Velasquez, Odilio

Applicant Odilio Velasquez, a 56-year-old laborer, sustained an admitted industrial injury to his head, brain, neck, and back on July 6, 2019, requiring home health care services that were authorized via utilization review (UR) beginning October 2022 and provided for approximately one year. After a November 22, 2023 UR non-certification discontinued the services, the WCJ found defendant failed to establish a change in applicant's condition or circumstances warranting renewed UR, and ordered continuation of home health care at 28 hours per week under Patterson v. The Oaks Farm. Defendant sought reconsideration, arguing that Patterson applies only where treatment was unilaterally and voluntarily provided, not where it was mandated by UR. The Appeals Board denied reconsideration, holding that Patterson applies to ongoing previously authorized treatment regardless of whether it was originally authorized through UR, and that defendant bears the burden of proving a material change in condition before ceasing such treatment without shifting the burden back to applicant through new RFA/UR/IMR processes.