In this en banc decision after reconsideration, the WCAB affirmed its April 20, 2011 holding that where an injured worker obtains unauthorized treatment outside a validly established and properly noticed MPN, the resulting non-MPN treatment reports are inadmissible and may not be relied upon to award benefits, including temporary disability indemnity. Applicant Elayne Valdez initially treated within the employer's MPN with Dr. Nagamoto but, on her attorney's referral, began treating with non-MPN physician Dr. Nario, whose reports the WCJ relied on to award temporary disability. The Board reasoned that the non-MPN physician cannot be the primary treating physician (PTP) since the MPN treater remains the PTP, and only the PTP renders opinions on medical issues necessary to determine eligibility for compensation. The Board grounded its holding not solely on Labor Code section 4616.6 but on the broader MPN statutory scheme, AD Rule 9785, and the Rushing decision. The Board affirmed its decision and remanded for determination of whether the MPN was validly established and properly noticed. The Board separately dismissed the petition of Armando Saldivar, an applicant in a different case, finding him not aggrieved under section 5900(a) in the present matter.
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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Provider takeaway
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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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