Sophia Calix, vs. Target Corporation, Permissibly Self-insured And Administered By Sedgwick, claims Management Services,

This case is about Target Corporation, a permissibly self-insured and administered by Sedgwick, Claims Management Services, and Sophia Calix, an applicant. The Workers' Compensation Appeals Board granted Target Corporation's Petition for Reconsideration and rescinded the June 3, 2009 Findings and Order issued by a workers' compensation administrative law judge (WCJ). The WCJ found that Target Corporation had not properly complied with Administrative Director (AD) Rules 9767.9 and/or 9767.12 and that Sophia Calix could treat outside of Target Corporation's Medical Provider Network (MPN). The Appeals Board found that Target Corporation had provided timely notification of its MPN and that Sophia Calix had received treatment from an MPN facility

TARGET CORPORATION, Permissibly Self-Insured and Administered By SEDGWICK, CLAIMS MANAGEMENT SERVICES, SOPHIA CALIX, WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIASOPHIA CALIX, Applicant,vs.TARGET CORPORATION, Permissibly Self- Insured and Administered By SEDGWICK,CLAIMS MANAGEMENT SERVICES, Defendant(s).Case No. ADJ6538283OPINION AND ORDER GRANTING PETITION FOR RECONSIDERATION AND DECISION AFTER RECONSIDERATION            Defendant seeks reconsideration of the June 3, 2009 Findings and Order issued by a workers’ compensation administrative law judge (WCJ). In that decision, the WCJ found that defendant had not properly complied with Administrative Director (AD) Rules 9767.9 and/or 9767.12 (Cal. Code Regs., tit. 8, §§ 9767.9 and/or 9767.12), and that defendant had neither a factual nor a legal basis for denying treatment outside of its Medical Provider Network (MPN). The WCJ found that applicant could treat outside defendant’s MPN.            In its Petition for Reconsideration, defendant contends that the WCJ erred in finding that it had not complied with the regulations as to timely notice to applicant of its MPN as the evidence does not support this decision. Defendant argues that documents admitted into evidence and applicant’s testimony at trial show that defendant provided applicant with timely notification, as does the fact that applicant obtained treatment from defendant’s MPN facility on the date of her injury. Defendant also argues that although AD Rule 9767.9 allows applicant to treat outside the MPN if the condition is “acute,”‘ applicant’s condition in this matter was not 1AD Rule 9767.9 provides that an acute condition is “a medical condition that involves a sudden onset of symptoms due to an illness, injury, or other medical problem that requires prompt medical attention and that has a duration of less than 90 days. Completion of treatment shall be provided for the duration of the acute condition.” (Cal. Code Regs., tit. 8, § 9767.9, subd. (e

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