Donna Ives vs. Dr Myers Distributing Company; Preferred Employers Insurance Company

In this case, Donna Ives, an employee of Dr. Myers Distributing Company, filed an application for adjudication of claim alleging that on December 7, 2015, she sustained industrial injury to her head, brain, eye, and nervous system. The employer accepted injury to the head. The parties stipulated that there was no chiropractic neurologist in the medical provider network. The Workers' Compensation Appeals Board rescinded the February 15, 2018 Findings of Fact and returned the matter to the trial level for further proceedings to develop the record and a new decision by the WCJ, as the defendant failed to properly refer the matter to medical utilization review and medical utilization review was not timely sought.

Dr Myers Distributing Company; Preferred Employers Insurance Company Donna Ives WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIADONNA IVES, Applicant,vs.DR MYERS DISTRIBUTING COMPANY; PREFERRED EMPLOYERS INSURANCE COMPANY, Defendant.Case No. ADJ11025609 (San Jose District Office)OPINION AND DECISION AFTER RECONSIDERATION            We previously granted Applicant’s Petition for Reconsideration (Petition) to further study the factual and legal issues in this case. This is our Opinion and Decision After Reconsideration. Applicant sought reconsideration of the Findings of Fact issued by a workers’ compensation administrative law judge (WCJ) on February 15, 2018, wherein the WCJ found that applicant, while employed on December 7, 2015, sustained industrial injury to her head, and claims industrial injury to her vision and spine. The WCJ also found that the parties stipulated that there is no chiropractic neurologist in defendant’s medical provider network (MPN), and that the November 13, 2017 request for authorization (RFA) did not constitute a valid request for treatment with a chiropractic neurologist. The WCJ found that issues of validity of the utilization review (UR) and the need for treatment with Dr. Rachman Chung are moot.            Applicant contended that the WCJ erred in finding that the RFA was invalid, arguing that the treatment with Dr. Rachman Chung, chiropractic neurologist, should be authorized.            We have considered the Petition for Reconsideration, and we have reviewed the record in this matter. No answer was received. The WCJ has filed a Report and Recommendation on Petition for Reconsideration (Report), recommending that applicant’s petition be denied. ,             Based on our review of the record, and for the reasons discussed herein, we will rescind the February 15, 2018 Findings of Fact, and return the matter to the trial level for further proceedings to develop the record and a new decision by the WCJ.FACTS            Applica

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