Luis Beltran Witron — ADJ13620994

Applicant Luis Beltran Witron sought reconsideration of a WCJ's Findings and Award denying him the right to treat outside defendant's Medical Provider Network (MPN). Applicant claimed entitlement to treat outside the MPN because defendant delayed in responding to his September 21, 2020 request to change his primary treating physician to NMCI Medical Clinic and failed to timely set an initial appointment. The Board found that although defendant delayed responding until February 2021, applicant presented no evidence of any treatment or attempts to obtain treatment after his September 2020 request, and failed to meet his burden of proving a neglect or refusal to provide care. The Board also held that AD Rule 9767.5(g)'s 20-day appointment requirement applies only to specialist referrals scheduled through a medical access assistant (MAA), not to initial appointments with a primary treating physician, and applicant never sought MAA assistance. The petition was denied.