H.B. 224

1

WORKERS' COMPENSATION - COSTS OF
2 MEDICAL REVIEW
3 1997 GENERAL SESSION
4 STATE OF UTAH
5 Sponsor: Gerry A. Adair
6 AN ACT RELATING TO WORKFORCE SERVICES; AMENDING PROVISIONS
7 CONCERNING PAYMENT OF COSTS FOR STUDY AND REPORT OF A MEDICAL
8 PANEL, DIRECTOR, OR CONSULTANT IN WORKERS COMPENSATION; MAKING
9 TECHNICAL CORRECTIONS; AND PROVIDING AN EFFECTIVE DATE.
10 This act affects sections of Utah Code Annotated 1953 as follows:
11 AMENDS:
12 35A-3-601 (Effective 07/01/97), as renumbered and amended by Chapter 240, Laws of Utah
13 1996
14 Be it enacted by the Legislature of the state of Utah:
15 Section 1. Section 35A-3-601 (Effective 07/01/97) is amended to read:
16 35A-3-601 (Effective 07/01/97). Medical panel -- Medical director or medical
17 consultants -- Discretionary authority of department to refer case -- Findings and reports --
18 Objections to report -- Hearing -- Expenses.
19 (1) (a) Upon the filing of a claim for compensation for injury by accident, or for death,
20 arising out of and in the course of employment, and if the employer or its insurance carrier denies
21 liability, the department may refer the medical aspects of the case to a medical panel appointed by
22 the department.
23 (b) When a claim for compensation based upon disability or death due to an occupational
24 disease is filed with the department, the department shall, except upon stipulation of all parties,
25 appoint an impartial medical panel.
26 (c) A medical panel shall consist of one or more physicians specializing in the treatment
27 of the disease or condition involved in the claim.

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

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




Legislative Review Note
as of 12-12-96 2:26 PM

A limited legal review of this bill raises no obvious constitutional or statutory concerns.

Office of Legislative Research and General Counsel

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