Employer Not Required to Pay for Services Provided By Unlicensed Provider

The Vermont Department of Labor has ruled an employer/carrier is not responsible for paying for treatment provided by an unlicensed or uncertified provider if Vermont law requires that only a licensed or certified practitioner can provide a particular type of medical service.  Myrick v. Ormond Bushey and Sons, Op. No. 07-14 WC (April 25, 2014).

The workers' compensation statute requires the employer to pay for reasonable medical services caused by a work injury, provided they were "lawfully delivered medical services."  Id. (citing 21 V.S.A. §640). If a practitioner is not required to be licensed or certified to provide treatment under Vermont law, then the employer may be responsible for paying a charge for service.  V.O. Windsor Hospital, Op. No. 12-08 WC (March 27, 2008)(citing 21 V.S.A. §640(a)).

Additionally, the decision reaffirms that an employer is not obligated to to pay charges of a provider who fails to maintain treatment records or submit appropriately documented medical bills.  Myrick v. Ormond Bushey and Sons, Op. No. 07-14 WC (April 25, 2014).

Lent Employee Doctrine Revisited

The lent employee doctrine occurs when one employer, the general employer, lends an employee to another employer, the special employer. The presumption is that employment continues under the general employer and the general employer remains liable for injuries suffered by the employee. See Thorn v. Albany Ladder, Op. No. 17-02WC (Apr. 2, 2002) (citing 3 Larson’s Workers’ Compensation Law §67.03). This presumption may be overcome if there is “a clear demonstration that a new temporary employer has been substituted for the old.” Id. In order for the special employer to become liable: “[T]here must be a contract of hire, express or implied between the special employer and employee. . . . This involves an informed consent by the employee before the employment-relation can be said to exist. This requirement being met, there remains the necessity of showing that the work being done is essentially that of the special employer and lastly that such special employer has the right to control the details of the work.” Mercier v. Holmes, 119 Vt. 368, 375 (1956).