Michael W. Cardamone- Certified Specialist in Pennsylvania Workers’ Compensation Law, represents injured workers across Pennsylvania. Recently, he litigated a case involving chiropractic treatment that was challenged as being not reasonable and necessary. Cardamone filed the requisite petition to bring the matter before a Workers’ Compensation Judge. He presented his client’s testimony and a narrative report from his client’s chiropractor, explaining why the treatment was beneficial.
Cardamone successfully argued that because the treatment provided his client with some symptom relief and allowed him to continue working, it was reasonable and necessary treatment. The Workers’ Compensation Judge ordered that the insurer pay for the treatment and awarded litigation costs.
Utilization Reviews under the Pennsylvania Workers’ Compensation Act can be quite stressful for injured workers. Why? Because once the Utilization Review is filed, the insurer does not have to pay for the challenged treatment until a favorable outcome. The Utilization Reviewer does not have the final say. The Workers’ Compensation Judge does. If treatment is found to be unreasonable or unnecessary by the Utilization Reviewer, a Petition to Review should be filed and the WCJ reviews it “de novo” which means, without regard to the underlying finding.Treatment does not have to cure the underlying condition to be deemed reasonable and necessary- the WCJ can find it to be reasonable and necessary if it provides palliative relief and/or the ability to function better.
For more information about Pennsylvania Workers’ Compensation Law or The Cardamone Law Firm- The Firm For Injured Workers In Pennsylvania, call Attorney Cardamone directly at 215-206-9068 or email Michael@CardamoneLaw.com 7 days a week.
The Cardamone Law Firm is a unique firm that only handles workers’ compensation cases for injured workers.