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PanelMed-legalDenied

Lura Brown — ADJ2648619

LURA BROWN, Applicant vs. SCRIPPS HEALTH, Permissibly Self-Insured, Defendant

ADJ number: ADJ2648619
Decision date: Jan 18, 2022
District office: San Diego District Office
WCJ: —
Claim administrator: Scripps Health (Permissibly Self-Insured); Sedgwick (third-party administrator referenced)
Commissioners: —

Injury / body parts: neck, back, right shoulder, right arm, right wrist, psyche, left knee, mouth, leg

LC §5814.5LC §4610LC §4610.5LC §4062LC §4062.2

Summary

Applicant Lura Brown sustained an admitted industrial injury on October 1, 2004 while working as a receptionist for Scripps Health, resulting in a 2009 stipulated award including future medical treatment. When a 2012 utilization review denied multiple treatment requests (durable medical equipment, swallow consultation, psychiatric pain treatment, neurological testing), applicant's counsel objected under the pre-2013 Labor Code section 4062/4062.2 process and obtained AME reports from Dr. Tung confirming the treatments were reasonable and necessary. Despite the AME findings, defendant unreasonably delayed providing the treatment until May 2019, requiring three expedited hearings and approximately seven years of effort. The WCJ awarded $5,000 in section 5814.5 attorney's fees for enforcing the medical award, and the WCAB affirmed on reconsideration, adopting the WCJ's Report.

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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Similar decisions

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Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.