CompFox AI Summary
This case involves a dispute over the authorization of pain medications for an applicant with a 1983 back injury. The employer initially denied medications based on utilization review but later approved them. The administrative law judge still awarded the medications, but the Appeals Board granted reconsideration. The Board rescinded the award, finding no actual dispute existed at the hearing and that the prior denial, though flawed, did not warrant the judge's ruling. The Board also noted concerns about the utilization review process potentially violating regulations.
Full Decision Text1 Pages
This case involves a dispute over the authorization of pain medications for an applicant with a 1983 back injury. The employer initially denied medications based on utilization review but later approved them. The administrative law judge still awarded the medications, but the Appeals Board granted reconsideration. The Board rescinded the award, finding no actual dispute existed at the hearing and that the prior denial, though flawed, did not warrant the judge's ruling. The Board also noted concerns about the utilization review process potentially violating regulations.
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