Okla. Admin. Code § 810:15-11-4

Current through Vol. 42, No. 4, November 1, 2024

Section 810:15-11-4 - Requests for assignment

(a) For cases not covered by a certified workplace medical plan, and where the employer, insurance company, or own risk employer does not provide case management, the Commission may grant case management on the request of any party or when the Commission determines that case management is appropriate. Nothing in this Section shall limit the Commission's ability to appoint a case manager by agreement of the parties, or as otherwise allowed by law.

(b) If the parties to a dispute cannot agree on an independent medical case manager of their own choosing, the Commission may appoint one from the list of qualified independent medical case managers maintained by the Commission.

(c) In order to be eligible for appointment in any given case, a qualified medical case manager:

(1) shall not have a financial interest in the claimant's award; and

(2) shall not have any financial interest in the employer's or insurer's business, nor regularly contract with or serve as a case manager for the employer, insurer, or employer's own risk group, or a certified workplace medical plan with which the employer or employer's own risk group contracts.

(d) The parties are encouraged to request the appointment of an independent medical case manager at a prehearing conference.

(e) Requests for the appointment of an independent medical case manager may be set for a prehearing conference, at the discretion of the Commission.

(f) Upon appointment, the parties shall send information and all medical records to the independent medical case manager, by regular mail, within ten (10) calendar days of receipt of the Commission order assigning the case manager.

(g) If a party makes a good faith effort to get medical records (including diagnostic films) and the records are unobtainable, then a letter to this effect shall be sent to the case manager with copies to all other parties and the Commission, together with information as to the known location of any such records or information not in either the attorney's or client's possession. If necessary, the case manager may contact persons in whose possession the records or information is located solely for the purpose of obtaining such records or information.

(h) The respondent shall pay all reasonable and customary charges of a medical case manager appointed by the Commission. Failure to timely pay a Commission appointed independent medical case manager for services rendered pursuant to Commission order may result in the imposition of assessments and sanctions by the administrative law judge or Commission, including a fine for contempt as provided in 85A O.S., § 73(B). Disputes regarding payment for services rendered by a Commission appointed independent medical case manager that cannot be resolved by the case manager and the parties themselves, may be addressed by filing a request for hearing before an administrative law judge of the Commission as provided in 810:10-5-16, or by mediation, as appropriate.

Okla. Admin. Code § 810:15-11-4

Adopted by Oklahoma Register, Volume 32, Issue 23, August 17, 2015, eff. 8/27/2015