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CHILDREN'S NAT. MEDICAL CENTER v. DC. DOES.

No. 09-AA-58.

992 A.2d 403 (2010)

CHILDREN'S NATIONAL MEDICAL CENTER and Frank Gates Service Company/Avizent, Petitioners, v. DISTRICT OF COLUMBIA DEPARTMENT OF EMPLOYMENT SERVICES, Respondent, Beverly McCormick, Intervenor.

District of Columbia Court of Appeals.

Decided April 8, 2010.

Attorney(s) appearing for the Case

David M. Schoenfeld, Rockville, MD, for petitioner.

Richard S. Love, Senior Assistant Attorney General, with whom Peter J. Nickles, Attorney General for the District of Columbia, Todd S. Kim, Solicitor General, and Donna M. Murasky, Deputy Solicitor General, were on the brief, for respondent.

Douglas K. Allston, Jr., Greenbelt, MD, for intervenor.

Before RUIZ and FISHER, Associate Judges, and BELSON, Senior Judge.

FISHER, Associate Judge:

In the workers' compensation system, utilization review ("UR") is a statutory procedure for determining "the necessity, character, or sufficiency of any medical care or service furnished or scheduled to be furnished" to an injured employee. D.C.Code § 32-1507(b)(6)(A) (2001). In this case, the Department of Employment Services ("DOES") held that the UR process had been completed although the employee's physician had not sought reconsideration...

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