Today's post comes to us via Dr. Bruce Rudin. You know, Dr. Rudin of the "Jesus Syndrome, Walks on Water" fame? This case is the employer's appeal of a Utilization Review certification of cervical spine surgery and related treatment rendered by Dr. Rudin. For my part, I do not find the UR certification of treatment, or the outcome of the appeal, particularly noteworthy. That said, the Board's opinion provides some insight into the employer's behemoth of a burden to challenge treatment that has been certified as Guidelines complaint, since as such, the treatment carries the presumption of "reasonable and necessary."
Add to that the fact it is Dr. Rudin's treatment. Astute readers of the Detour & Frolic have no doubt observed that those who challenge Bruce do so at their own peril. Add to that the fact that the Board appeared to be more than a little miffed at the position taken by the defense medical expert (Dr. Gelman, notorious in his own right) and you have all of the ingredients for a claimant-friendly outcome. The other take-away for this little ditty-Ignore a discogram and you do so at your own peril.
The decision is Joy Williams v. Sherwin Williams Company, IAB# 1379158 (5/16/13), authored by Angela "QuickFire" Fowler on behalf of a Board which convened on 5/10/13.
Irreverently yours,Cassandra Roberts
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