H.B. 224 Enrolled

WORKERS' COMPENSATION - COSTS OF
MEDICAL REVIEW
1997 GENERAL SESSION
STATE OF UTAH
Sponsor: Gerry A. Adair
AN ACT RELATING TO WORKFORCE SERVICES; AMENDING PROVISIONS
CONCERNING PAYMENT OF COSTS FOR STUDY AND REPORT OF A MEDICAL
PANEL, DIRECTOR, OR CONSULTANT IN WORKERS COMPENSATION;
MAKING TECHNICAL CORRECTIONS; AND PROVIDING AN EFFECTIVE DATE.
This act affects sections of Utah Code Annotated 1953 as follows:
AMENDS:
35A-3-601 (Effective 07/01/97), as renumbered and amended by Chapter 240, Laws of
Utah 1996
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 35A-3-601 (Effective 07/01/97) is amended to read:
35A-3-601 (Effective 07/01/97). Medical panel -- Medical director or medical
consultants -- Discretionary authority of department to refer case -- Findings and reports
-- Objections to report -- Hearing -- Expenses.
(1) (a) Upon the filing of a claim for compensation for injury by accident, or for death,
arising out of and in the course of employment, and if the employer or its insurance carrier denies
liability, the department may refer the medical aspects of the case to a medical panel appointed
by the department.
(b) When a claim for compensation based upon disability or death due to an occupational
disease is filed with the department, the department shall, except upon stipulation of all parties,
appoint an impartial medical panel.
(c) A medical panel shall consist of one or more physicians specializing in the treatment
of the disease or condition involved in the claim.
(d) As an alternative method of obtaining an impartial medical evaluation of the medical
aspects of a controverted case, the department may employ a medical director or medical

consultants on a full-time or part-time basis for the purpose of evaluating the medical evidence and
advising the department with respect to its ultimate fact-finding responsibility. If all parties agree
to the use of a medical director or medical consultants, they shall be allowed to function in the same
manner and under the same procedures as required of a medical panel.
(2) (a) The medical panel, medical director, or medical consultants shall make such study,
take such X-rays, and perform such tests, including post-mortem examinations if authorized by the
department, as it may determine to be necessary or desirable.
(b) The medical panel, medical director, or medical consultants shall make a report in
writing to the department in a form prescribed by the department, and also make such additional
findings as the department may require. In occupational disease cases, the panel shall certify to the
department the extent, if any, of the disability of the claimant from performing work for
remuneration or profit, and whether the sole cause of the disability or death, in the opinion of the
panel, results from the occupational disease and whether any other causes have aggravated,
prolonged, accelerated, or in any way contributed to the disability or death, and if so, the extent in
percentage to which the other causes have so contributed.
(c) The department shall promptly distribute full copies of the report to the applicant, the
employer, and its insurance carrier by certified mail with return receipt requested. Within 15 days
after the report is deposited in the United States post office, the applicant, the employer, or its
insurance carrier may file with the department written objections to the report. If no written
objections are filed within that period, the report is considered admitted in evidence.
(d) The department may base its finding and decision on the report of the panel, medical
director, or medical consultants, but is not bound by the report if other substantial conflicting
evidence in the case supports a contrary finding.
(e) If objections to the report are filed, the department may set the case for hearing to
determine the facts and issues involved. At the hearing, any party so desiring may request the
department to have the chairman of the medical panel, the medical director, or the medical
consultants present at the hearing for examination and cross-examination. For good cause shown,
the department may order other members of the panel, with or without the chairman or the medical

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director or medical consultants, to be present at the hearing for examination and cross-examination.
(f) The written report of the panel, medical director, or medical consultants may be received
as an exhibit at the hearing, but may not be considered as evidence in the case except as far as it is
sustained by the testimony admitted.
(g) [The] For any claim referred under Subsection (1) to a medical panel, medical director,
or medical consultant before July 1, 1997, the department shall pay out of the Employers
Reinsurance Fund established in Section 35A-3-702:
(i) expenses of the study and report of the medical panel, medical director, or medical
[consultants] consultant; and
(ii) the expenses of [their] the panel's, director's, or consultant's appearance before the
department [shall be paid out of the Employers' Reinsurance Fund].
(h) For any claim referred under Subsection (1) to a medical panel, medical director, or
medical consultant on or after July 1, 1997, the department shall pay out of the Uninsured
Employers' Fund established in Section 35A-3-704:
(i) the expenses of the study and report of the medical panel, medical director, or medical
consultant; and
(ii) the expenses of the panel's, director's, or consultant's appearance before the department.
Section 2. Effective date.
This act takes effect on July 1, 1997.

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