Certified Pennsylvania Work Comp Specialist, Michael W. Cardamone of The Cardamone Law Firm won a Petition for Review of a Utilization Review for his client. The central issue in the case was whether chiropractic treatment was reasonable and necessary. In this context, the burden of proof is on the employer to establish that the challenged treatment is not reasonable and necessary. Cardamone successfully argued that the treatment helped his client to continue working and provided functional improvement. After all, what could be more useful than treatment allowing an injured worker to keep his or her job?
In the litigation, Cardamone presented his client’s testimony and a narrative report of the treating physician which outlined why the treatment was reasonable and necessary. In December 2013, the Workers’ Compensation Judge issued her Decision finding that the Employer failed to prove the chiropractic treatment was unreasonable or unnecessary. Accordingly, the Employer/Insurer has to pay for the treatment, and litigation costs were awarded.
It is important for injured workers to challenge Utilization Review Determinations that find treatment unreasonable or unnecessary. Call me if you are not already represented by a Certified PA Work Comp Lawyer, so I can challenge the Determination by filing a Petition to Review. There are strict deadlines for appealing these Determinations so be guided accordingly and act quickly.
For more information about Pennsylvania Work Comp Procedure, call Michael directly at (215) 206-9068 or email MyPhillyWorkersComp@Gmail.com 7 days a week.
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