Home/Case Law/ANA LILIA RODRIGUEZ vs. COUNTRY VILLA HEALTH SERVICES, ZURICH AMERICAN INSURANCE CO. administered by TRISTAR RISK MANAGEMENT
Regular DecisionReconsideration

ANA LILIA RODRIGUEZ vs. COUNTRY VILLA HEALTH SERVICES, ZURICH AMERICAN INSURANCE CO. administered by TRISTAR RISK MANAGEMENT

Filed: Apr 28, 2011
San Francisco
ADJ7062572

CompFox AI Summary

The Workers' Compensation Appeals Board granted reconsideration of an award of temporary disability indemnity to an applicant who received treatment outside a valid Medical Provider Network (MPN). The Board overturned the original award, ruling that reports from physicians outside the MPN are inadmissible under current case law, Valdez v. Warehouse Demo Services. Consequently, the applicant is not entitled to temporary disability indemnity, reimbursement to the EDD, or attorney's fees based on those inadmissible reports. However, the applicant's unauthorized departure from the MPN was not deemed an unreasonable refusal of medical treatment.

Full Decision Text1 Pages

The Workers' Compensation Appeals Board granted reconsideration of an award of temporary disability indemnity to an applicant who received treatment outside a valid Medical Provider Network (MPN). The Board overturned the original award, ruling that reports from physicians outside the MPN are inadmissible under current case law, Valdez v. Warehouse Demo Services. Consequently, the applicant is not entitled to temporary disability indemnity, reimbursement to the EDD, or attorney's fees based on those inadmissible reports. However, the applicant's unauthorized departure from the MPN was not deemed an unreasonable refusal of medical treatment.

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