RETIREMENT HOUSING FOUNDATION; CNA CLAIMS PLUS, INC., JESSICA BROWN, WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAJESSICA BROWN, Applicant,vs.RETIREMENT HOUSING FOUNDATION;CNA CLAIMS PLUS, INC., Defendant(s).Case No. ADJ1956695 (LBO 0388842)OPINION AND ORDER GRANTING PETITION FOR RECONSIDERATION AND DECISION AFTER RECONSIDERATION Defendant seeks reconsideration of the January 9, 2009 Opinion on Decision and Order, wherein the workers’ compensation administrative law judge (WCJ) granted applicant’s request for benefits from October 10, 2008, to the present and continuing, and found, “that the assignment by the MPN doctor of a surgeon outside the MPN is still treatment within the MPN and the proposed surgery is ORDERED to be provided by defendants.” The parties stipulated that applicant, while employed as a food service worker during the period February 2007 through June 10, 2007, sustained industrial injury to her bilateral upper extremities, and that, pursuant to the Agreed Medical Examiner (AME), further medical treatment is required.Defendant contends the WCJ erred in allowing applicant to choose a specialist outside the medical provider network (MPN). We have considered the Petition for Reconsideration and applicant’s Response, and we have reviewed the record in this matter. The WCJ prepared a Report and Recommendation of Workers’ Compensation Administrative Law Judge on Petition for Reconsideration (Report), recommending that the petition be denied. , For the reasons discussed below, we will grant defendant’s petition for reconsideration and amend the Opinion on Decision and Order to find that applicant is required to treat with- specialists within defendant’s MPN, unless it is shown that the MPN does not contain a physician who can provide the approved treatment. The facts are not in dispute. “Applicant, Jessica Brown, born December 23, 1962, while employed during the period of February 2007 t
Jessica Brown vs. Retirement Housing Foundation: A Workers' Comp Case
This case involves a dispute between Jessica Brown, an injured employee, and Retirement Housing Foundation and CNA Claims Plus, Inc., her employer's workers' compensation carrier, over whether she can be referred by her MPN primary treating physician to a specialist outside the MPN. The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration and amended the Opinion on Decision and Order to find that applicant is required to treat with specialists within defendant's MPN, unless it is shown that the MPN does not contain a physician who can provide the approved treatment.
- Filed On:
- Court: California, Long Beach
- Case No. ADJ1956695
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