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Labor
Committee
February 23,
2010
S.B. # 61
Opposition – Reasonable and Necessary authority to Commissioners.
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It
is my opinion that the inclusion of “Reasonable and Necessary” plenary
(new
assessment of medical facts) authority of review now gives the same
authority
to the Workers Compensation Commissioners that the doctors only now
have in WC Sec. 31-294d. Here
is (f) one of the major changes in SB #
61 Raised Bill to the current statute.
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(f)
The Workers' Compensation Commission shall have plenary authority for
review of
decisions with respect to the provision or denial of medical care under
any
plan approved by the chairperson under subsection (d) of this section
and may
determine whether such medical care is reasonable or necessary.
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Under Sec.
31-294d of the Workers Compensation Act following, the physicians only
have the
authority to determine what is reasonable or necessary.
Sec.
31-294d. Medical
and surgical aid; hospital and nursing service. (a)(1) The
employer, as soon as the employer has knowledge of an
injury, shall provide a competent physician or surgeon to attend the
injured
employee and, in addition, shall furnish any medical and surgical aid
or
hospital and nursing service, including medical rehabilitation services
and
prescription drugs, as the physician or
surgeon deems reasonable or necessary. The employer, any insurer
acting on
behalf of the employer, or any other entity acting on behalf of the
employer or
insurer shall be responsible for paying the cost of such prescription
drugs
directly to the provider.
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In a Workers
Compensation case I spoke to you
about in 2008, here is the Compensation Review Board Opinion by the
Chairman.
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“Whether
a proposed surgical procedure is reasonable . . . is a question of fact
for the
commissioner to resolve.” Chairman
Workers Compensation John Mastropietro
CASE NO. 5164 CRB-8-06-11 VANNOY-JOSEPH v. STATE OF
CONNECTICUT
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Obviously the Chairman
already believes the
Workers Compensation has the authority to determine what is reasonable
and
necessary.
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Also in Vannoy the
Chairman has stated. “We remand the trial
commissioner’s decision
after clarifying the standard of scientific evidence needed to approve
an
unconventional surgical procedure.”
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The
medically reasonable
or necessary treatment recommended by the doctors is
presently worthless
due to the dilatory Workers Compensation practices subjecting treatment
delays
for years. If the spirit of Sec. 31-294d
was operating per statute, injured workers would be receiving immediate
and
continuing care.
Sec. 31-296a. Discontinuance or reduction of
payments
under oral agreements.
“No employer shall discontinue or reduce
payment on account of total or partial incapacity under any oral
agreement or
in any case where the employer's acceptance of compensability has been
conclusively presumed under subsection (b) of section 31-294c because
of
failure to file a timely notice contesting liability, if it is claimed
by or on
behalf of the injured person that his incapacity still continues,
unless such
employer notifies the commissioner and the employee of the proposed
discontinuance or reduction in the manner prescribed in section 31-296
and the
commissioner specifically approves such discontinuance or reduction in
writing.”
Sec. 31-296. Voluntary agreements.
(b) …”No discontinuance or
reduction of
total or partial incapacity shall become effective under any such
agreement
unless specifically approved in writing by the commissioner….”
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The
1993 legislation requiring all WC Commissioners be lawyers made the WC
Statute
into a Civil Process like Superior Court, but without rules. The
present
Workers Compensation Commission operates upon Case Precedents they set
in
Compensation Review Board decisions and Connecticut and all other
states Civli
Court decisions.
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In
Vannoy 5164 CRB-8-06-11 the
Workers Compensations Commissioner have exceeded the boundaries of
reasonable
and necessary and made themselves scientists.
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This
proposal SB # 61 to give Workers Compensation Commissioner authority
for
reasonable and necessary medical treatment decisions will make WC
Commissioners
doctors.
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The
best thing this committee can do for Injured Workers is the authorize a
review
to determine if We are currently getting the benefits deserved under
present
statutes before initiating unwarranted changes.
William
Lawler
12 Jackson St.
P.O. Box 3951
Manchester, CT 06045
860-841-4258
Proposed
Senate Bill # 61 may be viewed here:
http://www.cga.ct.gov/2010/TOB/S/2010SB-00061-R00-SB.htm
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