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The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior finding that the applicant was entitled to treat outside the defendant's Medical Provider Network (MPN). The Board found that the applicant failed to meet her burden of proving that the defendant neglected or refused to provide medical care within the MPN. Specifically, the applicant's unsubstantiated claim of one failed appointment attempt with an MPN physician and subsequent designation of an out-of-network doctor was insufficient. Therefore, the defendant retains control of the applicant's medical treatment within the MPN.
Full Decision Text1 Pages
The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior finding that the applicant was entitled to treat outside the defendant's Medical Provider Network (MPN). The Board found that the applicant failed to meet her burden of proving that the defendant neglected or refused to provide medical care within the MPN. Specifically, the applicant's unsubstantiated claim of one failed appointment attempt with an MPN physician and subsequent designation of an out-of-network doctor was insufficient. Therefore, the defendant retains control of the applicant's medical treatment within the MPN.
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