In 2013, a utilization review (UR) doctor advised Kirk King to stop his use of the drug Klonopin, which he had been taking since 2011, deeming it medically inappropriate for his condition. Utilization reviewers are responsible for acting on behalf of employers to decide whether the treatment plan for an employee’s work injury is medically necessary and appropriate, and modifying it if not.After discontinuing use, King suffered severe withdrawal symptoms, including multiple seizures. He and his wife sued the UR doctor for alleged negligence in failing to warn him about these dangerous symptoms.
Today, the California Supreme Court decided that since the injury “arose during the treatment of King’s industrial injury and in the course of the workers’ compensation claims process,” he and his wife’s claims are exclusively compensable as part of the workers’ compensation system. The Court affirmed that injuries arising as part of the UR process must be remedied solely through the workers’ compensation system.