342.315 Medical evaluations by university medical schools and "B" readers --
571 words·~3 min read·
/ky/342-315A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Procedures -- Report -- Payment of costs -- Performance assessment of medical
schools -- Use of telehealth.
(1)For workers who have had injuries or occupational hearing loss, the commissioner
shall contract with the University of Kentucky, the University of Louisville, and the
University of Pikeville medical schools to evaluate workers. For workers who have
become affected by occupational diseases, the commissioner shall contract with the
University of Kentucky, the University of Louisville, and the University of
Pikeville medical schools, or other physicians otherwise duly qualified as "B"
readers who are licensed in the Commonwealth and are board-certified pulmonary
specialists. Referral for evaluation may be made whenever a medical question is at
issue.
(2)The physicians and institutions performing evaluations pursuant to this section shall
render reports encompassing their findings and opinions in the form prescribed by
the commissioner. Except as otherwise provided in KRS 342.316, the clinical
findings and opinions of the designated evaluator shall be afforded presumptive
weight by administrative law judges and the burden to overcome such findings and
opinions shall fall on the opponent of that evidence. When administrative law
judges reject the clinical findings and opinions of the designated evaluator, they
shall specifically state in the order the reasons for rejecting that evidence.
(3)The commissioner or an administrative law judge may, upon the application of any
party or upon his own motion, direct appointment by the commissioner, pursuant to
subsection
(1)of this section, of a medical evaluator to make any necessary medical
examination of the employee. Such medical evaluator shall file with the
commissioner within fifteen
(15)days after such examination a written report. The
medical evaluator appointed may charge a reasonable fee not exceeding fees
established by the commissioner for those services.
(4)Within thirty
(30)days of the receipt of a statement for the evaluation, the employer
or carrier shall pay the cost of the examination. Upon notice from the commissioner
that an evaluation has been scheduled, the insurance carrier shall forward within
seven
(7)days to the employee the expenses of travel necessary to attend the
evaluation at a rate equal to that paid to state employees for travel by private
automobile while conducting state business.
(5)Upon claims in which it is finally determined that the injured worker was not the
employee at the time of injury of an employer covered by this chapter, the special
fund shall reimburse the carrier for any evaluation performed pursuant to this
section for which the carrier has been erroneously compelled to make payment.
(6)Not less often than annually the designee of the secretary of the Cabinet for Health
and Family Services shall assess the performance of the medical schools and render
findings as to whether evaluations conducted under this section are being rendered
in a timely manner, whether examinations are conducted in accordance with
medically recognized techniques, whether impairment ratings are in conformity
with standards prescribed by the "Guides to the Evaluation of Permanent
Impairment," and whether coal workers' pneumoconiosis examinations are
conducted in accordance with the standards prescribed in this chapter.
(7)The General Assembly finds that good public policy mandates the realization of the
potential advantages, both economic and effectual, of the use of telehealth. The
commissioner may, to the extent that he or she finds it feasible and appropriate,
require the use of telehealth, as defined in KRS 211.332, in the independent medical
evaluation process required by this chapter.