WCPanelIQ
PanelGranted

Saldana, Joel

JOEL SALDANA, Applicant vs. ATHENS BAKING COMPANY, COMPWEST INSURANCE COMPANY, administered by COMPWEST, Defendants

ADJ number
ADJ6609179
Decision date
Oct 22, 2023
District office
Fresno
WCJ
—
Claim administrator
CompWest Insurance Company, administered by CompWest
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, JOSEPH V. CAPURRO, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER
LC §4307.8LC §5307.8LC §4603.2LC §4600LC §3600LC §5307.1LC §5903LC §5952LC §5313LC §5310LC §123.7LC §5309LC §5907LC §5908LC §5908.5LC §5803LC §5901LC §5950CCR §10962CCR §10787

Summary

Applicant Joel Saldana sought reconsideration of a WCJ's Findings of Fact and Orders that denied further reimbursement for home health care services because applicant allegedly failed to produce detailed records of services and dates under Labor Code section 5307.8 (misstated as 4307.8) and Neri Hernandez. The WCJ also ordered Dr. Calhoun's reporting on homecare to be submitted to Utilization Review. Applicant argued that section 4603.2(b)(1)'s itemization requirement concerns payment, not the injured worker's burden of proof under sections 4600(h) and 5307.8, and that there was no basis to send Dr. Calhoun's reporting to UR. The Appeals Board granted reconsideration, finding on preliminary review that applicant proved home health care was reasonably required and industrially caused, but that the record lacked stipulations, issues, and any explanation for the UR finding. The Board deferred a final decision and ordered the matter set for a status conference and likely return to the trial level to create an adequate record.

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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