Ramiro Giron — ADJ15322493

Applicant Ramiro Giron, a tree trimmer, sought authorization for L5/S1 anterior and posterior spinal fusion surgery via an RFA submitted by Dr. Athanassious. The WCJ found the UR denial timely, reasoning that the reviewer's unsuccessful telephonic attempts to reach the treating physician extended the UR timeline from five days to fourteen days, and that the WCAB lacked jurisdiction to overrule the determination. On reconsideration, the Board found the WCJ improperly relied on the now-obsolete Smith v. Scholle Packaging panel decision, which interpreted repealed former section 4610(g)(1), rather than current section 4610(i) and (j). The Board determined the RFA was received September 4, 2025, requiring UR action by September 11, 2025, and found no evidence of written notice for additional information as required under section 4610(j)(2), nor any proof of service for the determination. The Board granted reconsideration, rescinded the F&O, and returned the matter to the trial level for further proceedings, including identification of the date of injury, ruling on Exhibit A admissibility, and proper exhibit identification.