Monday, February 19, 2007

Paper on Dueling Experts in Mediation

This paper written for an Australian alternative dispute resolution association discusses methods for a mediator to deconstruct polar opposite expert opinions.

Some of the methods involve a lot of cost such as bringing the experts together to discuss their opinions. In workers compensation we might apply this technique by discussing in the mediation what the experts might say if we brought them together.

This material would be useful for counsel to prepare their clients for mediation.

Monday, February 12, 2007

Utilization Review Must Name Actual Treating Physician

In Bucks County Community College v. WCAB (Nemes, Jr.), the Employer filed for utilization review of the treatment of a Dr. Files. The Claimant was actually being treated by Dr. Mercora, a physician of the same license and specialty of Dr. Files in the same group. When the utilization review was filed, the Employer did request review of all physicians under the same license and specialty.

The utilization reviewer went ahead and reviewed Dr. Mercora’s treatment and found it reasonable and necessary in part. On a petition to review the utilization review determination filed by the Claimant, the WCJ found the report was invalid and therefore the Employer did not meet its burden to show any treatment was not reasonable and necessary. The Board and the Court affirmed.

The Act and Regulations require that a health care provider under review must be an individual, not a hospital, corporation or group. Multiple physicians’ treatment cannot be reviewed under one request. Accordingly, the Court stated the Employer must file naming the correct treating physician for the utilization review to be valid.

Thursday, February 08, 2007

The Mechanics of Biomechanical Low Back Pain

Interesting article on fatigue and recovery of the low back in lifting occupations.

Two disc replacement surgery. Press Release.

Thursday, February 01, 2007

Supreme Court Grants Petition for Appeal in Knechtel

The Supreme Court granted the Claimant's Petition for Appeal in Marilyn Knechtel v. WCAB (Marriott Corp.). In the Commonwealth Court's decision, the Claimant's designated health care provider at the IME was limited to the role of obtaining a firsthand view of the exam process as a foundation for later rebutting in testimony the validity of the exam results. Post

Uninsured Employer Guarantee Fund Statement of Policy

The Bureau's Statement of Policy on the Uninsured Employer's Guarantee Fund is published at the Pennsylvania Bulletin site.

Forms: Claim Petition for Benefits from the Uninsured Employer Guaranty Fund and Uninsured Employer (LIBC-500) and Notice of Claim Against Uninsured Employer (LIBC-501) are available on the Downloadable Forms portion of the Bureau site.