Home/Case Law/BACILISA MARTINEZ vs. WEIMER FARMS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for LEGION INSURANCE CO. in liquidation, administered by SEDGWICK CMS
Regular DecisionWorkers' Compensation

BACILISA MARTINEZ vs. WEIMER FARMS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for LEGION INSURANCE CO. in liquidation, administered by SEDGWICK CMS

Filed: Mar 08, 2013
Fresno
ADJ4129998 (ANA0358353)

CompFox AI Summary

The Appeals Board granted removal and rescinded the WCJ's order for further medical development concerning Dr. Amaral's lien. The Board found that Dr. Amaral failed to meet his evidentiary burden to prove his treatment was reasonable and necessary for the industrial injury. Reports from examining physicians did not constitute substantial medical evidence, and Dr. Amaral provided insufficient detail regarding the necessity of his treatment for specific injuries. Therefore, Dr. Amaral was ordered to take nothing on the unpaid balance of his lien.

Full Decision Text1 Pages

The Appeals Board granted removal and rescinded the WCJ's order for further medical development concerning Dr. Amaral's lien. The Board found that Dr. Amaral failed to meet his evidentiary burden to prove his treatment was reasonable and necessary for the industrial injury. Reports from examining physicians did not constitute substantial medical evidence, and Dr. Amaral provided insufficient detail regarding the necessity of his treatment for specific injuries. Therefore, Dr. Amaral was ordered to take nothing on the unpaid balance of his lien.

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