Under the Pennsylvania Workers’ Compensation Act, a carrier may file a Uilization Review Request to determine whether medical treatment is reasonable or necessary for a work-related injury. If any party, such as the medical provider, injured worker, or insurance carrier, is unsatisfied with the outcome of the unitization review, an appeal may be filed to a Workers’ Compensation Judge, by filing, by filing a petition to review utilization review determination (UR Petition). Jerry M. Lehocky filed a UR Petition on behalf of an injured worker following an unfavorable Utilization Review. The carrier had requested a Utilization Review to determine the reasonableness and neceddity of all the treatment being provided to the injured worker by his treating physician. The Utilization Review Determination concluded that none of the treatment was both reasonable and necessary. The Emploer was ordered to make payment for the medical services which had been subject to review.




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