WCPanelIQ
PanelGranted

Kimberly Dicato — ADJ14808720

KIMBERLY DICATO, Applicant vs. GOOD SAMARITAN HOSPITAL permissibly self-insured, administered by ATHENS ADMINISTRATORS, Defendants

ADJ number
ADJ14808720
Decision date
May 15, 2022
District office
Van Nuys
WCJ
—
Claim administrator
Athens Administrators (TPA for permissibly self-insured Good Samaritan Hospital)
Commissioners
DEIDRA E. LOWE, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: COVID-19, respiratory system (shortness of breath, coughing), head (headaches), heart (palpitations), hands (numbness), psyche (depression), loss of smell, loss of taste, hair loss, sleep

LC §4600LC §4603.2LC §4616LC §4622LC §5702CCR §9767.5

Summary

Applicant Kimberly Dicato, a nurse, claimed a COVID-19 injury accepted by her self-insured employer Good Samaritan Hospital, administered by Athens Administrators. After applicant designated a non-MPN physician as her PTP and defendant objected, the WCJ found defendant's MPN invalid, found applicant had medical control under Labor Code sections 4600(c) and 4603.2, and allowed her to select Robert Weber, M.D. as PTP. Defendant petitioned for reconsideration. The WCAB granted reconsideration, holding that the WCAB and WCJ lack jurisdiction to declare an approved MPN invalid because such disputes must be petitioned to the Administrative Director under Labor Code section 4616. The Board rescinded the F&O and remanded for the WCJ to consider whether defendant's conduct constituted a refusal to provide treatment and to issue a new decision based only on admitted evidence.

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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