CompFox AI Summary
Alicia Rodriguez, applicant, suffered a brain injury during employment with Dynamic Edge Consulting, insured by Travelers Property Casualty Company of America. The initial WCJ decision found the defendant liable for 24-hour home health care due to a failure in timely utilization review of Dr. Roger Bertoldi's prescription, which incorporated Sue Coleman's evaluation. Defendant petitioned for reconsideration, arguing the prescription was non-compliant and their duty was investigative, not to submit to UR. The Appeals Board granted the petition, deferring a final decision for further review and encouraging mediation.
Full Decision Text1 Pages
Alicia Rodriguez, applicant, suffered a brain injury during employment with Dynamic Edge Consulting, insured by Travelers Property Casualty Company of America. The initial WCJ decision found the defendant liable for 24-hour home health care due to a failure in timely utilization review of Dr. Roger Bertoldi's prescription, which incorporated Sue Coleman's evaluation. Defendant petitioned for reconsideration, arguing the prescription was non-compliant and their duty was investigative, not to submit to UR. The Appeals Board granted the petition, deferring a final decision for further review and encouraging mediation.
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