Workforce Services, Department of

Workers' Compensation - Medical Commission

Effective Date: 02/14/2003 to Current

Rule Type: Current Rules & Regulations

Reference Number: 053.0019.1.02142003

RULES AND REGULATIONS

MEDICAL COMMISSION WORKERS' COMPENSATION DIVISION

CHAPTER 1

GENERAL PROVISIONS AND DEFINITIONS

Section 1. AUTHORITY. These rules of practice and procedure are promulgated by the Medical Commission under the authority of W. S. §27-14-616 (LexisNexis 2001) and W. S. § 16-3-102 (LexisNexis 2001). The commission was created as a separate and independent impartial hearing body funded under the workers' compensation account.

Section 2. DEFINITIONS.

(a) 'Access point' means a designated site where the party must go for purposes of attending the medically contested case hearing through the videoconference format;

(b) 'Commission' means the Wyoming Medical Commission as set forth in W.S. §27-1 4-616;

(c) 'Division' means the Workers' Compensation Division of the Department of Workforce Services;

(d) 'Executive secretary' means the employee designated by the division to assist the commission in the conduct of its activities; including acting as Hearing Officer for all contested cases, ruling on all discovery, pretrial and procedural motions, conducting all preliminary hearings, and other procedural matters to facilitate the expeditious resolution of all contested cases.

Section 3. PURPOSE OF RULES. These rules are intended to set forth clear and comprehensive procedures for the conduct of contested cases by the Medical Commission pursuant to the Wyoming Administrative Procedure Act W.S. §16-3-101 through §16-3-115 (1977 and Cum. Supp. 1993).

Section 4. APPLICATION OF RULES. These rules shall apply to the conduct of contested cases before the Medical Commission as authorized by W.S. §27-14-616. Cases shall be determined by the Medical Commission in accordance with the contested case procedure of the Wyoming Administrative Procedure Act and the Wyoming Rules of Civil Procedure, as applicable under these rules and regulations.

Section 5. CONSTRUCTION. These rules are to be liberally construed to assure the unbiased, fair, expeditious and impartial conduct of contested case proceedings before the Medical Commission.

(e) "Medically contested case" means a case in which the primary issue is:

1. (i) a worker/claimant's percentage of physical impairment;
2. (ii) whether a worker/claimant is permanently totally disabled;
3. (iii) whether a worker/claimant who has been receiving temporary total disability benefits remains eligible for those benefits under W.S. § 27-14-404 (c).

(iv) any other issue, the resolution of which is primarily dependent upon the evaluation of conflicting evidence as to medical diagnosis, medical prognosis, the reasonableness and appropriateness of fees charged by a health care provider.

(f) "Medical hearing panel" means three members of the medical commission selected by the executive secretary, under the supervision and guidance of the chairman of the medical commission, to conduct and decide a medically contested case hearing;

(g) "Parties" means the employee, employer, health care provider or division. A party may choose to not participate in a matter by failure to make an appearance at the initial pre-hearing conference after notice.