Provides relative to the workers' compensation medical treatment schedule. (8/1/26)

Senate Bill 162 amends Louisiana Revised Statutes 23:1203.1(K) to restrict the evidentiary scope available in appeals of workers' compensation medical treatment schedule decisions. Currently, when a party appeals a medical director or associate medical director decision regarding whether recommended medical care complies with the statutory medical treatment schedule, the bill constrains the evidence that may be presented on that appeal. Specifically, the bill adds language providing that only evidence reviewed by the medical director or associate medical director during the initial determination shall be admissible when a party files a Disputed Claim for Compensation form to appeal that decision. The bill retains the existing standard that such decisions may be overturned only by clear and convincing evidence that the decision was not in accordance with law. The effective date is August 1, 2026.

The practical effect of this change falls primarily on injured workers, employers, and insurers involved in workers' compensation disputes concerning medical treatment authorization. Under existing law, parties could potentially introduce new evidence at the appeal stage that was not presented to or considered by the medical director. This bill eliminates that opportunity by restricting appeals to the administrative record that the medical director or associate medical director actually reviewed. For injured workers seeking to challenge a denial or limitation of medical treatment, this restriction means they cannot supplement the record with additional medical evidence, expert opinions, or other documentation at the appeal stage. Employers and insurers may benefit from the more limited appeal scope as it prevents defendants from being confronted with entirely new evidence after the initial medical director determination.

This amendment operates within the existing workers' compensation medical treatment framework established in R.S. 23:1203.1, which requires that medical treatment decisions follow guidelines meeting specific criteria including reliance on systematic medical literature review, published criteria for rating study quality, current guideline status, and interdisciplinary scope. The appeal structure established in present law, involving initial appeals to the medical director within fifteen days and subsequent appeals through the Disputed Claim for Compensation process within forty-five days, remains unchanged in structure and timing. The modification addresses only what evidence may be presented during the second-stage appeal, creating a closed-record appellate process for this category of workers' compensation disputes.