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ADJ8375307 →Apr 14, 2021 · Santa AnaPanel decision
WCAB panel affirmed the WCJ's decision denying the petition for reconsideration and confirming reimbursement to CIGA for bill review and utilization review expenses as part of medical treatment costs.
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Published panel decisions, almost all since 2021: the litigated tail of a system that mostly settles. Issues and outcomes were extracted by AI and released only where the source passage checked. A row is a decision, never a claimant. Not legal advice.
The WCAB affirms the Findings and Order except amends Finding of Fact 2 to clarify that third-party credit does not apply to QME deposition costs but applies to future workers' compensation benefits.
The Petition for Removal was dismissed as moot because the applicant attended the medical examination on December 2, 2020, rendering the challenge to the Order Compelling Attendance moot.
Petition for reconsideration granted; WCJ's Findings and Order rescinded; matter returned to trial level for further proceedings consistent with the opinion.
The Appeals Board denied the Petition for Reconsideration, affirming the lack of jurisdiction to review the UR and IMR decisions and rejecting applicant's contentions of bad faith or improper UR.
Findings and Award affirmed except as amended: applicant entitled to reimbursement for self-procured medical treatment at the amount provided by the Official Medical Fee Schedule; matter returned to trial level for determination of amount due under OMFS.
The Board granted reconsideration, rescinded the January 25, 2021 Findings and Award, and returned the matter to the trial level for further development of the medical record on permanent disability and apportionment.
The Findings, Award and Order issued by the WCJ on October 27, 2020 is rescinded and the matter is returned to the trial level for further proceedings consistent with the opinion.
The Joint Findings and Award of October 10, 2019 is affirmed in its entirety, including denial of additional medical mileage reimbursement and affirmation of penalties for unreasonable delay in payment.
The Board rescinded the WCJ's Findings and Order and denied cost petitioner's claim for reimbursement of copying services dated January 25 and 26, 2018, for records from Sunlight Supply, BHHC, and Concentra Medical Center.
The Workers' Compensation Appeals Board rescinded the Joint Findings and Order issued on November 16, 2020, and returned the matter to the trial level for further proceedings consistent with this decision.