When can the ER request a 2nd opinion under LC 4062(b)?

When can the ER request a 2nd opinion under LC 4062(b)?

• A. Where there is a dispute about the need for spinal surgery
• B. Where the EE has lost an eye
• C. Where there is an issue about AOE/COE
• D. Where there is a dispute about the need for medical treatment

Answer: (A)

The main idea is that a second medical opinion can be requested when there is a dispute over whether a proposed medical treatment is medically necessary. Spinal surgery is a high-stakes, high-cost intervention where independent review is commonly sought to resolve disagreements between the employee and the employer/insurer about necessity. That makes a dispute about the need for spinal surgery the clearest and most direct trigger for invoking the 4062(b) second-opinion process. The other scenarios don’t fit as cleanly: issues about causation (AOE/COE) aren’t about medical necessity, losing an eye is a consequence rather than a debate over treatment necessity, and while a general dispute about medical treatment could trigger a second opinion, the example of a spinal surgery dispute directly aligns with how 4062(b) is typically applied.

The main idea is that a second medical opinion can be requested when there is a dispute over whether a proposed medical treatment is medically necessary. Spinal surgery is a high-stakes, high-cost intervention where independent review is commonly sought to resolve disagreements between the employee and the employer/insurer about necessity. That makes a dispute about the need for spinal surgery the clearest and most direct trigger for invoking the 4062(b) second-opinion process.

The other scenarios don’t fit as cleanly: issues about causation (AOE/COE) aren’t about medical necessity, losing an eye is a consequence rather than a debate over treatment necessity, and while a general dispute about medical treatment could trigger a second opinion, the example of a spinal surgery dispute directly aligns with how 4062(b) is typically applied.