Home/Case Law/Gregory Long vs. RALPHS GROCERY COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES
Regular DecisionReconsideration

Gregory Long vs. RALPHS GROCERY COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES

Filed: Jul 20, 2018
San Francisco
ADJ4092389 (SBR 0291114), ADJ4203796 (SBR 0291115), ADJ3646941 (SBR 0309645)

CompFox AI Summary

The Workers' Compensation Appeals Board (WCAB) denied reconsideration of a Findings and Order that found the defendant complied with a prior Independent Medical Review (IMR) decision. The WCAB affirmed the administrative law judge's ruling that each prescription for applicant Gregory Long's opioid pain medication requires separate Utilization Review (UR) and potential IMR, despite a previous IMR approval. The Board also noted its lack of jurisdiction to hear constitutional challenges to the UR/IMR process. Applicant's claims of unequal protection and fraud were rejected, and the WCAB found no impairment to his access to medical treatment.

Full Decision Text1 Pages

The Workers' Compensation Appeals Board (WCAB) denied reconsideration of a Findings and Order that found the defendant complied with a prior Independent Medical Review (IMR) decision. The WCAB affirmed the administrative law judge's ruling that each prescription for applicant Gregory Long's opioid pain medication requires separate Utilization Review (UR) and potential IMR, despite a previous IMR approval. The Board also noted its lack of jurisdiction to hear constitutional challenges to the UR/IMR process. Applicant's claims of unequal protection and fraud were rejected, and the WCAB found no impairment to his access to medical treatment.

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