CompFox AI Summary
The Workers' Compensation Appeals Board granted reconsideration and rescinded the original Findings and Order. The Board remanded the case to the trial level to further develop the medical record concerning the applicant's Bell's palsy. This is to clarify whether the condition is causally related to the industrial injury or solely a result of litigation stress, which would impact the defendant's liability for treatment. The applicant argued the defendant failed to follow utilization review procedures and unreasonably substituted its claims examiner's opinion for the treating physician's. The court acknowledged that if the Bell's palsy is industrial, even partially, the defendant is liable for treatment.
Full Decision Text1 Pages
The Workers' Compensation Appeals Board granted reconsideration and rescinded the original Findings and Order. The Board remanded the case to the trial level to further develop the medical record concerning the applicant's Bell's palsy. This is to clarify whether the condition is causally related to the industrial injury or solely a result of litigation stress, which would impact the defendant's liability for treatment. The applicant argued the defendant failed to follow utilization review procedures and unreasonably substituted its claims examiner's opinion for the treating physician's. The court acknowledged that if the Bell's palsy is industrial, even partially, the defendant is liable for treatment.
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