Successful prosecution of de novo request for hearing.
The hearing was to challenge the Pennsylvania Bureau of Workers’ Compensation Fee Review Section’s final determination that an injured worker’s shoulder surgery expenses must be paid by the insurance carrier and the employer. We argued that the work-relatedness of the shoulder surgery is currently in dispute, thus barring the Bureau’s attempt to compel payment. We also proffered the argument that due process of the provider remained intact since a challenge to work-relatedness must be adjudicated before a provider has standing to challenge the amount or timeliness of payment. The decision of the court quashed the Bureau’s determination and held that no surgical expenses are payable.