WCPanelIQ
PanelGranted

Guritzky, Dawn Leah

DAWN LEAH GURITZKY, Applicant vs. REGENTS OF THE UNIVERSITY OF CALIFORNIA, SANTA MONICA UCLA MEDICAL CENTER; Permissibly Self-Insured Administered, Administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, Defendants

ADJ number
ADJ268422
Decision date
Jan 4, 2026
District office
Marina del Rey
WCJ
—
Claim administrator
Sedgwick Claims Management Services (for permissibly self-insured Regents of the University of California, Santa Monica UCLA Medical Center)
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, PATRICIA A. GARCIA, DEPUTY COMMISSIONER

Injury / body parts: back, shoulders, psyche

LC §5950LC §5909LC §5900LC §4600LC §4610LC §4610.5LC §4610.6LC §4062LC §139.5LC §5307.1LC §5307.8LC §5814.5LC §5813LC §5903LC §5952LC §5907LC §5908LC §5908.5LC §5803LC §5901CCR §10600CCR §10109

Summary

Applicant Dawn Leah Guritzky, a nurse who sustained an industrial injury to her back, shoulders, and psyche on February 10, 2004, sought reconsideration of a September 10, 2025 Findings and Order. The WCJ had denied her appeal of an IMR Final Determination that upheld a UR denial of home health care services, finding the IMR was not based on plainly erroneous facts under Labor Code section 4610.6(h)(5), and ordered further development of the record on sanctions/duty-to-investigate issues. Applicant argued the IMR determination misread the MTUS regarding homecare for activities of daily living (ADLs) and that the WCJ erred in ordering further development. The Board granted reconsideration, finding it unclear from preliminary review whether the record was sufficient to support the WCJ's decision, particularly where IMR failed to consider the in-home ADL assessment by Continuity Home Care (Applicant's Exhibit 46). A final decision after reconsideration was deferred pending further review of the merits.

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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