Arteaga, Sonia

Lien claimant Medland Medical sought reconsideration of a WCJ's June 28, 2024 Findings and Order that deferred the issue of medical treatment reimbursement pending retrospective utilization review (UR). Applicant, an auditor, sustained a cumulative trauma injury and settled her claim via Compromise and Release for $35,000. Medland argued that defendant Zenith Insurance waived its right to conduct retrospective UR by failing to timely respond to each request for authorization (RFA). The Board denied reconsideration, adopting the WCJ's Report, finding that Zenith timely deferred UR on a non-medical-necessity basis in response to the first RFA on 10/24/2022, which exempted it from issuing delay notices to subsequent RFAs under CCR 9792.9.1(b)(1). The Board also addressed Labor Code section 5909 timeliness, concluding it timely acted within 60 days of case transmission.