ROBERT ACEVEDO, Applicant vs. OLD DOMINION FREIGHT LINE, INC., and ACE AMERICAN INSURANCE COMPANY, administered by GALLAGHER BASSETT SERVICES, INC., Defendants
ADJ number
ADJ12595156
Decision date
Apr 28, 2024
District office
Van Nuys
WCJ
Robert Sommer
Claim administrator
Gallagher Bassett Services, Inc. (administering for Ace American Insurance Company)
Commissioners
—
Injury / body parts: head, brain, lungs, lower extremities
Applicant Robert Acevedo, a truck driver, claimed industrial injury to his head, brain, lungs, and lower extremities on September 26, 2019. A neurologist, Dr. Nudleman, was authorized through UR as a 'consult' (not a treating physician), and he subsequently requested diagnostic testing (EEG, QEEG, Cognitive P300 evoked response) stating that upon completion impairment ratings, future medical care, and work limitations would be determined. Defendant submitted the request to UR/IMR, which denied the diagnostics as not medically necessary, and argued the WCAB lacked jurisdiction over UR/IMR determinations. The WCJ found, and the Appeals Board affirmed, that the requested testing was not 'medical treatment' under Labor Code section 4600 but was more analogous to a medical-legal evaluation going to nature and extent, and therefore not subject to UR or IMR. The Board affirmed the F&O, holding it has jurisdiction over the matter.
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.
Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.