Kenneth Hoadley — ADJ8117286

Applicant Kenneth Hoadley sustained an industrial left knee injury on November 2, 2011, and defendant authorized a surgery performed by non-MPN surgeon Dr. Stone on April 28, 2016. Because applicant resided in Oregon, defendant arranged travel, but on the day of surgery applicant was told he had to pay out of pocket and ultimately charged $17,263 to his credit card. The WCJ found applicant entitled to reimbursement in excess of the OMFS (totaling $20,049.35 including $18,353.49 for the surgery) reasoning defendant failed to make payment arrangements with the surgeon before surgery. The Appeals Board granted reconsideration and held that reimbursement for self-procured medical treatment is limited to the amount allowed under the Official Medical Fee Schedule, regardless of whether an applicant or a provider seeks reimbursement. The Board amended the Findings and Award and remanded to the trial level for the WCJ to determine the amount due under the OMFS.