Be aware, without your testimony, SB 151 might pass. Public Hearing will be held at the Legislative Office Building at 2 pm on Tuesday February 28, 2012. Plenty of free parking. If you view the preceding posting regarding the cornerstone of CT WC Law, you will see the physician determines reasonable or necessary medical treatment, not the commissioners.
Nowhere is the Statute is this power given to commissioners, that is why this is the third year in a row they are trying to sneak it in. How can both the physicians and commissioners have the same power? That is what I would like to ask our lawmakers.
CTLA and ConnectiCOSH have co-sponsored this legislation. This is going to sound like a bad joke: What do CTLA and ConnectiCOSH have in common?
CTLA is Connecticut Trial Lawyers Association – Need I say more?
ConnectiCOSH Connecticut Council on Occupational Safety and Health is a Labor Organization promoting unions and they also claim helping individuals with Occupational, Safety and Health.
What interest do they have in promoting legislation which will give Workers Compensation Commissioners the power to determine reasonable medical treatment in the following proposed legislation? Here is the phrase in (b) they are trying to disguise and got them busted the two prior years.
“by the commissioner upon a determination that the proposed care is not reasonable”
General Assembly Raised Bill No. 151
February Session, 2012 LCO No. 495
Referred to Committee on Labor and Public Employees
AN ACT CONCERNING ADDITIONAL REQUIREMENTS FOR AN EMPLOYER'S NOTICE TO DISPUTE CERTAIN CARE DEEMED REASONABLE FOR AN EMPLOYEE UNDER THE WORKERS' COMPENSATION ACT.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. (NEW) (Effective October 1, 2012) (a) No employer or an employer's insurer shall discontinue, reduce or deny a course of treatment which a physician or surgeon deems reasonable or necessary unless the employer notifies the commissioner, physician or surgeon and the employee of the proposed discontinuance, reduction or denial of the course of medical care and the commissioner approves such discontinuance, reduction or denial of such care in writing. Such notice shall specify the reason maintained by the employer or the employer's insurer that the course of medical care deemed reasonable by the physician is not reasonable and be in substantially the following form:
STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION
YOU ARE HEREBY NOTIFIED THAT THE EMPLOYER OR INSURER INTENDS TO DISCONTINUE, REDUCE OR DENY TREATMENT .... (date) FOR THE FOLLOWING REASONS:
If you object to the discontinuance, reduction, or denial of treatment as stated in this notice, YOU MUST REQUEST A HEARING NOT LATER THAN 15 DAYS after your receipt of this notice, or this notice will automatically be approved.
To request an Informal Hearing, call the Workers' Compensation Commission District Office in which your case is pending.
Be prepared to provide medical and other documentation to support your objection. For your protection, note the date when you received this notice.
(b) No discontinuance or reduction of an ongoing course of treatment shall be effective unless approved in writing by the commissioner upon a determination that the proposed care is not reasonable. The parties may request a hearing on any such proposed discontinuance, reduction or denial not later than fifteen days after receipt of such notice. Such notice of intention to discontinue, reduce or deny medical treatment shall be issued not later than five days after a notice of need for treatment is received by the employer, employer's insurer, employer's claim administrator or Second Injury Fund. The commissioner shall not approve such discontinuance, reduction or denial prior to expiration of the period for requesting a hearing or the completion of the hearing, whichever is later. Either party may request a formal hearing on the commissioner's decision to grant or deny the discontinuance, reduction or denial. The employer shall have the burden of proof that the medical care or treatment is unreasonable.
(c) The notice required in subsection (a) of this section shall include an opinion from a physician licensed to practice medicine in Connecticut that the course of treatment recommended by the attending physician is not reasonable or necessary and does not meet the standard of care that should be exercised by a physician practicing in the same specialty as the attending physician and the basis for such opinion. If the employer intends to rely on the opinion of a physician who performs an examination pursuant to section 31-294f of the general statutes, and such examination has not yet taken place, then the name of the physician, date, time and location of the examination, which shall be held not more than two weeks after the employee's receipt of the notice, shall be attached to the notice in lieu of an opinion that the treatment is not reasonable or necessary. The treatment recommended by the attending physician or surgeon may not be discontinued, reduced or denied until the results of the examination pursuant to section 31-294f of the general statutes is considered at an informal hearing.
(d) If the employer or employer's insurer seeks to discontinue, reduce or deny the course of medical care found reasonable by a physician based upon a dispute between physicians not as to the reasonableness of the course of care, but as to the better course of care, the patient shall be entitled to choose the course of care after informed consent.
Statement of Purpose: (This is propaganda written by the 1%)
To prevent an employer or employer's insurer from discontinuing, reducing or denying employee's course of treatment under the Workers' Compensation Act unless the employer provides notice and an opinion from another physician that such treatment is not reasonable, necessary, does not meet the appropriate standard of care.
What we need is :
1.) Good Faith and Fair Dealing WC law with direct appeal to Civil Court an option.
2.) Equitable Tolling Statute for Workers Compensation. Elkins v. Derby, CA Supra.