Applicant Candace Porter sustained an admitted industrial injury to her lower back while working as a copy service technician for Kyocera Document Solutions. A dispute arose over an IMR determination dated June 20, 2023 that affirmed UR's non-certification of treatment (home health and driving evaluation, and CT/MRI scans) requested by her primary treating physician, Dr. Kambiz Hannani. The WCJ rescinded the IMR determination, finding clear and convincing evidence of plainly erroneous findings of fact under Labor Code section 4610.6(h)(5), and remanded the matter to the Administrative Director for a new IMR by a different reviewer. Defendant Travelers petitioned for removal, arguing the determination was mooted by a second RFA/UR, that the wrong standard of proof was applied, and that the WCJ exceeded the scope of the appeal. The Board treated the petition as a petition for reconsideration (because an IMR determination is a final order on a threshold issue) and denied it, adopting the WCJ's Report.
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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