question about Spinal surgery 2nd opinion process (Californi

This category is meant for discussion of technical legal issues in workers' compensation. If you are an injured worker, do not ask questions here. Go to the Injured Workers' forum.

question about Spinal surgery 2nd opinion process (Californi

Postby cement on Thu Mar 05, 2009 3:59 pm

Does anyone know if failure to include the treating physician on the formal spinal surgery 2nd opinion objection notice is enough to make the objection defective? Even if the treating physician was notified 2 days after the request, via the UR non certification? We sent the request to UR first, once UR denied, then we sent the spinal surgery 2nd opinion in, this all occurred within 10 days of receipt of the medical report.
cement
 
Posts: 21
Joined: Mon Mar 02, 2009 8:34 am

Re: question about Spinal surgery 2nd opinion process (Californi

Postby jakelast@aol.com on Sun Mar 08, 2009 2:18 pm

It should not. The WCAB decision in Brasher holds that once you have denied authorization through UR, the burden shifts to Applciant do make the request for a second surgical opinion. If Applicant did not make the request because they relied upon your already having filed, there is no reason for the applicant to complain you did not do it correctly as it was their burden in the first place.

If the complaint is that you did not do it correctly, concede the point and advise applicant to file his own objection and request for a second opinion. If it is the DWC that is refusing to provide a second opinion physician, that is not really defendant's problem but is applicants.

Jake Jacobsmeyer
Shaw, Jacobsmeyer, Crain, Claffey & Nix
Jake Jacobsmeyer
Shaw, Jacobsmeyer, Crain & Claffey
User avatar
jakelast@aol.com
 
Posts: 89
Joined: Sun Mar 08, 2009 2:12 pm


Return to Legal

Who is online

Users browsing this forum: No registered users and 9 guests

cron