South Dakota had a recent SD Supreme Court case where the department and appellate court held for the employer and insurer on a medical issue.  The case went up to our high court.  The issue was whether the work injury remained a major contributing cause of the claimant's need for treatment.

The treating doctor testified on behalf of the employee.  The insurer had a record review done by an orthopedic surgeon. The court reversed the department's ruling on causation for two very important reasons: 1. the court indicated a strong preference for the treating doctor; and 2. the court indicated it's disdain for record reviews.

Record reviews are helpful, but in order to have a fighting chance in SD, you must have the patient examined.  The court discussed how the record review doctor never took a history and found that to be very important. 

Record reviews are still a helpful tool as you do not need to disclose them if they are adverse.  If you have a favorable record review and the case is litigated, you need to get an IME and have that doctor testify at hearing in order to have a chance at prevailing.

Please contact me if you have any questions.  Charles Larson - (605) 336-2424 -calarson@bgpw.com