34A-2-601 - Medical panel, director, or consultant -- Findings and reports -- Objections to report -- Hearing -- Expenses. - Utah Statutes

34A-2-601. Medical panel, director, or consultant -- Findings and reports --Objections to report -- Hearing -- Expenses.
(1) (a) The Division of Adjudication may refer the medical aspects of a case described inthis Subsection (1)(a) to a medical panel appointed by an administrative law judge:
(i) upon the filing of a claim for compensation arising out of and in the course ofemployment for:
(A) disability by accident; or
(B) death by accident; and
(ii) if the employer or the employer's insurance carrier denies liability.
(b) An administrative law judge may appoint a medical panel upon the filing of a claimfor compensation based upon disability or death due to an occupational disease.
(c) A medical panel appointed under this section shall consist of one or more physiciansspecializing in the treatment of the disease or condition involved in the claim.
(d) As an alternative method of obtaining an impartial medical evaluation of the medicalaspects of a controverted case, the division may employ a medical director or one or moremedical consultants:
(i) on a full-time or part-time basis; and
(ii) for the purpose of:
(A) evaluating medical evidence; and
(B) advising an administrative law judge with respect to the administrative law judge'sultimate fact-finding responsibility.
(e) If all parties agree to the use of a medical director or one or more medical consultants,the medical director or one or more medical consultants is allowed to function in the samemanner and under the same procedures as required of a medical panel.
(2) (a) A medical panel, medical director, or medical consultant may do the following tothe extent the medical panel, medical director, or medical consultant determines that it isnecessary or desirable:
(i) conduct a study;
(ii) take an x-ray;
(iii) perform a test; or
(iv) if authorized by an administrative law judge, conduct a post-mortem examination.
(b) A medical panel, medical director, or medical consultant shall make:
(i) a report in writing to the administrative law judge in a form prescribed by the Divisionof Adjudication; and
(ii) additional findings as the administrative law judge may require.
(c) In an occupational disease case, in addition to the requirements of Subsection (2)(b),a medical panel, medical director, or medical consultant shall certify to the administrative lawjudge:
(i) the extent, if any, of the disability of the claimant from performing work forremuneration or profit;
(ii) whether the sole cause of the disability or death, in the opinion of the medical panel,medical director, or medical consultant results from the occupational disease; and
(iii) (A) whether any other cause aggravated, prolonged, accelerated, or in any waycontributed to the disability or death; and
(B) if another cause contributed to the disability or death, the extent in percentage to

which the other cause contributed to the disability or death.
(d) (i) An administrative law judge shall promptly distribute full copies of a reportsubmitted to the administrative law judge under this Subsection (2) by mail to:
(A) the applicant;
(B) the employer;
(C) the employer's insurance carrier; and
(D) an attorney employed by a person listed in Subsections (2)(d)(i)(A) through (C).
(ii) Within 20 days after the report described in Subsection (2)(d)(i) is deposited in theUnited States post office, the following may file with the administrative law judge a writtenobjection to the report:
(A) the applicant;
(B) the employer; or
(C) the employer's insurance carrier.
(iii) If no written objection is filed within the period described in Subsection (2)(d)(ii),the report is considered admitted in evidence.
(e) (i) An administrative law judge may base the administrative law judge's finding anddecision on the report of:
(A) a medical panel;
(B) the medical director; or
(C) one or more medical consultants.
(ii) Notwithstanding Subsection (2)(e)(i), an administrative law judge is not bound by areport described in Subsection (2)(e)(i) if other substantial conflicting evidence in the casesupports a contrary finding.
(f) (i) If a written objection to a report is filed under Subsection (2)(d), the administrativelaw judge may set the case for hearing to determine the facts and issues involved.
(ii) At a hearing held pursuant to this Subsection (2)(f), any party may request theadministrative law judge to have any of the following present at the hearing for examination andcross-examination:
(A) the chair of the medical panel;
(B) the medical director; or
(C) the one or more medical consultants.
(iii) For good cause shown, an administrative law judge may order the following to bepresent at the hearing for examination and cross-examination:
(A) a member of a medical panel, with or without the chair of the medical panel;
(B) the medical director; or
(C) a medical consultant.
(g) (i) A written report of a medical panel, medical director, or one or more medicalconsultants may be received as an exhibit at a hearing described in Subsection (2)(f).
(ii) Notwithstanding Subsection (2)(g)(i), a report received as an exhibit underSubsection (2)(g)(i) may not be considered as evidence in the case except as far as the report issustained by the testimony admitted.
(h) For a claim referred under Subsection (1) to a medical panel, medical director, ormedical consultant before July 1, 1997, the commission shall pay out of the Employers'Reinsurance Fund established in Section 34A-2-702:
(i) expenses of a study or report of the medical panel, medical director, or medical

consultant; and
(ii) the expenses of the medical panel's, medical director's, or medical consultant'sappearance before an administrative law judge.
(i) (i) For a claim referred under Subsection (1) to a medical panel, medical director, ormedical consultant on or after July 1, 1997, the commission shall pay out of the UninsuredEmployers' Fund established in Section 34A-2-704 the expenses of:
(A) a study or report of the medical panel, medical director, or medical consultant; and
(B) the medical panel's, medical director's, or medical consultant's appearance before anadministrative law judge.
(ii) Notwithstanding Section 34A-2-704, the expenses described in Subsection (2)(i)(i)shall be paid from the Uninsured Employers' Fund whether or not the employment relationshipduring which the industrial accident or occupational disease occurred is localized in Utah asdescribed in Subsection 34A-2-704(20).

Amended by Chapter 215, 2009 General Session