WCPanelIQ
PanelRemanded

Johnny Baird — ADJ10267198

JOHNNY BAIRD, Applicant vs. WAREHOUSE SPECIALISTS, INC.; TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA, Defendants

ADJ number
ADJ10267198
Decision date
Sep 23, 2021
District office
Van Nuys
WCJ
—
Claim administrator
Travelers Property Casualty Company of America
Commissioners
JOSÉ H. RAZO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER

Injury / body parts: various body parts

LC §5900LC §5902LC §5903LC §4610LC §5313LC §5701LC §5906CCR §10843CCR §10955CCR §10544CCR §10750CCR §10341CCR §10325

Summary

Johnny Baird, a warehouse worker, claimed a cumulative industrial injury (1/11/2015–1/11/2016) and sought 24-hour home healthcare services requested in primary treating physician Dr. Saeed Nick's February 14, 2020 RFA. The WCJ found AOE/COE injury, that the utilization review of the 2/14/2020 RFA was untimely, but that Dr. Nick's reporting was not substantial medical evidence. Applicant sought reconsideration/removal seeking an award of home healthcare or further development of the record; defendant did not dispute the UR timeliness finding but argued the treatment was not reasonable or medically necessary. The Board treated the petition as one for reconsideration, finding the medical treatment and UR timeliness issues to be final/threshold orders. Crucially, the Board found that the February 14, 2020 RFA itself was never admitted into evidence at the Expedited Trial, making it impossible to evaluate the basis for the WCJ's findings. The Board rescinded the June 16, 2021 Findings of Fact and returned the matter to the WCJ for further proceedings.

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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