Medical Disputes Before the MRT: What You Should Know

Employers, insurers, and third-party administrators have an important, and sometimes under-utilized, tool when they believe medical treatment is unnecessary, inappropriate, and/or excessive: requesting medical dispute review through the Medical Resolution Team (MRT). Under OAR 436-009-0008, the Director has jurisdiction over medical service, treatment, and fee disputes, subject to the rule’s limitations and applicable deadlines.

Filing an MRT dispute can help control claim costs and obtain a formal determination regarding disputed treatment. Obtaining a favorable Order from the MRT finding particular treatment is/has been unnecessary, inappropriate, and/or excessive can often help move the claim towards closure and/or a reasonable settlement. However, there are also risks, including an unfavorable decision, and the potential for accumulating additional fees/costs. Reinisch Wilson attorneys are utilizing the MRT more and more frequently, and are successfully challenging medical treatment on behalf of our clients.  We can assist in evaluating whether an MRT dispute makes sense based on the medical evidence, applicable rules, and circumstances of the claim.

If you have questions about a potential medical dispute or would like assistance evaluating or filing an MRT dispute, please contact a Reinisch Wilson attorney. We are happy to help you assess the risks and benefits and determine the best course of action.