CompFox AI Summary
This case concerns a workers' compensation applicant seeking cervical spine surgery. The defendant employer and insurer sought reconsideration of an award granting the surgery, primarily arguing the decision lacked substantial medical evidence and presenting a new AME report. However, the defendant conceded the administrative law judge's finding that their utilization review denial was untimely. The Appeals Board denied reconsideration, finding the defendant waived their procedural arguments by not challenging the timeliness. While acknowledging the new AME report was newly discovered evidence, the Board found it did not impact the decision as it did not mention the proposed surgery.
Full Decision Text1 Pages
This case concerns a workers' compensation applicant seeking cervical spine surgery. The defendant employer and insurer sought reconsideration of an award granting the surgery, primarily arguing the decision lacked substantial medical evidence and presenting a new AME report. However, the defendant conceded the administrative law judge's finding that their utilization review denial was untimely. The Appeals Board denied reconsideration, finding the defendant waived their procedural arguments by not challenging the timeliness. While acknowledging the new AME report was newly discovered evidence, the Board found it did not impact the decision as it did not mention the proposed surgery.
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