Alexander, Melody

Applicant Melody Alexander challenged approximately 44 UR denials of various treatment requests (adjustable bed, motorized scooter, lumbar injections) arising from a 2018 industrial injury, arguing the UR decisions were untimely because the UR physicians lacked complete/accurate medical records, were given inaccurate histories, and because the carrier allegedly interfered in the UR process. The WCJ found the UR decisions were timely under Dubon II because applicant did not contest the calendar dates or service of the decisions, and therefore the WCAB lacked jurisdiction to address medical necessity. The Board granted reconsideration, adopted the WCJ's Opinion and Report, and affirmed the decision, amending only Finding of Fact No. 1 to reflect the parties' stipulation that applicant sustained injury to her lumbar spine and left knee (correcting a clerical omission). The Board also addressed its own jurisdiction under newly amended Labor Code section 5909, concluding it timely acted on the petition within 60 days of case transmission on August 14, 2024.