MICHELLE WHITE, Applicant vs. STRATEGIC OUTSOURCING, INC., professional employer organization for UNITED FACILITY SOLUTIONS, INC.; ACE AMERICAN INSURANCE COMPANY, administered by CANNON COCHRAN MANAGEMENT SERVICES, INC.; UNITED FACILITY SOLUTIONS, INC.; REDWOOD FIRE AND CASUALTY COMPANY, administered by BERKSHIRE HATHAWAY HOMESTATE COMPANIES, Defendants
ADJ number
ADJ12812938
Decision date
May 27, 2024
District office
Van Nuys
WCJ
David L. Pollak
Claim administrator
Berkshire Hathaway Homestate Companies (administering Redwood Fire and Casualty Company); Cannon Cochran Management Services, Inc. (administering ACE American Insurance Company)
Commissioners
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Injury / body parts: cervical spine, lumbar spine, both shoulders, both knees, teeth, jaw, temporomandibular joint (TMJ)
Michelle White claimed industrial injury to multiple body parts including teeth, jaw, and TMJ while working as a security lead. After a $50,000 compromise and release was approved in July 2022, Mayer Schames, D.D.S. (The Dental Trauma Center) filed a lien for $13,499.78 for dental treatment. The WCJ issued partial findings that the applicant sustained an industrial injury to her teeth, jaw, and TMJ based on Dr. Schames's report and found the dental treatment reasonable, but deferred the reasonableness of charges pending bill review. Redwood Fire and Casualty Company sought reconsideration, arguing the WCJ erred in finding industrial injury and reasonable treatment. The WCAB denied reconsideration, adopting and incorporating the WCJ's report which found Dr. Schames's opinion constituted substantial medical evidence and that the defendant waived retrospective utilization review by failing to notify the provider of deferral.
Issues
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Holding
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Analysis
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Applicant takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Defense takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Provider takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Similar decisions
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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