CompFox AI Summary
The Workers' Compensation Appeals Board granted reconsideration of the Findings of Fact and Order issued on December 31, 2020, by the WCJ, concerning a dispute over the timeliness of utilization review (UR) for applicant Ramona Melero's home health care request. Applicant contended that the utilization reviewer improperly delayed the request. The Board affirmed the WCJ's finding that defendant timely completed UR, stating that there was no evidence to support the applicant's argument that the reasons for the delay were already known to the defendant. The Board also discussed its equitable powers and the doctrine of equitable tolling in cases where administrative errors prevent timely action on petitions for reconsideration.
Full Decision Text1 Pages
The Workers' Compensation Appeals Board granted reconsideration of the Findings of Fact and Order issued on December 31, 2020, by the WCJ, concerning a dispute over the timeliness of utilization review (UR) for applicant Ramona Melero's home health care request. Applicant contended that the utilization reviewer improperly delayed the request. The Board affirmed the WCJ's finding that defendant timely completed UR, stating that there was no evidence to support the applicant's argument that the reasons for the delay were already known to the defendant. The Board also discussed its equitable powers and the doctrine of equitable tolling in cases where administrative errors prevent timely action on petitions for reconsideration.
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