Warehouse Demo Services; Zurich North America, Adjusted By ESIS Elayne Valdez WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAELAYNE VALDEZ, Applicant,vs.WAREHOUSE DEMO SERVICES; ZURICH NORTH AMERICA, Adjusted By ESIS, Defendants.Case No. ADJ7048296OPINION AND DECISION AFTER RECONSIDERATION (EN BANC) On July 14, 2011, the Appeals Board granted reconsideration of the en banc decision issued in this matter on April 20, 2011, to further study the factual and legal issues in this case. The following is our Decision After Reconsideration. For the reasons discussed below, we will affirm the April 20, 2011 en banc decision,1 wherein we held that, where unauthorized treatment is obtained for an industrial injury outside a validly established and properly noticed medical provider network (MPN), the resulting non-MPN treatment reports are inadmissible and may not be relied upon to award benefits. Applicant seeks reconsideration of our prior decision contending that (1) by the plain meaning of Labor Code section 4616.6,2 “inadmissibility of non-MPN reports is limited to the independent medical review appeal;” (2) “ruling that 4616.6 is a broad rule of inadmissibility to all proceedings causes mischief, exorbitant costs, and an absurd result;” (3) the Appeals Board’s decision “violates longstanding law;” (4) “defendant waived admissibility of the medical reports by failing to raise it at trial;” (5) the 1 En banc decisions of the Appeals Board (Lab. Code, § 115) are binding precedent on all Appeals Board panels and WCJs. (Cal. Code Regs., tit. 8, § 10341; City of Long Beach v. Workers’ Comp. Appeals Bd. (Garcia) (2005) 126 Cal.App.4th 298, 313, fn. 5 [70 Cal.Comp.Cases 109, 120, fn. 5]; Gee v. Workers’ Comp. Appeals Bd. (2002) 96 Cal.App.4th 1418, 1425, fn. 6 [67 Cal.Comp.Cases 236, 239, fn. 6].) In addition to being adopted as a precedent decision in accordance with Labor Code section 115 and Appeals Board Rule 10341, this en
Elayne Valdez vs. Warehouse Demo Services; Zurich North America, Adjusted By Esis
- Filed On:
- Court: California, San Francisco
- Case No. ADJ7048296
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