KOREY RIVOTA, Applicant vs. NATIONAL CEMENT COMPANY, INC.; ARCH INSURANCE COMPANY, administered by GALLAGHER BASSETT SERVICES, INC., Defendants
ADJ number
ADJ9856812
Decision date
Jan 31, 2021
District office
Van Nuys
WCJ
David L. Pollak
Claim administrator
Gallagher Bassett Services, Inc. (administering for Arch Insurance Company)
Commissioners
—
Injury / body parts: head, brain, nose, eyes, ears, mouth, cervical spine, lumbar spine, both shoulders, both lower extremities, ribs, lungs, internal system (sleep disorder), psychiatric system, urological system (sexual dysfunction), endocrine system (diabetes), cardiovascular system (hypertension)
LC §4600
Summary
Applicant Korey Rivota, a cement truck driver, sustained extensive industrial injuries in May 2014 and was awarded 100% permanent disability with future medical treatment. Since January 2020, the defendant authorized inpatient residential care at Casa Colina's Transitional Living Center per the treating physician, but in October 2020 denied a continuation request via utilization review. The WCJ found the applicant entitled to continued residential rehabilitation absent any change in circumstances under Patterson v. The Oaks Farm, holding that the defendant could not unilaterally cease previously authorized treatment without showing changed circumstances. The WCAB denied the defendant's Petition for Reconsideration, adopting and incorporating the WCJ's report.
Issues
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Holding
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Analysis
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Applicant takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Defense takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Provider takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Similar decisions
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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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.