WCPanelIQ
PanelGranted in Part

Liliana Perez — ADJ6877517

LILIANA PEREZ, Applicant vs. E&J GALLO WINERY, permissibly self-insured, Defendants

ADJ number
ADJ6877517
Decision date
May 24, 2021
District office
Stockton
WCJ
—
Claim administrator
E&J Gallo Winery (permissibly self-insured)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, MARGUERITE SWEENEY, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: right shoulder

CCR §10507CCR §10605

Summary

Applicant Liliana Perez sought reconsideration of a WCJ's January 10, 2020 Findings of Fact and Order holding that a request for an orthopedic surgical consultation for the right shoulder is a form of treatment subject to utilization review (UR) and, by extension, independent medical review (IMR). After the F&O issued, applicant submitted a February 10, 2020 IMR determination that apparently allowed the disputed surgical consult. The Board, having previously granted reconsideration to further study the issues, issued a Notice of Intention to admit the February 10, 2020 IMR determination into evidence as Applicant's Exhibit 2. The Board noted that subsequent developments may have rendered the dispute moot and requested that applicant withdraw the Petition if the matter had been resolved, to conserve judicial resources. The parties were given 25 days to object before the matter would be deemed submitted for decision after reconsideration.

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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