June 16, 2011
The injured worker, a resident of Oberlin, Dauphin County, PA, suffered a work injury to the low back while employed for Pitt Ohio Express in 1994. Recently, he treated with Stuart Hartman, D.O. for the work injury, who prescribed medications filled by Injured Workers’ Pharmacy.
In an effort to stop paying for prescription medications relating to the work injury, the workers’ compensation insurance carrier, BABB Absence Management Services, filed a Utilization Review Petition for the prescriptions, which were found to be reasonable and necessary and to be paid by the workers’ compensation insurance carrier. Defendant appealed the Decision, which was heard by Judge Charles Clark in Harrisburg, Pennsylvania. The Judge found the lay witnesses credible that the workers’ compensation insurance carrier failed to pay the properly submitted, work-related medical bills to Injured Workers’ Pharmacy when the UR found the bills to be reasonable and necessary.
The injured worker was awarded 50% penalties totaling $14,911.18 plus 10% interest. BABB Absence Management Services was also ordered to pay $2,418.75 in attorney fees for unreasonable contest.
