Bret Ross vs. Allergan, Inc.; American Home Assurance

(LAO 0785886)In this case, Bret Ross, an employee of Allergan, Inc. and American Home Assurance, sought reconsideration of a decision by a workers' compensation administrative law judge (WCJ) that all disputes for medical treatment must be submitted to utilization review (UR). The WCJ found that Ross had sustained an industrial injury to his back, left leg, left hip, left ankle, left foot, and psyche, causing 94% permanent disability and a need for further medical treatment. Ross argued that UR for a chronic medical condition was not required and that he was entitled to all medical treatment that was reasonably required to relieve his chronic pain. The Workers' Compensation Appeals Board granted Ross' petition for reconsideration

Allergan, Inc.; American Home Assurance Bret Ross WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIABRET ROSS, Applicant,vs.ALLERGAN, INC.; AMERICAN HOME ASSURANCE, Defendants.Case No. ADJ2148650 (LAO 0785886)OPINION AND ORDER GRANTING RECONSIDERATION AND DECISION AFTER RECONSIDERATION            Applicant seeks reconsideration of the Findings and Orders issued by a workers’ compensation administrative law judge (WCJ) on July 15, 2011, wherein the WCJ found that every dispute for medical treatment must be submitted to utilization review (UR). In the Opinion on Decision, the WCJ noted that applicant had self-procured five peroneal nerve blocks, after they were denied by UR, in order to reduce the chronic pain from his industrial reflex sympathetic dystrophy (RSD). Previously, the WCJ found that applicant, while employed as a chief of security on February 14, 2000, sustained industrial injury to his back, left leg, left hip, left ankle, left foot, and psyche, causing 94% permanent disability and a need for further medical treatment.            Applicant contends in essence that the WCJ erred in finding that his requests for peroneal nerve blocks were subject to UR, arguing that UR for a chronic medical condition is not required. Applicant also argues that, pursuant to Labor Code section 46001, he is entitled to all medical treatment that is reasonably required to relieve his chronic pain as his condition is beyond a cure.            We have considered the Petition for Reconsideration, and we have reviewed the record in this matter. Defendant filed an answer. The WCJ has filed a Report and Recommendation on Petition for Reconsideration (Report), recommending that the petition be denied. For the reasons discussed below, 1            Unless otherwise stated, all further statutory references are to the Labor Code. , we will grant reconsideration, rescind the July 15, 2011 Findings and Orders, and return the matter to the trial level for further proceedings and a new d

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