CompFox AI Summary
The Workers' Compensation Appeals Board denied the employer's petition for reconsideration. The Board affirmed the administrative law judge's order for continued treatment at Casa Colina for the applicant's traumatic brain injury (TBI). This decision was based on a prior Independent Medical Review (IMR) finding that Casa Colina treatment was reasonable and no evidence of changed condition. Furthermore, the employer's failure to conduct timely utilization review for the requested treatment authorized the Board to determine medical necessity based on substantial evidence.
Full Decision Text1 Pages
The Workers' Compensation Appeals Board denied the employer's petition for reconsideration. The Board affirmed the administrative law judge's order for continued treatment at Casa Colina for the applicant's traumatic brain injury (TBI). This decision was based on a prior Independent Medical Review (IMR) finding that Casa Colina treatment was reasonable and no evidence of changed condition. Furthermore, the employer's failure to conduct timely utilization review for the requested treatment authorized the Board to determine medical necessity based on substantial evidence.
Read the full decision
Join + legal professionals. Create a free account to access the complete text of this decision and search our entire database.