In November 1998, the plaintiff injured his lower back while working for a flooring company. On October 25, 2000, he sued his employer for workers' compensation benefits. On May 7, 2002, the employer's insurance company entered into a settlement under which the plaintiff received $105,000 for his injury. The insurance company remained liable for future medical benefits.
On November 4, 2010, the insurance company filed a motion to reopen the case and terminate its obligation for future medical benefits. The insurance company alleged that the plaintiff had been misusing prescription medications and his pain-management physician had released him from care.
The plaintiff responded that the physician had wrongfully released him from care and requested the trial court to hold the insurance company in contempt for failure to provide a pain specialist. The plaintiff also requested the court to order the insurance company to provide him with a panel of four physicians from which he could select a new physician as provided by §25-5-77(a) of the Code of Alabama 1975.
On December 21, 2010, the Jefferson County Circuit Court denied the insurance company's motion to terminate medical benefits, but did not rule on the request for a panel of four physicians. The insurance company referred him to another pain-management physician.
On February 11, 2011, the plaintiff filed a motion to compel the insurance company to provide him with a panel of four physicians so that he could choose another pain-management physician. In response, the insurance company argued that it had already provided a panel of four physicians when the plaintiff became dissatisfied with the doctor who had performed surgery on him (circa 1999). The insurance company argued that the plaintiff had chosen a new physician or surgeon from that panel. The plaintiff maintained that he was entitled to both a panel of four physicians and a panel of four surgeons and that he had chosen from the panel of surgeons. The insurance company responded that all surgeons are physicians and that therefore the plaintiff was entitled to only one panel of four.
On March 22, 2011, the circuit court ruled in the plaintiff's favor and ordered the insurance company to provide a panel of four physicians. The insurance company appealed to the Alabama Court of Civil Appeals, which found that the insurance company did not present sufficient evidence to demonstrate a clear legal right to a reversal. Therefore, the circuit court's ruling was affirmed. See Ex parte Everest National Insurance Company, decided on September 16, 2011.
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