Home/Case Law/MARIA MORALES vs. ROSS STORES, ARCH INSURANCE, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES
Regular DecisionReconsideration

MARIA MORALES vs. ROSS STORES, ARCH INSURANCE, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

Filed: Apr 01, 2014
Los Angeles
ADJ8477179 ADJ8477166 ADJ8477152

CompFox AI Summary

The Appeals Board granted reconsideration and rescinded the WCJ's decision regarding three admitted industrial injuries to applicant Maria Morales. Defendant argued the WCJ erred in finding they denied reasonable medical care. The Board found that while the MPN was properly established and noticed, defendant's failure to timely respond to applicant's repeated requests for assistance did not constitute a neglect or refusal to provide reasonable medical treatment, thus requiring her to treat within the MPN. A dissenting opinion argued that the defendant's lack of responsiveness to the applicant's need for surgery authorization and communication breakdowns within the MPN constituted a neglect of care.

Full Decision Text1 Pages

The Appeals Board granted reconsideration and rescinded the WCJ's decision regarding three admitted industrial injuries to applicant Maria Morales. Defendant argued the WCJ erred in finding they denied reasonable medical care. The Board found that while the MPN was properly established and noticed, defendant's failure to timely respond to applicant's repeated requests for assistance did not constitute a neglect or refusal to provide reasonable medical treatment, thus requiring her to treat within the MPN. A dissenting opinion argued that the defendant's lack of responsiveness to the applicant's need for surgery authorization and communication breakdowns within the MPN constituted a neglect of care.

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