Either the employee or the employer may object to the medical determination made by the treating physician provided that the medical issue does not fall within the exceptions from objections. If the employee objects to the utilization review decision to modify, delay , or deny the recommended treatment, the employee must notify the employer. If the employer has an attorney a medical evaluation must be obtained as provided and no other medical evaluation may be obtained.
The employer may object to the recommendation for spinal surgery made by the treating physician. If the employee has an attorney, the parties must agree on an orthopedic surgeon or neurosurgeon to prepare a second opinion to resolve the dispute. If an agreement is not reached or the employee does not have an attorney, the administrative director must randomly select an orthopedic surgeon or orthopedic surgeon to prepare a second opinion to resolve the dispute.
An employee that was unrepresented at the time of the medical evaluation and later obtains an attorney is entitled to the same reports that employee represented at the time of evaluation is entitled to.
