Act 147 amends the Workers' Compensation Act  <  C&W Journal  >  Broad Interpretation of Course of Employment

Court Confirms Narrow UR Determinations

Nathan Hughes

Source: Bucks County Community College v. WCAB (Nemes, Jr.), A.2d (Pa. Cmwlth. 2007).

Analysis

Although a prospective Utilization Review (UR) Determination was partially favorable to the employer, it was held to be invalid because the claimant had not treated with the named provider for months. Despite the notation on the UR Request that it apply to all providers of the same license and specialty, the Court held that one UR can only apply to a single individual provider.

What it Means For You

Precision and thoroughness are important when filing Utilization Review requests. Separate requests must be completed for each individual provider, including multiple doctors in the same office. Contact a Cipriani & Werner attorney to discuss the best procedure for challenging the compensability of a claimant's treatment in your case.

About C&W

Cipriani & Werner is a professional corporation providing civil litigation and workman's compensation legal services to clients throughout Pennsylvania and New Jersey. If you have questions, feel free to contact Nathan Hughes at (412) 563-2500.

You can also read more about the article's related practice groups:
Workers' Compensation