By Jane Salem, staff attorney, Nashville On Friday, the Appeals Board released an opinion affirming a trial Court decision that a proposed treatment is reasonable and necessary when the treating physicians, who examined the injured worker, recommended it. The employer’s reliance on a utilization review opinion saying the employee was a “suboptimal candidate” for the … Continue reading Board Affirms Opinion on Reasonable Necessity of Treatment (But Splits on Fees)
Tag: Utilization review
UR and the ODG–Procedure and Presumptions
By Judge Thomas Wyatt, Chattanooga With apologies to Jerry Seinfeld, what’s the deal with acronyms? I mean, are we so busy that we can’t say we live in the United States? Do we really save time by saying we live in the U.S. of A? And it can be confusing. If you are a college … Continue reading UR and the ODG–Procedure and Presumptions
Re-defining the UR Rules
By Sarah G. Byrne Shortly before Christmas, my brother posted a picture of my nephew on Facebook. He was sporting a tee-shirt challenging Santa to define the word “good.” My first thought: He’ll be a lawyer. After all, lawyers are wordsmiths who agonize over every word in order to re-define the rules. Speaking of, the … Continue reading Re-defining the UR Rules
From the Bench 