Eldina Novalic, V. Peacehealth Sw Wa Medical Center

CourtCourt of Appeals of Washington
DecidedJuly 16, 2024
Docket58451-4
StatusUnpublished

This text of Eldina Novalic, V. Peacehealth Sw Wa Medical Center (Eldina Novalic, V. Peacehealth Sw Wa Medical Center) is published on Counsel Stack Legal Research, covering Court of Appeals of Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Eldina Novalic, V. Peacehealth Sw Wa Medical Center, (Wash. Ct. App. 2024).

Opinion

Filed Washington State Court of Appeals Division Two

July 16, 2024

IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

DIVISION II ELDINA NOVALIC, No. 58451-4-II

Appellant,

v. UNPUBLISHED OPINION PEACEHEALTH AND THE DEPARTMENT OF LABOR AND INDUSTRIES,

Respondents.

PRICE, J. — Eldina Novalic was injured while working as a nurse for PeaceHealth

Southwest Washington Medical Center (PeaceHealth). She applied for workers’ compensation

benefits pursuant to the Industrial Insurance Act (IIA), Title 51 RCW. As part of the administration

of Novalic’s claim, PeaceHealth requested that Novalic attend an independent medical

examination (IME). Because of the COVID-19 pandemic and related travel restrictions,

PeaceHealth notified Novalic shortly before the examination that it would be conducted remotely

by telehealth. Novalic’s counsel objected, and Novalic did not attend.

As a result of Novalic’s failure to attend the exam, the Department of Labor and Industries

(Department) suspended her benefits. Both the Board of Industrial Insurance Appeals (BIIA) and

the superior court affirmed the suspension of benefits.

Novalic appeals the superior court’s order affirming the decision of the BIIA. Novalic

argues that the superior court erred because (1) she was given inadequate notice that the exam No. 58451-4-II

would be by telehealth and (2) PeaceHealth violated the Department’s telehealth policy when it

shifted the exam to telehealth without her consent. Novalic also requests attorney fees.

We affirm.

FACTS

I. BACKGROUND

In 2019, Novalic injured her back while employed by PeaceHealth, a self-insured

employer.1 Novalic opened a claim with the Department and sought benefits under the IIA. The

Department initially allowed the claim.

Some time later, one of Novalic’s evaluating doctors believed that as a consequence of her

back injury, Novalic was suffering from anxiety. As a result, CorVel Corporation (CorVel), the

claims administrator handling Novalic’s claim on behalf of PeaceHealth, scheduled an IME with

a psychiatrist. Initially, the examination was scheduled for February 2020, but it was canceled

before it could take place.

II. THE DEPARTMENT’S TEMPORARY TELEHEALTH POLICY

The next month, in response to the onset of the COVID-19 pandemic, the Department

issued a new payment policy called the “Temporary Record Review & Telehealth Independent

Medical Exams Policy.”2 Administrative Record (AR) at 18. One portion of the policy was

1 Self-insured employers “pay directly to workers any disability and medical benefits.” Dep’t of Lab. & Indus. v. Ortiz, 194 Wn. App. 146, 152, 374 P.3d 258 (2016). The IIA defines a “self insurer” as an “employer . . . which has been authorized under [the IIA] to carry its own liability to its employees covered by this title.” RCW 51.08.173. 2 On the first page of the policy, immediately above the title, the document carries the description “Payment Policies for Healthcare Services Provided to Injured Workers and Crime Victims.” AR at 18.

2 No. 58451-4-II

entitled “Payment [P]olicy: Temporary Telehealth IME and Record Review.” AR at 20. In that

portion, the policy explained that it was designed to limit the spread of COVID-19 while allowing

IMEs to continue. The policy provided that the Department was temporarily “allowing the

delivery of independent medical exams . . . via telehealth.” AR at 20. The policy further instructed

providers on how to conduct telehealth exams to be able to bill for them and how to bill and

document telehealth exams.

However, the payment-related provisions also contained several clauses that purported to

limit the provider’s ability to conduct telehealth exams. For example, the policy stated that the

provider was responsible for assessing “a worker’s ability and willingness to participate in an exam

via telehealth, as well as ensuring telehealth is the appropriate method of service delivery for safe

and effective care.” AR at 20. The policy also provided that the “claims manager, worker,

representative, employer, or any other party to the claim[] must also agree a telehealth IME is

appropriate.” AR at 20 (emphasis added).

III. MAY EXAM NOTICES, NOVALIC’S RESPONSE, AND THE DEPARTMENT’S ORDER

On May 7, 2020, nearly two months after the issuance of the Department’s telehealth

policy, CorVel provided 14 days’ advanced notice to Novalic’s counsel that a psychiatrist would

conduct an IME of Novalic. CorVel communicated the date, time, and that the location of the

exam would be in Vancouver. The notice stated that Novalic’s attendance of the examination was

mandatory and advised that failure to attend the exam may result in the suspension of benefits.

On May 19, 2020, three days before the exam was scheduled to take place, Novalic was

informed that the exam would be shifted from being in person to a telehealth appointment. Novalic

was told that she had the option of attending the exam at the Vancouver office where staff could

3 No. 58451-4-II

assist Novalic in connecting with the psychiatrist on an office computer or she could attend the

telehealth appointment using any smartphone, tablet, or computer.

The next day, Novalic’s attorney objected and advised PeaceHealth that Novalic would not

attend the IME because it was not going to be conducted in person. Novalic’s attorney explained:

The mental status examination, which is the most important part of the psychiatric evaluation, needs to be based on personal observations.

AR at 186. As a result of Novalic’s refusal to attend, the exam was cancelled.

Several months later, Novalic’s attorney sent a series of letters to the Department in

response to correspondence from PeaceHealth. Novalic’s attorney further explained his objection

to using telehealth as a way to administer a mental status examination, claiming that

[t]he use of teleconferencing produces substantial visual distortions, as evidenced by national video productions, such as witnessed on PBS NewsHour, broadcast[ed] nightly.

AR at 188. Novalic’s attorney also argued that PeaceHealth did not provide Novalic with the

required 14 days of notice that the exam would be held by telehealth. Novalic’s attorney later

claimed that the exam could not be conducted remotely because “[t]he appearance, body gestures

and manner of speech are distorted by teleconferencing.” AR at 189.

The Department rejected these arguments and issued an order on July 31, 2020, suspending

Novalic’s benefits based on her refusal to “submit to, and/or cooperate with a medical

examination.” AR at 219.

IV. PROCEDURAL HISTORY

Novalic appealed the Department’s order to the BIIA. Both Novalic and PeaceHealth filed

cross motions for summary judgment. Novalic claimed that PeaceHealth did not have the authority

4 No. 58451-4-II

to require her to attend the exam by telehealth and, as a result, the Department did not have the

authority to suspend her benefits. Novalic did not provide any declarations from medical experts

supporting her position that in-person observations were necessary for psychiatric examinations.

PeaceHealth argued that the Department’s order should be affirmed because Novalic failed

to establish good cause for her failure to attend the exam.

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