Mendoza, Eddie

Applicant Eddie Mendoza sustained an industrial injury on February 7, 2022 to his head, neck, and back, including a traumatic brain injury, while working as a laborer, and received residential rehabilitation care at Casa Colina. After a July 10, 2024 RFA for continued 24-hour residential care was denied by UR and upheld by IMR, the WCJ found defendant failed to establish a change of circumstances under Patterson v. The Oaks Farm and ordered defendant to continue paying for care after July 24, 2024. Defendant sought reconsideration, arguing the WCJ ignored evidence of changed circumstances and that the timely UR/IMR denial was controlling. The Appeals Board granted reconsideration to further study the issues, noting unresolved questions about whether a care plan was created under section 4610(i)(4)(C), the effect of the timely UR/IMR, and the need to potentially develop the record given over a year of additional medical reporting and Dr. Patterson's deposition. The Board deferred a final decision pending further review.