Lacking Qualifications Supports Utah Court’s Convening 2nd Medical Panel

Salt Lake City, UT (WorkersCompensation.com) -- How qualified do doctors have to be to make their medical opinion stand up in a workers' compensation proceeding in Utah?

According to the court in Nucor and Ace American Insurance Company v. Labor Commission, No. 20220597-CA (Utah Ct. App. 12/29/23), that's for an administrative law judge decide, and he's well within his authority to discard the findings of one medical panel in favor of a more qualified medical panel.

During the course of his 20-year-employment with an employer, a steel worker developed arthritis, sleep apnea, and serious pulmonary and respiratory issues related to occupational exposure as well as hernias following an alleged industrial accident.

The worker sought workers' compensation benefits, and an administrative law judge concluded that the worker met his burden to prove medical causation and awarded him partial benefits. The Utah Labor Commission upheld the decision, prompting the employer to petition for judicial review, arguing that it was improper for the ALJ to reject one medical panel's report and refer the medical issues in the case to a second panel.

Utah law specifies that a medical panel shall consist of one or more physicians specializing in the treatment of the disease or condition involved in the claim.

In upholding the Commission's determination, the court ruled that the ALJ followed Utah law as it existed at the time the panels were convened.

"The first panel consisted of only two panelists: an occupational disease specialist and a general surgeon," the court wrote. "Therefore, the Commission acted within its discretion to uphold the ALJ's rejection of the first panel's report and appointment of the second panel to address [the worker's] medical issues."

The second panel included experts in toxicology and surgical treatment of traumatic injuries, and in the court's view, the first panel's "insufficient qualifications" established a reasonable basis for the Commission to sanction the appointment of the second panel.

Thus, the court "decline[d] to disturb the Commission's decision."

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