CompFox AI Summary
The Appeals Board rescinded the WCJ's decision disallowing Monrovia Memorial Hospital's lien. The employer denied the industrial causation of the applicant's need for surgery, thus forfeiting their right to mandate treatment within their Medical Provider Network. Therefore, the applicant was entitled to seek treatment outside the MPN. The case is returned to the trial level for determination of the surgery's necessity and reasonable fee, considering the hospital's classification for billing purposes.
Full Decision Text1 Pages
The Appeals Board rescinded the WCJ's decision disallowing Monrovia Memorial Hospital's lien. The employer denied the industrial causation of the applicant's need for surgery, thus forfeiting their right to mandate treatment within their Medical Provider Network. Therefore, the applicant was entitled to seek treatment outside the MPN. The case is returned to the trial level for determination of the surgery's necessity and reasonable fee, considering the hospital's classification for billing purposes.
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