WCPanelIQ
PanelMed-legalDenied

Blosser, Wayne

WAYNE BLOSSER, Applicant vs. RB SPENCER, INC., AIR CONDITIONING AND HEATING; INSURANCE COMPANY OF THE WEST, Defendants

ADJ number
ADJ15040609
Decision date
Apr 27, 2025
District office
Sacramento
WCJ
Parker Shelton
Claim administrator
Insurance Company of the West
Commissioners
—

Injury / body parts: head, neck, back, shoulders, psyche, brain, lungs, bowel, bladder, upper extremities, lower extremities, sexual dysfunction, pulmonary system, cardiovascular system

LC §5909LC §5900LC §4600LC §4610LC §4610.5LC §5502CCR §10600CCR §10109

Summary

Applicant Wayne Blosser, a 100% permanently and totally disabled HVAC installer confined to a wheelchair from multiple industrial injuries, sought home modifications to enable wheelchair access to his residence. The WCJ awarded home modifications in the form of a mobile/ADU build (up to $460,000) on applicant's property, with interim ADA-compliant apartment or skilled nursing housing pending construction. Defendant sought reconsideration arguing denial of due process, lack of WCAB jurisdiction (claiming the issue was subject to UR/IMR), and insufficient evidentiary support. The Board denied reconsideration, adopting the WCJ's Report, finding defendant had ample notice and opportunity to investigate dating back to 2021, that no genuine medical-necessity dispute existed (the parties had stipulated to wheelchair confinement and need for modifications), and that the issue was one of implementation rather than medical necessity, so UR/IMR did not deprive the WCAB of jurisdiction.

Issues

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Holding

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Analysis

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Applicant takeaway

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Defense takeaway

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Provider takeaway

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