Albarran, Alejandra

Applicant Alejandra Albarran, a housekeeper who claimed a 2008 industrial injury, sought reconsideration of a July 26, 2023 F&O concerning medical transportation. The treating physician submitted an RFA on October 22, 2021 for transportation to a single October 29, 2021 appointment, and claims administrator Sedgwick CMS issued a letter on October 27, 2021 declining to review it on the ground that transportation 'is not a medical procedure.' The WCJ had found this letter was a timely UR denial but that the record did not support ongoing transportation to all appointments. The Appeals Board granted reconsideration and affirmed the decision, except it amended Finding of Fact No. 5 to reflect that defendant's letter was NOT a UR decision because the defendant declined to perform utilization review—meaning the WCAB had jurisdiction over the medical necessity dispute. However, the Board agreed with the WCJ that both RFAs requested transportation only for a single 2021 appointment, and a broader blanket request was not substantiated by the record.