Tennessee: Insurer Gets Stung for $27,000 in Attorney’s Fees In $187 Utilization Review Dispute

A workers’ compensation insurer for a Tennessee employer, who sought utilization review regarding two trigger point injections, totaling $187, to treat an injured worker’s back pain and who stood its ground when the UR provider opined that the injections were medically unnecessary, has been ordered to pay the worker’s lawyer more than $27,000 in attorney’s fees and expenses following a trial court’s decision that the injections were reasonable and necessary to treat the worker’s injury. The Special Appeals Panel of the Tennessee Supreme Court affirmed the trial court’s decision and noted that early on in the dispute, the worker’s attorney had offered to waive his fees if the insurer would pay the claim. Also important to the decision was the fact that prior to its objection to the trigger point injections, the insurer had approved and paid for a number of other such injections.

Thomas A. Robinson, J.D., the Feature National Columnist for the LexisNexis Workers’ Compensation eNewsletter, is the co-author of Larson’s Workers’ Compensation Law (LexisNexis).

LexisNexis Online Subscribers: Citations below link to Lexis Advance.

See Grissom v. UPS, 2017 Tenn. LEXIS 4 (Jan. 9, 2017)

See generally Larson’s Workers’ Compensation Law, § 133.02.

Source: Larson’s Workers’ Compensation Law, the nation’s leading authority on workers’ compensation law

For a more detailed discussion of the case, see