Home/Case Law/NICOLE CARTER vs. STATE OF CALIFORNIA - DEPARTMENT OF CORRECTIONS - INMATE CLAIMS
Regular DecisionRegular Panel Decision

NICOLE CARTER vs. STATE OF CALIFORNIA - DEPARTMENT OF CORRECTIONS - INMATE CLAIMS

Filed: Aug 22, 2019
Marina Del Rey
ADJ8487806

CompFox AI Summary

The Workers' Compensation Appeals Board affirmed a prior decision disallowing a lien claimant's claim for payment for medical treatment. The Board found that the treating physician's prior opinion, stating the applicant had reached maximum medical improvement and required no further treatment, constituted substantial evidence. Therefore, the lien claimant failed to meet its burden of proving the treatment was reasonably required to cure or relieve the applicant's industrial injury. The Board also noted a lack of evidence regarding the scope of a prior settlement and dismissed arguments about utilization review.

Full Decision Text1 Pages

The Workers' Compensation Appeals Board affirmed a prior decision disallowing a lien claimant's claim for payment for medical treatment. The Board found that the treating physician's prior opinion, stating the applicant had reached maximum medical improvement and required no further treatment, constituted substantial evidence. Therefore, the lien claimant failed to meet its burden of proving the treatment was reasonably required to cure or relieve the applicant's industrial injury. The Board also noted a lack of evidence regarding the scope of a prior settlement and dismissed arguments about utilization review.

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NICOLE CARTER vs. STATE OF CALIFORNIA - DEPARTMENT OF CORRECTIONS - INMATE CLAIMS (2019) – Marina Del Rey | CompFox