Fund
by WCAB
decision after
reconsideration panel
decision
normally report on
panel decisions.
significance.
April 22, 2002. The treating
doctor requested a trial of spinal
cord stimulation. The defendant
referred the request to utilization
review. Utilization review denied
a DWC Form 233 Objection to
Treating Physician's
Recommendation for Spinal
Surgery. The case went to trial
and the Workers' Compensation
Judge (WCJ) awarded the spinal
surgery. The defendant petitioned
for reconsideration. The
following opinion was generated
by the Workers' Compensation
Appeals Board (WCAB).
spinal surgery, an employer has
the following options: 1)
authorize the surgery, 2) object
to the surgery, pursuant to 4062
(b), by filing a DWC Form 233
within 10 days of receipt of the
doctor's recommendation, 3)
submit the recommendation to
utilization review, or 4) pursue
both options 2 and 3, either
simultaneously or by filing an
objection after a utilization
review denial, meeting the time
lines for each process. The
under the second opinion
procedures in section 4062 (b)."
Just because the WCAB did not
meet its time lines is no reason to
penalize the defendant.
Therefore, the procedure must be
completed even if the WCAB
does not act timely. Only at that
point can the WCJ make a
decision. The decision must then
be based on the merits of each
individual case.
Firm: Samuelsen, Gonzalez,
Valenzuela and Brown
Address: 18500 Von
Karman #470, Irvine
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