WCPanelIQ
SignificantRemanded

J Deanna Brasher

DEANNA BRASHER, Applicant vs. NATIONWIDE STUDIO FUND; and STATE COMPENSATION INSURANCE FUND, Defendant(s).

ADJ number
—
Decision date
Date unavailable
District office
Oakland
WCJ
—
Claim administrator
State Compensation Insurance Fund
Commissioners
—

Injury / body parts: spine

LC §4060LC §4061LC §4062LC §4062.1LC §4062.2LC §4610LC §5307.3LC §5307.4CCR §9788.1CCR §9788.11

Summary

Applicant Deanna Brasher, a photographer, sustained an industrial spine injury on April 22, 2002. Her treating physician requested approval for a spinal cord stimulator trial, and defendant both submitted the request to utilization review (resulting in denial) and timely objected on DWC Form 233 under Labor Code section 4062(b). The DWC Medical Unit rejected defendant's timely objection, requiring the treating physician to first appeal the UR denial before a second-opinion surgeon would be selected. The WCJ upheld the Medical Unit's procedure and denied surgery without prejudice pending the second opinion. On reconsideration, the WCAB reversed, holding that the Medical Unit's scheme was an improper delay unsupported by statute, and that the second opinion process should be completed and decided on the merits by the WCJ.

Issues

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Holding

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Analysis

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Provider takeaway

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