by jakelast@aol.com on Sun Dec 06, 2009 11:45 pm
The WCJ may be thinking that any issue involving Medical treatment needs to be addressed by UR in order to determine if it is medically indicated. The issue of whether the medical treatment is related to the original injury can be addressed by UR but that report may not be admissable on the actual nature and extent of injury issue.
In Simmons the issue was whether the UR docs comments on the relationship of a body part was admissable on the issue of nature and extent of injury with defendant arguing it was and applicant arguing only a lc 4062(a) report was admissable on that issue.. The WCAB held the report is not admissable on that issue but could be the necessary trigger to allow defendant to object to the opinion of the PTP regarding that relationship and seek a medical legal report on the issue.
However the decision does not require UR to address that issue, it merely allows the issue to be triggered by UR. A LC 4062(a) objection as to the nature and extent of injury is also a basis for moving forward. If the Medical Unit has already issued a panel, it will not issue another one absent agreement or an order of the WCAB.
Jake Jacobsmeyer
Shaw, Jacobsmeyer, Crain & Claffey