CompFox AI Summary
This case concerns the unilateral termination of nurse case manager services by an employer, which the Workers' Compensation Appeals Board affirmed as a form of medical treatment. The Board held that employers cannot unilaterally cease approved nurse case manager services without substantial medical evidence showing they are no longer necessary. Additionally, the Board clarified that an injured worker does not need to obtain a Request for Authorization to challenge such a termination, and expedited hearings are appropriate for these disputes. Ultimately, the employer failed to meet its burden of proving a change in the applicant's condition justifying the discontinuation of services.
Full Decision Text1 Pages
This case concerns the unilateral termination of nurse case manager services by an employer, which the Workers' Compensation Appeals Board affirmed as a form of medical treatment. The Board held that employers cannot unilaterally cease approved nurse case manager services without substantial medical evidence showing they are no longer necessary. Additionally, the Board clarified that an injured worker does not need to obtain a Request for Authorization to challenge such a termination, and expedited hearings are appropriate for these disputes. Ultimately, the employer failed to meet its burden of proving a change in the applicant's condition justifying the discontinuation of services.
Read the full decision
Join + legal professionals. Create a free account to access the complete text of this decision and search our entire database.