Carolyn Bertrand vs. County Of Orange Permissibly Self-insured York

This case involves Carolyn Bertrand, an employee of the County of Orange, who sustained an industrial cumulative trauma injury to her low back and neck. The case was resolved by way of a Stipulated Findings and Award in which the parties agreed that all future disputes regarding medical treatment would be referred to the Agreed Medical Examiner (AME). The County of Orange sought reconsideration of the Findings and Order, arguing that the intent of the stipulation was to return to the AME in the event of a dispute after the Utilization Review (UR) process, and not to circumvent UR. The Workers' Compensation Appeals Board dismissed the petition for reconsideration, but granted removal to amend the Findings and Order to reflect that the parties' stip

COUNTY OF ORANGE permissibly self-insured YORK CAROLYN BERTRAND WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIACAROLYN BERTRAND, Applicant,vs.COUNTY OF ORANGE, permissibly self-insured; YORK, Defendants.Case No. ADJ3135829 (AHM 0099139)OPINION AND ORDERSDISMISSING PETITION FORRECONSIDERATION;GRANTING REMOVAL ANDDECISION AFTERREMOVAL            Defendant, County of Orange, permissibly self-insured, seeks reconsideration of the Findings and Order, issued May 19, 2014, in which a workers’ compensation administrative law judge (WCJ) put into effect the parties’ stipulation in their July 20, 2004 Stipulations with Request for Award, that all future disputes regarding medical treatment would be referred to Dr. Lynn Wilson, the Agreed Medical Examiner (AME).            Defendant contends the WCJ’s order to return to the AME misconstrued the parties’ stipulation, and that the intent of the stipulation was to return to the AME in the event of a dispute after the Utilization Review (UR) process, and not to circumvent UR. Defendant asserts, however, that the new Independent Medical Review (IMR) process supersedes the parties’ stipulation to have the AME resolve treatment disputes.            The WCJ has prepared a Report and Recommendation on Petition for Reconsideration recommending the petition be denied. Applicant has filed an answer contending that the WCJ properly concluded that the parties are bound by their contractual agreement to resolve medical disputes outside the statutory framework.            We shall dismiss defendant’s petition for reconsideration, as the WCJ’s order to have treatment requests referred to the AME for determination is not a final order from which reconsideration may be sought. However, we shall treat defendant’s petition as seeking removal of this matter to the Appeals , Board, and will grant removal to amend the Findings and Order to reflect that the parties’ stipulation may be enforced to require their medical treatment disputes be d

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