The California Supreme Court issued an opinion today that utilization review physicians cannot be sued for malpractice, upholding established law that the workers’ comp system provides injured employees an exclusive remedy against an employer for compensable work-related injuries.

The court considered the application of workers’ comp exclusivity to claims arising from the utilization review process. Utilization reviewers act on behalf of employers and determine whether the treatment plan recommended for an employee’s injury is medically necessary after consulting a schedule of uniform treatment guidelines.

If the reviewer concludes that a recommended treatment is not medically necessary, the treatment request may be denied.

In 2008, Kirk King sustained a back injury while at work, and reportedly suffered chronic pain as a result of the injury, which in turn caused him anxiety and depression. In 2011, a mental health professional prescribed psychotropic drugs, including Klonopin, to treat King.

Dr. Naresh Sharma, an anesthesiologist employed by defendant CompPartners Inc., a licensed workers’ comp utilization review management company, conducted a utilization review in 2013 of King’s Klonopin prescription and determined the drug was medically unnecessary and decertified the prescription.

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