BRUCE KELLY, Applicant vs. COMMUNICATION TECHNOLOGY SERVICES LLC and MASSACHUSETTS BAY INSURANCE COMPANY, administered by THE HANOVER INSURANCE GROUP, Defendants
ADJ number
ADJ11998537
Decision date
Jun 8, 2023
District office
Van Nuys
WCJ
Jiblet Croft
Claim administrator
The Hanover Insurance Group (administering Massachusetts Bay Insurance Company)
Commissioners
—
Injury / body parts: head, brain, eyes, ears, jaw/TMJ, psyche, cervical spine, both shoulders, lumbar spine, both knees
Summary
Bruce Kelly, a wire and cable installer, sustained an admitted traumatic brain injury on January 24, 2019, after falling from a ladder. The WCJ found that a June 10, 2022 Utilization Review non-certification was untimely due to improper service on applicant's attorney, that inpatient neuro rehabilitation was reasonable and necessary, and that applicant was entitled to Nurse Case Manager services. Defendant sought reconsideration, arguing applicant failed to meet his burden of proof for the inpatient treatment and nurse case manager services. The WCAB panel adopted and incorporated the WCJ's Report and denied reconsideration, finding the awards supported by the treating physician's opinions, the MTUS guidelines, and applicant's credible testimony showing a change/deterioration in his condition. The panel emphasized that nurse case manager services constitute a form of medical treatment under Patterson v. The Oaks Farm.
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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