Say What You Need to Say
“Say what you need to say.”
~ John Mayer
The 2007 Grammy-winning song “Say” by John Mayer gave straightforward and simple relationship advice. If you read the lyrics, he repeats the refrain 36 times.
The Commonwealth of Kentucky Workers’ Compensation Board recently affirmed an ALJ’s decision that a “compound cream is a reasonable and necessary medical expense for the cure and relief” of a specific work-related injury. In trying to overturn the ALJ’s opinion, the employer’s physician expert said only that compound creams are experimental with limited research supporting their efficacy.
The Board noted that the employer in this case has the “burden to prove the contested treatment (i.e. compound cream) is unreasonable or unnecessary, “and (sic) your physician reviewer is not saying what you need to say!”
If you want to successfully dispute expensive compound creams, you need expert testimony that compound creams are considered unproductive or outside the type of treatment generally accepted by the medical profession as reasonable.
If you want to do better, make sure you have physician reviewers who have the expertise and gravitas to “say what you need to say.”
Call us. We can do better.