Utilization Review (UR) Process

In the case Securitas Security Services USA, Inc. v. Workers’ Compensation Appeal Board (Schuch), the claimant’s treating doctor for depressive disorder went under Utilization Review. The findings were that the treatment was reasonable and necessary, with no appeal from the employer. The claimant tried to use the findings of the UR decision as the reason and evidence for his filed Review Petition to amend the work injury to include depression, stating the employer accepted the UR decision and therefore can not deny liability. The Commonwealth Court decided that legislation regarding the UR process does not impose liability and claimant must still meet burden of proof in a Review Petition.