Felipe Andrade vs. Union Framing, Inc., Permissibly Self- Insured,

(OAK 0347028) is a case in which Felipe Andrade sought reconsideration of a decision affirming the determination of a workers' compensation administrative law judge that Andrade was entitled to self-procure medical treatment outside of the defendant's medical provider network at the defendant's expense due to the defendant's failure to provide timely notice of an appropriate list of doctors in its medical provider network. The Appeals Board dismissed the petition for reconsideration, finding that the decision did not deprive Andrade of any rights or benefits and that the issue of the defendant's entitlement to enforce future participation in its medical provider network had been prematurely raised.

UNION FRAMING, INC., Permissibly Self- Insured, FELIPE ANDRADE WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAFELIPE ANDRADE, Applicant,vs.UNION FRAMING, INC., Permissibly Self-Insured, Defendant.Case No. ADJ3771318 (OAK 0347028)OPINION AND ORDER DISMISSING PETITION FOR RECONSIDERATION            Applicant, Felipe Andrade, seeks reconsideration of the Decision After Reconsideration, issued May 19, 2009, in which we affirmed the February 11, 2009 Findings and Award of the workers’ compensation administrative law judge (WCJ), who held that because defendant failed to give applicant timely notice of an appropriate list of doctors in its medical provider network (MPN) and “neglected and refused to provide reasonable medical treatment by failing to provide applicant with required notice of his rights under the MPN,” applicant was entitled to self-procure reasonable medical treatment outside of defendant’s MPN.            In affirming the WCJ’s determination, we adopted and incorporated his Report and Recommendation on Petition for Reconsideration as the decision of the Appeals Board, except that we expressly excluded the second full paragraph on page 15 of his report. In that paragraph, the WCJ offered his opinion that an employer’s right to control medical treatment through an MPN will be lost if the employer fails to satisfy all of the notification requirements, and that “once lost for failure to comply, the employer may not regain control.” In our Decision After Reconsideration, we stated that discussion of this issue was premature, as defendant “has not yet attempted to transfer the applicant into its MPN.” ,             Applicant contests the exclusion of that rationale from our determination to affirm the WCJ’s holding that applicant is entitled to self-procure medical treatment outside defendant’s MPN at defendant’s expense. Applicant asserts that the issue he sought to litigate was defendant’s entitlement to enforce future participation in its MPN, and

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