical modalities after one year from the date of full payment of the settlement unless the form specifically provides otherwise.” Shortly thereafter, the Workers’ Compensation Commission introduced a new form, the Form 14B, Physician’s Statement.
The Form 14B, Physician’s Statement is one of the more useful forms for both claimants and defendants in that it succinctly solicits from the treating doctor the three most pertinent questions that need to be answered after a claimant reaches maximum medical improvement:
- What is the extent of permanent impairment that the claimant has suffered?
- What work restrictions does the claimant have as a result of his injury, if any?
- What future medical care and treatment does the claimant need as a result of his injury?
Although the Form 14B has proven useful in obtaining the answers to these three highly relevant questions, the Commission’s requirements for when the Form 14B must be used have been less than clear. In September of 2007, at the same time the Form 14B was introduced by the Commission, the Form 16A was also introduced. Unlike the traditional Form 16 Agreement for Permanent Disability/Disfigurement Compensation, the Form 16A requires the attachment of a Form 14B stating what future medical treatment is agreed to amongst the parties as part of the settlement. Per the language of the Form 16A, “Only medical care specifically detailed herein will be paid under this agreement.”
As both defense attorneys and claims adjusters will undoubtedly recall, shortly after introducing the Forms 14B and 16A, the Commission began taking the position that it would not set either a Clincher Conference or an Informal Conference/Viewing unless a completed Form 14B was filed with the Commission. However, such a requirement was not found in the statutes or the regulations until February 26, 2010 when Regulation 67-802 and Regulation 67-803 were amended. Pursuant to the amended versions of these Regulations, the filing of a Form 14B (for all claims arising after July 1, 2007) is specifically required when:
1) Requesting an Informal Conference (a necessary step to settling a claim on a Form 16 or Form 16A with an unrepresented claimant);
2) Settling a claim on a Form 16A with a represented claimant; or
3) When requesting a Clincher Conference.
From a practical perspective, problems arose when the authorized treating physician either refused to complete the Form 14B or requested an unreasonable fee for doing so. To address the latter problem, the Commission released a memo on December 14, 2009 stating that the Form 14B was to be considered a “special report” as defined in Section 8 of the Medical Services Provider Manual and, as such, the maximum fee for completing the Form 14B was to be $64.00. This fee schedule clarification did not resolve the former problem. In some cases, the narrative report from the treating doctor would clearly address the extent of impairment, work restrictions and the future treatment needs, but the Commission, during that time, still refused to set the matter for a Clincher Conference or an Informal Conference/Viewing unless that same information was contained on a Form 14B signed by the doctor.
The Commission changed its stance somewhat in two advisory memos dated May 13, 2011 and January 25, 2012, respectively. Pursuant to the memoranda, a narrative report from a doctor addressing a claimant’s future medical treatment needs would be sufficient to get a Clincher Conference set or a Clincher settlement approved. This change represented a significant departure from the rigid requirements of Regulation 67-803, which allowed no substitution whatsoever for the filing of a Form 14B as a prerequisite to getting a Clincher conference set. The Commission did not relax the requirements of Regulation 67-802, however, and still requires the filing of a Form 14B before it will set any Informal Conference/Viewing. Technically, a Form 14B must be filed before the Commission will approve a settlement with a represented claimant if done on a Form 16A, but in the case of the represented claimant, the requirement is easy to avoid.
In conclusion, while most practitioners and claims adjusters find the Form 14B Physician’s Statement a useful tool, it is also a required filing when settling a claim on a Form 16 or Form 16A with an unrepresented claimant. While the Commission will accept a narrative doctor’s report in lieu of a Form 14B to set up a Clincher Conference, they will not accept a narrative report in lieu of a completed Form 14B to set up an Informal Conference/Viewing. From a practical perspective, once the authorized treating physician releases the claimant at maximum medical improvement, as long as the final medical record adequately addresses future treatment needs, if any, then there is no reason to delay settlement while waiting for the doctor to complete a Form 14B unless the claimant is both unrepresented and the settlement is going to be on a Form 16 or Form 16A basis.
ABOUT THE AUTHOR
Lee Gremillion is an attorney with McAngus Goudelock & Courie. Founded in 1995, MG&C is a full-service law firm with offices in Columbia, Greenville, Charleston and Myrtle Beach, SC, and Asheville, Charlotte and Raleigh, NC. The firm’s practice areas include workers’ compensation defense, employment, banking and consumer law, administrative law, government relations, construction litigation, commercial litigation, products litigation, business law, real estate law and health care and regulatory issues. Mr. Gremillion may be reached at 803.227.2930 or by email.