WCPanelIQ
PanelRemanded

Sevillano, Peter

PETER SEVILLANO, Applicant vs. LMS TRANSPORT; NATIONAL INTERSTATE INSURANCE, Defendants

ADJ number
ADJ10649854
Decision date
Aug 10, 2023
District office
Van Nuys
WCJ
—
Claim administrator
National Interstate Insurance Company
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, CRAIG SNELLINGS, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER
CCR §10961

Summary

Defendant National Interstate Insurance, the carrier for LMS Transport, petitioned for reconsideration of a March 9, 2022 WCJ decision that found applicant Peter Sevillano entitled to home health care in the form of LVN-level care and certified nurse's assistant care for 12 hours per day, 7 days per week. Defendant argued the WCJ erred because a subsequent RFA by Dr. Wogensen superseded the initial RFA by Dr. Miller. After the Board granted reconsideration and held a commissioners' settlement conference, the parties agreed to resolve the matter via Compromise and Release as to all issues. Because the District Office is precluded from acting on a case pending reconsideration under CCR section 10961, the Board rescinded the March 9, 2022 decision and returned the matter to the WCJ to consider the C&R. The Board emphasized its decision was not a ruling on the merits.

Issues

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Holding

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Analysis

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Applicant takeaway

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Defense takeaway

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Provider takeaway

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