CompFox AI Summary
This case involves a dispute over the need for carpal tunnel release surgery. The applicant's physician recommended surgery, but the employer denied authorization and sought a Qualified Medical Examiner (QME) without initiating utilization review as required by Labor Code section 4610. The Workers' Compensation Appeals Board (WCAB) granted removal, rescinded the order to take the case off calendar, and remanded it for an expedited hearing. The WCAB found the applicant was entitled to a hearing on whether a QME was permissible without prior utilization review and on the entitlement to the recommended surgery.
Full Decision Text1 Pages
This case involves a dispute over the need for carpal tunnel release surgery. The applicant's physician recommended surgery, but the employer denied authorization and sought a Qualified Medical Examiner (QME) without initiating utilization review as required by Labor Code section 4610. The Workers' Compensation Appeals Board (WCAB) granted removal, rescinded the order to take the case off calendar, and remanded it for an expedited hearing. The WCAB found the applicant was entitled to a hearing on whether a QME was permissible without prior utilization review and on the entitlement to the recommended surgery.
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