WCPanelIQ
PanelDenied

Sherrill Claytor — ADJ11059073

SHERRILL CLAYTOR, Applicant vs. ALEXANDER R. LATTERI, M.D.; STATE COMPENSATION INSURANCE FUND, Defendants

ADJ number
ADJ11059073
Decision date
Jan 16, 2023
District office
Anaheim
WCJ
—
Claim administrator
State Compensation Insurance Fund
Commissioners
JOSÉ H. RAZO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, PATRICIA A. GARCIA, DEPUTY COMMISSIONER

Injury / body parts: lumbar spine, left hip, left hemi-sacrum, inferior ramus, left symphysis, left pelvis, left acetabulum

LC §4600LC §4616LC §4616.3CCR §9767.9CCR §9767.12CCR §10964

Summary

Applicant Sherrill Claytor sustained an industrial injury in 2014 and treated with Dr. Curtis Spencer, a non-MPN physician, as her PTP from 2014 to 2019 with defendant's authorization. In September 2019, she selected Dr. Scott Small (asserted by defendant to be an MPN physician) as her PTP, but continued concurrently treating with Dr. Spencer; in June 2020 she requested to resume treating with Dr. Spencer as PTP. The WCJ found applicant could treat with Dr. Spencer outside the MPN, and defendant sought reconsideration. The Appeals Board affirmed, holding that defendant failed to present substantial evidence that Dr. Small was actually in the MPN or that applicant was effectively transferred into the MPN, and there was years of authorized non-MPN treatment without a valid transfer of care. The Board confirmed defendant may transfer applicant's care into the MPN in the future only by complying with the notice and transfer-of-care requirements of AD Rules 9767.9 and 9767.12.

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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