Home/Case Law/MATHEW JAMISON vs. DEE FAIRBANKS ENTERPRISES, STATE COMPENSATION INSURANCE FUND
Regular DecisionReconsideration

MATHEW JAMISON vs. DEE FAIRBANKS ENTERPRISES, STATE COMPENSATION INSURANCE FUND

Filed: Apr 09, 2009
ADJ3694832 (RDG 0125163)

CompFox AI Summary

The Appeals Board granted reconsideration, rescinded the WCJ's decision disallowing a medical equipment lien, and remanded for further proceedings. The WCJ incorrectly relied solely on Tapia to disallow the lien without addressing the claimant's arguments regarding defendant's utilization review (UR) process compliance. The Board emphasized that the WCJ must determine whether the treatment was reasonable and necessary, consider the UR process, and explain the reasoning for the decision on all contested issues.

Full Decision Text1 Pages

The Appeals Board granted reconsideration, rescinded the WCJ's decision disallowing a medical equipment lien, and remanded for further proceedings. The WCJ incorrectly relied solely on Tapia to disallow the lien without addressing the claimant's arguments regarding defendant's utilization review (UR) process compliance. The Board emphasized that the WCJ must determine whether the treatment was reasonable and necessary, consider the UR process, and explain the reasoning for the decision on all contested issues.

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MATHEW JAMISON vs. DEE FAIRBANKS ENTERPRISES, STATE COMPENSATION INSURANCE FUND (2009) – | CompFox