CompFox AI Summary
The Workers' Compensation Appeals Board reversed a prior Independent Medical Review (IMR) decision that denied the applicant's Norco prescription. The Board found the IMR reviewer failed to consider all submitted medical records and prior IMR determinations, leading to plainly erroneous findings of fact. Specifically, the IMR reviewer incorrectly stated there was no documentation of functional improvement with Norco, despite such documentation being present. The case is remanded for a new IMR review by a different reviewer or organization.
Full Decision Text1 Pages
The Workers' Compensation Appeals Board reversed a prior Independent Medical Review (IMR) decision that denied the applicant's Norco prescription. The Board found the IMR reviewer failed to consider all submitted medical records and prior IMR determinations, leading to plainly erroneous findings of fact. Specifically, the IMR reviewer incorrectly stated there was no documentation of functional improvement with Norco, despite such documentation being present. The case is remanded for a new IMR review by a different reviewer or organization.
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