Surgery denied based on utilization review.

Utilization review is a fancy way for the insurance company to say "we sent your medical records to a doctor in Texas and paid him to say that your surgery is not neccessary." Essentially, insurance companies do not like to pay for medical procedures if they do not have to do so. In Georgia workers' comp claims, insurance companies frequently send recommendations to out of state doctors (usually doctors in Texas for some reason) to say that a procedure or test is not neccessary. A utilization review report in Georgia is not even admissible evidence. If the workers' comp carrier has denied your surgery based on utilization review, contact workers' comp Atlanta attorney Brian H. Sumrall at (404) 857-3835 or visit

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