CompFox AI Summary
The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision that denied applicant's right shoulder surgery due to a fraud conviction. The WCAB found that the trial judge's decision was not supported by substantial evidence, particularly regarding the causal link between the fraudulent activities and the need for surgery. The case is remanded for further proceedings, including a potential appointment of a new physician, to determine if the surgery is industrially necessary and not solely a result of the fraud. The WCAB emphasized the need to further develop the record to ensure substantial justice.
Full Decision Text1 Pages
The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision that denied applicant's right shoulder surgery due to a fraud conviction. The WCAB found that the trial judge's decision was not supported by substantial evidence, particularly regarding the causal link between the fraudulent activities and the need for surgery. The case is remanded for further proceedings, including a potential appointment of a new physician, to determine if the surgery is industrially necessary and not solely a result of the fraud. The WCAB emphasized the need to further develop the record to ensure substantial justice.
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