CompFox AI Summary
The Workers' Compensation Appeals Board granted reconsideration and returned the case to the trial level for further proceedings. The applicant sought reimbursement for medical treatment obtained outside the defendant's Medical Provider Network (MPN), arguing the defendant lost control of medical care by initially denying his upper extremity injury. While the Board found the MPN was properly established, they determined the applicant was justified in self-procuring treatment for his denied upper extremity injuries. The case was remanded for the WCJ to determine if the defendant met MPN transfer requirements and for further development on the applicant's claim of unreasonable delay of medical treatment.
Full Decision Text1 Pages
The Workers' Compensation Appeals Board granted reconsideration and returned the case to the trial level for further proceedings. The applicant sought reimbursement for medical treatment obtained outside the defendant's Medical Provider Network (MPN), arguing the defendant lost control of medical care by initially denying his upper extremity injury. While the Board found the MPN was properly established, they determined the applicant was justified in self-procuring treatment for his denied upper extremity injuries. The case was remanded for the WCJ to determine if the defendant met MPN transfer requirements and for further development on the applicant's claim of unreasonable delay of medical treatment.
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