CompFox AI Summary
This case involves a worker who sustained severe injuries from gunshot wounds and sought additional physical therapy. The defendant employer argued that the request was untimely and beyond the post-surgical treatment period, and that the applicant failed to establish medical necessity. The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, upholding the finding that the employer failed to timely and effectively serve the Utilization Review denial. The Board found the additional physical therapy was reasonable and necessary, and that the request fell within the permissible 24-visit limitation after the post-surgical period concluded.
Full Decision Text1 Pages
This case involves a worker who sustained severe injuries from gunshot wounds and sought additional physical therapy. The defendant employer argued that the request was untimely and beyond the post-surgical treatment period, and that the applicant failed to establish medical necessity. The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, upholding the finding that the employer failed to timely and effectively serve the Utilization Review denial. The Board found the additional physical therapy was reasonable and necessary, and that the request fell within the permissible 24-visit limitation after the post-surgical period concluded.
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