Chavez, Darrin

Applicant Darrin Chavez, a Ready-Mix concrete driver, sustained a catastrophic industrial brain injury on May 25, 2018, resulting in TBI, seizures, cognitive deficits, and other impairments. Defendant initially authorized and continuously provided home health care services (RN, LVN, and attendant care) following his June 2020 discharge from Casa Colina, but then discontinued those services through a series of UR non-certifications. The WCJ found defendant could not unilaterally terminate previously-authorized services under Patterson v. The Oaks Farm absent substantial medical evidence of a change in applicant's condition or circumstances. On reconsideration, the Board granted defendant's petition but, as its Decision After Reconsideration, rescinded the F&O and substituted findings affirming that defendant failed to meet its burden of establishing a change of circumstances or condition warranting review of medical necessity. The Board ordered defendant to continue providing RN, LVN, and attendant care services and deferred all other issues, including the 'catastrophic' finding and section 4610(i)(3) applicability.