Monday, June 06, 2005

WCJ Does Not Have Jurisdiction To Rule On URO When Provider Does Not Send Records

In County of Allegheny, et al. v. WCAB (Geisler) the Commonwealth Court held the WCJ does not have jurisdiction in an appeal from a URO based on the provider's failure to provide records. The Court observed that a provider could intentionally not respond to the records request and proceed to make its case before the WCJ, bypassing the URO process.

Under this ruling, a prospective URO will be required to recommence payment for treatment. Certainly there is no res judicata effect of the first URO, since the determination was not on the merits.

A provider that has an excuse for not supplying records should still appeal to the WCJ, but the WCJ can only enter an order that in a subsequent prospective URO the reviewer must review treatment back to the date of the original UR request.

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