• Judge Rules that Portions of the Louisiana Medical Treatment Guidelines Are Unconstitutional
  • July 15, 2015 | Authors: Joseph J. Cefalu; Trenton J. Oubre; James R. Raines
  • Law Firm: Breazeale, Sachse & Wilson, L.L.P. - Baton Rouge Office
  • On June 24, 2015, a Louisiana District Court Judge in East Baton Rouge Parish ruled in Janice Hebert Barber, et al. v. Louisiana Workforce Commission, et al., 19th Judicial District Court, Docket No.: 621,071, Sec. 26, that portions of the Medical Treatment Guidelines ("MTG") are unconstitutional and cannot be enforced by the Office of Workers' Compensation. The suit was brought by medical providers, plaintiffs' attorneys, and a number of claimants. The Judge held that the plaintiffs' attorneys and medical providers had no standing to challenge the constitutionality of the MTG.

    As for the claimants' challenges to the MTG, the Judge ruled that (1) the automatic "tacit denial" of a request for authorization of medical treatment (on Form 1010s), if not approved by the employer within 5 business days, is unconstitutional as well as (2) the requirement of an employee to request variances from the MTG if the requested medical treatment is not covered by the MTG. The Judge also ruled that the Louisiana Workforce Commission is enjoined from applying the aforementioned provisions. The Judge also made a broad ruling regarding the unconstitutionality of Louisiana's Workers' Compensation system as a whole without any specifics of the impact of this finding.

    No final written judgment has been signed by the Judge to date; however, it is expected that once a final judgment is signed, the parties will be appealing the Judge's ruling.

    It appears that the workers' compensation judges are still applying the MTG as written and will await a final decision from a higher court regarding the constitutionality of the MTG and the workers' compensation system as a whole before any change of procedure is mandated. The Louisiana Workforce Commission and Office of Workers' Compensation issued the following statement on June 29, 2015 regarding the Judge's ruling:

    The LWC and Office of Workers' Compensation is aware of a district court ruling enjoining a portion of the workers' compensation medical review process. We're obviously disappointed with the decision. At the direction of the state legislature, the medical treatment guidelines were implemented in 2011 based on the best medical practices as determined by Louisiana physicians, rather that lawyers or judges. The new process expedites appropriate medical treatment for injured workers so that they can recover faster and return to work sooner. Since implementation, medical costs have decreased and disability benefits have stabilized, resulting in lower insurance premiums for employers. The Louisiana Supreme Court has rejected challenges to the guidelines and approved the process. We are consulting with counsel to identify options for sustaining reforms that have been a big win for injured workers and for the employers who pay for the system. In the meantime, our customers will experience no change in service pending a written judgment clarifying the scope of the court's decision.