What the panel ordered
The Appeals Board grants the Petition for Reconsideration and defers issuance of a final decision pending further review of the merits and the entire record.
Applicant seeks reconsideration of the Findings of Fact and Order issued by the WCJ on June 27, 2024, which found the UR of the January 25, 2023 treatment request untimely and the treatment not reasonable or necessary. The WCJ's decision was vacated and the matter set for further review.
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
The Appeals Board found the WCJ erred in deeming the treatment moot due to passage of time, granting reconsideration to further review the merits and evidence of treatment necessity.
From the decision · page 1Applicant seeks reconsideration of the Findings of Fact and Order issued by the workers' compensation administrative law judge (WCJ) in this matter on June 27, 2024. In that decision, the WCJ found in pertinent part that applicant, while employed on June 3, 2021 as a gardener by defendant, sustained industrial injury arising out of and in the course of his employment to the head, neck, and concussion. The WCJ further found that the Utilization Review (UR) of the January 25, 2023 treatment request for authorization (RFA) was untimely, however the treatment requested in the RFA was not reasonable or necessary. Further, that the issue was moot as a new determination could now be obtained under Labor Code section 4610(k)1, and that Patterson2 does not apply to this case at this time.