ADJ9337517 — California WCAB decision

What the panel ordered

Defendant's Petition for Reconsideration denied; WCJ's Findings and Order of May 13, 2021 affirmed

Petition for Reconsideration filed by Defendant; WCJ decision dated May 13, 2021 affirmed after reconsideration

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.

Medical treatment / UR / IMRApplicant prevailed

Defendant did not meet burden of proof that applicant unreasonably refused medical care because no care was ever offered to applicant.

From the decision · page 6The burden of proof rests upon the party holding the affirmative of the issue. Labor Code Section 3202.5. Defendant alleges applicant unreasonably refused medical care. It is this Court's determination that no care was ever offered to applicant. The Defendant's own witness testified that no care was to be offered when Continuity Care initially went to applicant's home. Continuity Care seemed to have no knowledge of the evaluation provided by Sue Coleman, and no knowledge of her recommendations. Continuity Care did not even have knowledge as to whom had referred them to applicant in the first place. Pursuant

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

The rules the panel named

Authorities as the decision cited them, with how this panel applied each one.

Labor Code Section 3202.5

Burden of proof rests upon the party holding the affirmative of the issue

Defendant alleged applicant unreasonably refused medical care; burden on defendant to prove refusal

From the decision · page 6The burden of proof rests upon the party holding the affirmative of the issue. Labor Code Section 3202.5. Defendant alleges applicant unreasonably refused medical care. It is this Court's determination that no care was ever offered to applicant. The Defendant's own witness testified that no care was to be offered when Continuity Care initially went to applicant's home. Continuity Care seemed to have no knowledge of the evaluation provided by Sue Coleman, and no knowledge of her recommendations. Continuity Care did not even have knowledge as to whom had referred them to applicant in the first place. Pursuant

Labor Code Section 5702; County of Sacramento v. Workers' Comp. Appeals Bd. (Weatherall) (2000) 77 Cal.App.4th 1114; Labor Code Section 4600; California Code of Regulations, title 8, section 10742

Defendant remains obligated to provide home health care 24/7 pursuant to parties' stipulations

Defendant must provide home health care as stipulated; disputes over manner of care may be brought to Appeals Board

From the decision · page 1As outlined in the WCJ's report, the evidentiary record shows that home health care was not actually offered to applicant. We therefore do not address whether applicant's December 28, 2020 letter constituted a refusal of care. Our decision here should thus not be construed as an explicit or implicit endorsement of whether applicant's request regarding nurses' COVID-19 testing information is reasonable. Defendant remains obligated to provide home health care to applicant 24 hours per day, 7 days per week pursuant to the parties' December 10, 2020 stipulations. (See Lab. Code, § 5702; see also County of Sacramento v. Workers' Comp. Appeals Bd. (Weatherall) (2000) 77 Cal.App.4th 1114 [65 Cal.Comp.Cases 1]; Lab. Code, § 4600.) If there is a dispute over the manner in which this care is offered or provided in the future, either party may seek intervention from the Appeals Board as warranted following a genuine, good faith effort to resolve the dispute informally. (Cal. Code Regs., tit. 8, § 10742.)

ADJ9337517 · January 25, 2022

What the panel ordered

What was disputed, and how it came out

The facts that decided it

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The rules the panel named

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