Case name: Resort Retainers v. Labor Commission, No. 20090668-CA (Utah Ct. App. 08/19/10).
Ruling: The Utah Court of Appeals held that a worker was entitled to surgery based on the recommendations of a medical panel's report.
What it means: In Utah, a referral to a medical panel is necessary when there are conflicting medical reports. A panel's decision will not be overturned if it is well reasoned, supported by evidence, and persuasive.
Summary: The worker sustained a back injury while working. She sought temporary total disability benefits. Two doctors opined that she was not a good candidate for surgery. A third doctor recommended surgery, and the matter was referred to a medical panel, which recommended surgery. The third doctor reversed his opinion after reviewing the worker's medical records and a videotape showing the worker performing activities with minimal pain. The medical panel issued a supplemental report, still recommending surgery. The Utah Court of Appeals held that the worker was entitled to benefits for surgery.
The employer objected to the medical panel's first report because based on the third doctor's second opinion, there was no conflicting medical issue. The court noted that at the time of the report, there were conflicting opinions. The court stated that the second referral to the medical panel was also correct and did not "exceed the bounds of reason and rationality."
The employer asserted that the medical panel's report was without any supporting medical opinion. The court stated that although the three doctors recommended against surgery for the worker, the medical panel conducted its own investigation of the worker before recommending surgery.
Next, the employer argued that a more recent doctor's opinion should have been considered. The court stated that a new evidentiary hearing was not necessary because there was no new medical evidence, only a new opinion based on the same information. The court stated that if a new hearing was required after each new medical opinion, the process of determining benefits would potentially never end.
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November 8, 2010
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