by Emily Anderson, Esq.

The Board recently published new rules, effective July 1, 2017. The most substantive change is to Rule 205, which provides expedited access to judges via conference calls to address delays of more than 5 days in authorization for medical treatment or testing in compensable claims. In order to implement Rule 205(c), the Board has provided a new form: WC-PMT. In filing this form, the claimant or claimant’s attorney must show three things:

1. The authorized medical provider has recommended treatment or testing;

2. The employer/insurer was sent documentation regarding this recommended treatment or testing; and

3. There has been no authorization within 5 business days.

Once this form is submitted, a telephone conference will be scheduled with a judge within 5 business days. The employer/insurer will then have three options:

1. Participate in the telephonic conference and show cause for why the medical treatment has not been authorized;

2. Authorize the treatment by filling out section C of the WC-PMT and filing it with the Board, which will automatically cancel the telephone conference; or

3. Controvert the medical treatment/testing by filling out section D of the WC-PMT, and filing it with the Board, which will also automatically cancel the telephone conference.

Service of this form needs to be on all of the parties as well as the authorized medical provider, as appropriate. Postponements of the telephone conference will be discouraged and granted only when good cause is shown. Any party requesting a postponement must contact the Board and reschedule for a date within 5 days of the original conference date. Failure of any party to participate in the conference does not preclude the judge from ruling on the petition. One additional important note is that Rule 205(c) only applies in accepted cases and does not require a WC-205 be submitted, just a referral for medical treatment by the authorized treating physician with no response within 5 days. We anticipate insurers are going to see the new WC-PMT forms in increasing numbers as providers and claimant’s attorneys become aware of the new process (although the form has to be submitted by the claimant or claimant’s attorney).

The other Board Rule Changes are as follows:

1. Rules 61 (b)11 and (b)42 explain what information can be changed on the Form WC-14a and the WC-Request to Change information.

2. Rule 61(b) has been updated to emphasize the importance of serving all forms filed with the Board on all parties to the claim.

3. Rule 102(c) allows the parties to agree that a hearing postponement can be for less than 30 days or more than 90 days from the date of the hearing notice. Additionally, if the Administrative Law Judge does not hear from the parties by 2:00, which is generally the deadline to inform the Judge if the hearing is moving forward or not, it is in the Judge’s discretion whether to keep the case on the calendar or postpone the hearing.

4. Rules 203(a) and 205(a) outline updates now that dental services have been added to the fee schedule.

For a complete summary of the Board Rule changes, click here.

For a copy of the new WC-PMT form, click here.