EPIC MANAGEMENT OAK INSURANCE CO Administered by BERSHIRE HATHAWAY Kimberly Bigham WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAKIMBERLY BIGHAM, Applicant,vs.EPIC MANAGEMENT; OAK INSURANCECO., Administered by BERSHIRE HATHAWAY, Defendants.Case No. ADJ6755122(San Bernardino District Office)OPINION AND ORDERGRANTING PETITION FOR RECONSIDERATIONAND DECISION AFTERRECONSIDERATION Defendant seeks reconsideration of the Findings and Award issued November 13, 2013, wherein the workers’ compensation administrative law judge (WCJ) found that applicant was “entitled to medical treatment/medications as specified by Dr. Hesseltine and as listed in Exhibit A dated 9/24/13 without modification or non-certification. The UR [utilization] review dated 9/24/13 is not valid for failure to comply with the regulations . . . so IMR [independent medical review] is not allowed.” The WCJ deferred all issues regarding applicant’s claimed industrial injury to her back, upper extremities, headaches, bladder, internal, scar/skin, right lower extremity and sleep problems. In the Report and Recommendation on Petition for Reconsideration (Report), the WCJ explained that the defendant’s utilization review dated September 24, 2013 was invalid because it failed to be properly served upon applicant’s counsel including failure to serve applicant’s counsel with Dr. Hesseltine’s records and the “independent medical review materials.” The WCJ’s Report recommends that the typographical error present in the Award, referring to “Finding 6” and “Finding 8”, be corrected ti indicate “Finding 3” and “Finding 4” respectively. Defendant contends that the WCJ erred: (1) by issuing an Award which included “other issues are deferred per “Finding 8” when only four findings were issued and thereby making the decision “vague, ambiguous and unintelligible”; (2) by basing the opinion upon California Code of Regulations, , title 8, section 9792.9(l)(7), which requires service upon a
Kimberly Bigham vs. EPIC MANAGEMENT OAK INSURANCE CO Administered By BERSHIRE HATHAWAY
In this case, Kimberly Bigham was appealing a workers' compensation decision from Epic Management, Oak Insurance Co., administered by Berkshire Hathaway. The administrative law judge found that Bigham was entitled to medical treatment as specified by her doctor without modification or non-certification. The judge also deferred all issues regarding Bigham's claimed industrial injury. The defendant sought reconsideration of the decision, arguing that the judge had erred in issuing an Award with a typographical error and by basing the opinion on a regulation that conflicted with the Labor Code. The Workers' Compensation Appeals Board granted the defendant's Petition for Reconsideration and affirmed the WCJ's decision, except that it was amended to correct the typographical error in the Award.
- Filed On:
- Court: California, San Bernardino
- Case No. ADJ6755122
To continue reading ... start a FREE Trial for 10 days
Discover the cases you didn’t know you were missing!
Copyright © 2023 - CompFox Inc.