Home/Case Law/MIKE REIS vs. SILVAS OIL COMPANY, EMPLOYERS INSURANCE OF WAUSAU
Regular DecisionReconsideration

MIKE REIS vs. SILVAS OIL COMPANY, EMPLOYERS INSURANCE OF WAUSAU

Filed: Nov 14, 2014
Fresno
ADJ8484771

CompFox AI Summary

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration, reversing a prior decision that had found carpal tunnel surgery authorized. The Board determined that a letter from defendant's attorney did not authorize the surgery, and the subsequent utilization review (UR) was timely and not procedurally defective. As the UR was timely, any challenges to its validity must go through Independent Medical Review (IMR), which had previously determined the surgery was not medically supported. Therefore, the prior award granting the surgery was rescinded.

Full Decision Text1 Pages

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration, reversing a prior decision that had found carpal tunnel surgery authorized. The Board determined that a letter from defendant's attorney did not authorize the surgery, and the subsequent utilization review (UR) was timely and not procedurally defective. As the UR was timely, any challenges to its validity must go through Independent Medical Review (IMR), which had previously determined the surgery was not medically supported. Therefore, the prior award granting the surgery was rescinded.

Read the full decision

Join + legal professionals. Create a free account to access the complete text of this decision and search our entire database.

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

MIKE REIS vs. SILVAS OIL COMPANY, EMPLOYERS INSURANCE OF WAUSAU (2014) – Fresno | CompFox