CompFox AI Summary
The Workers' Compensation Appeals Board granted reconsideration to rescind a prior award of spinal surgery for Tammy Baldridge. The Board found that the defendant timely denied the surgery through utilization review and that the applicant failed to meet her burden of proof. Specifically, the applicant did not demonstrate that the recommended surgery was medically reasonable and necessary, particularly in light of the ACOEM Guidelines and conflicting medical opinions.
Full Decision Text1 Pages
The Workers' Compensation Appeals Board granted reconsideration to rescind a prior award of spinal surgery for Tammy Baldridge. The Board found that the defendant timely denied the surgery through utilization review and that the applicant failed to meet her burden of proof. Specifically, the applicant did not demonstrate that the recommended surgery was medically reasonable and necessary, particularly in light of the ACOEM Guidelines and conflicting medical opinions.
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