WCPanelIQ
PanelMed-legalDenied

Valdiviezo, Carlos

CARLOS VALDIVIEZO, Applicant vs. THE OLYMPIC CLUB; THE NORTH RIVER INSURANCE COMPANY, administered by CRUM & FORSTER, Defendants

ADJ number
ADJ10885532
Decision date
Date unavailable
District office
San Francisco
WCJ
Elizabeth Dehn
Claim administrator
Crum & Forster (administering for The North River Insurance Company)
Commissioners
—

Injury / body parts: bilateral wrists, bilateral elbows

LC §5909LC §5900LC §5902LC §4616.2LC §5814LC §5814.5LC §4062CCR §10600CCR §9767.10CCR §9767.9CCR §9767.12CCR §10940CCR §10628

Summary

Applicant Carlos Valdiviezo sustained an accepted bilateral wrist and elbow injury while working as a groundskeeper for The Olympic Club. After his primary treating physician (PTP), Dr. Smolins, was terminated from defendant's Medical Provider Network (MPN), defendant sent a Notice of Terminated Provider that was English-only (despite applicant requiring a Spanish interpreter) and mailed the PTP copy to an incorrect address. The WCJ found defendant failed to comply with the continuity of care notification requirements of CCR section 9767.10(d)(1), entitling applicant to continue treating with Dr. Smolins outside the MPN at defendant's expense, and imposed a Labor Code section 5814 penalty plus section 5814.5 attorney fees for unreasonable delay of medical care. The Appeals Board denied reconsideration, adopting and incorporating the WCJ's Report and Opinion on Decision.

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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