CompFox AI Summary
The Appeals Board granted reconsideration of a WCJ's decision awarding $7,200 for shockwave therapy to the applicant's elbows. The Board found that the lien claimant failed to establish the medical reasonableness and necessity of the treatment, as the Agreed Medical Examiner's opinion did not specifically endorse shockwave therapy. The WCJ's exclusion of the defendant's utilization review denial letters was also questioned, but the Board reopened the record to allow for further development of evidence regarding the treatment's necessity. Consequently, the matter was returned to the trial level for further proceedings and a new decision.
Full Decision Text1 Pages
The Appeals Board granted reconsideration of a WCJ's decision awarding $7,200 for shockwave therapy to the applicant's elbows. The Board found that the lien claimant failed to establish the medical reasonableness and necessity of the treatment, as the Agreed Medical Examiner's opinion did not specifically endorse shockwave therapy. The WCJ's exclusion of the defendant's utilization review denial letters was also questioned, but the Board reopened the record to allow for further development of evidence regarding the treatment's necessity. Consequently, the matter was returned to the trial level for further proceedings and a new decision.
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