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En BancMed-legalGranted

Elayne Valdez

ELAYNE VALDEZ, Applicant vs. WAREHOUSE DEMO SERVICES; ZURICH NORTH AMERICA, Adjusted by ESIS, Defendant(s).

ADJ number: —
Decision date: Date unavailable
District office: —
WCJ: —
Claim administrator: ESIS (adjusting for Zurich North America)
Commissioners: Joseph M. Miller JOSEPH M. MILLER, CHAIR, Ronnie G. Caplane RONNIE G. CAPLANE, COMMISSIONER, Alfonso J. Moresi ALFONSO J. MORESI, COMMISSIONER, Deidra E. Lowe DEIDRA E. LOWE, COMMISSIONER

CCR §10848

Summary

On April 20, 2011, the Appeals Board issued an en banc decision holding that where unauthorized treatment is obtained outside a validly established and properly noticed Medical Provider Network (MPN), reports from non-MPN doctors are inadmissible, may not be relied upon, and defendant is not liable for the cost of those reports. Applicant Elayne Valdez filed a timely petition for reconsideration on May 16, 2011, with defendant answering and applicant filing an allowed supplemental pleading. The Board, considering statutory time constraints, granted reconsideration to allow further study of the factual and legal issues in order to issue a just and reasoned decision. The order directed that all further correspondence be filed with the Office of the Commissioners in San Francisco pending issuance of a Decision After Reconsideration.

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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Similar decisions

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Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. 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.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. 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.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. 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.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. 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.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. 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.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. 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.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. 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.