Home/Case Law/BALTAZAR PEREZ vs. BLAKE FUENTES PAINTING, INC., STATE COMPENSATION INSURANCE FUND
Regular DecisionReconsideration

BALTAZAR PEREZ vs. BLAKE FUENTES PAINTING, INC., STATE COMPENSATION INSURANCE FUND

Filed: Feb 26, 2009
ADJ3559950 (GOL 0098088)

CompFox AI Summary

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior finding, determining that Dr. Duell's lien claim for medical treatment was not allowable. The Board found that the employer timely denied authorization for the treatment through utilization review, and the treatment was inconsistent with the ACOEM Guidelines. Furthermore, the applicant failed to properly dispute the utilization review denial as required by law. Consequently, Dr. Duell is awarded nothing on his lien claim.

Full Decision Text1 Pages

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior finding, determining that Dr. Duell's lien claim for medical treatment was not allowable. The Board found that the employer timely denied authorization for the treatment through utilization review, and the treatment was inconsistent with the ACOEM Guidelines. Furthermore, the applicant failed to properly dispute the utilization review denial as required by law. Consequently, Dr. Duell is awarded nothing on his lien claim.

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BALTAZAR PEREZ vs. BLAKE FUENTES PAINTING, INC., STATE COMPENSATION INSURANCE FUND (2009) – | CompFox