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PanelRemanded

Ernst, John

JOHN ERNST, Applicant vs. GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER/COMMONSPIRIT HEALTH, administered by SEDGWICK, Defendants

ADJ number: ADJ16747878
Decision date: Feb 11, 2026
District office: Los Angeles
WCJ: —
Claim administrator: Sedgwick
Commissioners: ANNE SCHMITZ, DEPUTY COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: left shoulder

LC §3202.5LC §4600LC §4604.5LC §5313

Summary

Applicant John Ernst, a registered nurse, sustained an admitted left shoulder injury on July 23, 2021. His PTP requested authorization for three series of orthovisc injections, and an April 19, 2022 UR was stipulated to be untimely; a later May 2, 2022 UR modified the request to approve one orthovisc injection. After an expedited trial, the WCJ found the three-series treatment not medically necessary, stating no evidence supported medical necessity. The Board granted reconsideration and rescinded the F&O because the WCJ failed to explain how the May 2, 2022 UR (approving one injection) and Dr. Yacoubian's July 27, 2022 report (stating the single injection significantly helped) failed to rebut the MTUS. The matter was returned to the trial level to develop the record on medical necessity.

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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Similar decisions

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Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.