|Organization:||Department of Industrial Accidents|
|Docket Number:||DIA Board No. 017148-99|
- Employee: Steven Santos
- Employer: Town of Dennis
- Insurer: MIIA
FABRICANT, J. The employee appeals from a decision in which an administrative judge denied his claim for medical benefits under §§ 13 and 30, based on the failure of the medical provider to follow the procedures for utilization review ("UR"), pursuant to 452 Code Mass. Regs. § 6.04. Because we conclude that the evidence was insufficient, as a matter of law, to deny the claim on that basis, we recommit the case for further findings addressing the issues of causation and the reasonableness and necessity of the disputed treatments.