WCPanelIQ
PanelGranted in Part

Link, Darrel

DARREL LINK, Applicant vs. NORTHROP GRUMMAN SYSTEMS CORPORATION; AIU INSURANCE COMPANY, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., Defendants

ADJ number
ADJ16034617
Decision date
Aug 11, 2025
District office
Van Nuys
WCJ
—
Claim administrator
Sedgwick Claims Management Services, Inc. (administering AIU Insurance Company)
Commissioners
CRAIG SNELLINGS, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER

Injury / body parts: head, neck, back, ribs, lungs, right shoulder, clavicle, left hand, nervous system, brain (traumatic brain injury), psyche (mood disorder)

LC §3600LC §3207LC §4600LC §4604LC §4610LC §4610.3LC §4610.5LC §5300LC §5301LC §5304LC §5307.27LC §5900LC §5904LC §5909CCR §10109

Summary

Applicant Darrel Link, an aircraft mechanic, claimed industrial injury on March 17, 2022. His treating physician submitted a November 8, 2023 RFA for a transitional living center residential rehabilitation program and medications, which defendant's UR certified as medically necessary on November 16, 2023. Defendant later denied liability on an intoxication defense, which it lost, and then sought to vacate its own UR certification on the theory that the prescribing physician was no longer available. The WCJ found the UR certified the treatment and that the court lacked jurisdiction to alter the medical-necessity determination, ordering defendant to authorize the treatment. The Board granted reconsideration only to admit the trial exhibits and to amend a finding to state the November 16, 2023 UR determination was timely and valid, otherwise affirming the order that defendant comply with its own UR certification.

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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