Supreme Court Opinion Impacts UR

On June 16, 2022, the Supreme Court of Kentucky rendered an opinion, soon to be published, in the case of Tracy Scott Toler (appellant) v. Oldham County Fiscal Court, Hon. Jonathan R. Weatherby, Administrative Law Judge, and Workers’ Compensation Board (appellees), 2021-SC-0356-WC.

In layman’s terms, the Supreme Court of Kentucky has concluded that a physician who is not licensed in the Commonwealth of Kentucky is not a “physician” as defined by KRS 342.0011(32) (“‘Physician’ means physicians and surgeons, psychologists, optometrists, dentists, podiatrists, and osteopathic and chiropractic practitioners acting within the scope of their license issued by the Commonwealth”), and therefore a written report or oral testimony by a physician who is not licensed in Kentucky is inadmissible as evidence.

Accordingly, Utilization Review (UR) and/or Peer Review (PR) referrals for Kentucky workers’ compensation claims must be performed by Kentucky-licensed physicians in order for those reports to be admissible as evidence.

OMCA has a comprehensive panel of Kentucky-licensed physician reviewers and has instigated protocols to ensure that our clients’ UR and/or PR requests are referred to the appropriate physician holding an active medical license issued by the Commonwealth of Kentucky.

We can help you comply with the latest opinions and guidelines. This is brand new, there will be much commentary on it, and we will keep you apprised as things develop.

Call us. We can do better.

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

Posted in News