stewshe@comcast.net
Senior Member
Posts: 1381
Joined: Jun 2002
|
Thursday February 26, 2009 5:25 PM
|
|
lyounglaw,
I had a similar case a week or two ago. The CA's UR objected to the 1 day hospital stay on back surgery their UR authorized and they filed a Spinal Surgery Objection with the A.D....but it was defective...no cc to the EE and they did not sign the required Proof of Service, but substituted one of their own POS which did not have all of the same elements.
This should "bounce" back from the AD, leaving them defenseless with no "valid" objection.
Also, they cannot get a 2nd opinion as to the surgery to second guess their UR...Sandhagen doesn't allow it. The only possibility is discussed below, unless the AA agrees to someone else:
The purpose of the objection to the AD was to obtain a "Second Opinion Physician" on the Spinal Surgery issue and in my case they have blown the proper procedure by not objecting properly.
There is no incentive in my case for the EE to agree to anyone as a 2nd opinion.
Now, the question is, did your client send a timely objection to the AD within 10 days on DWC Form 233 and otherwise comply with all the requirements of CCR Sec. 9788.1?
-------------------------
Stew (James T. Stewart) e-mail: stewshe@comcast.net
Author: Work Comp Index & Tables & Schedules in "The Labor Code Book," by LexisNexis/Matthew Bender.
7th ed. Work Comp Index (912 pgs), $119.00 ea; next ed. summer, 2010 {Discounts for orders of 12 or more}
Send check or money order & shipping info. (I cannot take credit cards.)
Prices INCLUDE sales tax, and shipping.
James T. Stewart; 1937 Santa Ana; Clovis, CA 93611
Edited: Thursday February 26, 2009 at 5:29 PM by stewshe@comcast.net
|
|
