California High Court: Workers’ Comp Law Provides Exclusive Remedy in Utilization Review Case
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.