SHALISA CHAMBERLAIN vs. HUMPHREY & GIACOPUZZI VETERINARY HOSPITAL STATE COMPENSATION INSURANCE FUND

Humphrey & Giacopuzzi Veterinary Hospital and State Compensation Insurance Fund (State Fund) appealed a decision by the Workers' Compensation Appeals Board (WCAB) granting medical treatment to Shalisa Chamberlain for an injury she sustained while employed as a veterinary technician. The WCAB found that State Fund's utilization review (UR) determination was untimely and concluded that Chamberlain was entitled to medical treatment including a one-year gym membership extension, follow-up with a psychologist, follow-up with a psychiatrist, pain management follow-ups with Dr. Kenly, a urology consultation, a neurology consultation, 16 hours of home health assistance every week, and eight visits of additional chiropractic treatment for the neck and back. The WC

HUMPHREY & GIACOPUZZI VETERINARY HOSPITAL STATE COMPENSATION INSURANCE FUND SHALISA CHAMBERLAIN WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIASHALISA CHAMBERLAIN, Applicant,vs.HUMPHREY & GIACOPUZZIVETERINARY HOSPITAL; STATECOMPENSATION INSURANCE FUND, Defendants.Case No. ADJ6945720(Oxnard District Office)OPINION AND DECISIONAFTER RECONSIDERATION            We previously granted the Petition for Reconsideration filed by defendant, State Compensation Insurance Fund (State Fund), to allow sufficient opportunity for further study of the factual and legal issues in this case. This is our Decision After Reconsideration.            State Fund’s petition sought reconsideration of the Findings of Fact and Orders issued by the workers’ compensation administrative law judge (WCJ) on March 14, 2014. In that decision, the WCJ found that applicant sustained industrial injury “to her low back, soft tissue, neck, buttocks, right hip, and feet due to weight gain; and claims to have sustained injury to her psyche, vision, balance, urology, weight gain, brain, and internal organs.” (Italics added.) The WCJ also found that defendant’s utilization review (UR) determination was untimely and concluded that applicant was entitled to the following medical treatment: (a) a one-year gym membership extension; (b) a follow-up with a psychologist; (c) a follow-up with a psychiatrist; (d) pain management follow-ups with Dr. Kenly; (e) a urology consultation; (f) a neurology consultation; (g) 16 hours of home health assistance every week; and (h) eight visits of additional chiropractic treatment for the neck and back.            In its petition, State Fund contends: (1) its UR determination was timely and, therefore, the WCJ’ s Order of medical treatment that was denied through UR was improper; and (2) the WCJ’s Order of medical treatment for body parts that have not been determined as industrial was also improper./ / / ,             Applicant filed an Answer. The WCJ prepared a Report

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