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The Appeals Board granted reconsideration of a prior award finding applicant sustained an industrial injury to his face and eyes and was entitled to cataract surgery. The Board found the defendant did not timely communicate its Utilization Review denial, rendering it invalid, but determined further medical evidence was needed to establish the surgery's industrial causation and medical necessity. The Board rescinded the original award and returned the matter for further proceedings to develop the record on these specific issues. A dissenting opinion argued the defendant waived the causation objection and that the treating physician's report constituted substantial medical evidence supporting the surgery.
BARTON BUHTZ vs. SELECTIVE EMPLOYEES, ARROWOOD INDEMNITY COMPANY is a workers' compensation case decided in San Francisco. This case addresses legal issues related to compensation claims, benefits, and court rulings.
It is commonly referenced in legal research involving workers' compensation laws in San Francisco.
Full Decision Text1 Pages
The Appeals Board granted reconsideration of a prior award finding applicant sustained an industrial injury to his face and eyes and was entitled to cataract surgery. The Board found the defendant did not timely communicate its Utilization Review denial, rendering it invalid, but determined further medical evidence was needed to establish the surgery's industrial causation and medical necessity. The Board rescinded the original award and returned the matter for further proceedings to develop the record on these specific issues. A dissenting opinion argued the defendant waived the causation objection and that the treating physician's report constituted substantial medical evidence supporting the surgery.
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