Home/Case Law/JUAN LUNA vs. CAPITAL DRYWALL, L.L.P.; SEABRIGHT INSURANCE
Regular DecisionRegular Panel Decision

JUAN LUNA vs. CAPITAL DRYWALL, L.L.P.; SEABRIGHT INSURANCE

Filed: Sep 11, 2013
Pomona
ADJ8460289

CompFox AI Summary

This case concerns a dispute over the admissibility of medical reports from physicians outside the defendant's Medical Provider Network (MPN). The Appeals Board rescinded the original findings and award, remanding the case for a new decision. This decision hinges on the employer's failure to provide adequate notice of the MPN and their denial of the employee's claim, entitling the employee to self-procure treatment and rendering those medical reports admissible. The arbitrator must now reconsider the findings regarding self-procured medical expenses and mileage reimbursement.

Full Decision Text1 Pages

This case concerns a dispute over the admissibility of medical reports from physicians outside the defendant's Medical Provider Network (MPN). The Appeals Board rescinded the original findings and award, remanding the case for a new decision. This decision hinges on the employer's failure to provide adequate notice of the MPN and their denial of the employee's claim, entitling the employee to self-procure treatment and rendering those medical reports admissible. The arbitrator must now reconsider the findings regarding self-procured medical expenses and mileage reimbursement.

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JUAN LUNA vs. CAPITAL DRYWALL, L.L.P.; SEABRIGHT INSURANCE (2013) – Pomona | CompFox