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PanelGranted

Gartz, Julie

JULIE GARTZ, Applicant vs. UNITED CONTINENTAL HOLDINGS, INC., permissibly self-insured, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., Defendants

ADJ number: ADJ15516233
Decision date: Aug 3, 2025
District office: San Francisco
WCJ: —
Claim administrator: Sedgwick Claims Management Services, Inc. (for permissibly self-insured United Continental Holdings, Inc.)
Commissioners: ANNE SCHMITZ, DEPUTY COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: bilateral wrists, bilateral shoulders, neck, bilateral elbows, bilateral thumbs (claimed)

LC §4604LC §4604.5LC §4610LC §5300LC §5803LC §5900LC §5901LC §5907LC §5908LC §5908.5LC §5909LC §5950CCR §10451.2CCR §10600

Summary

Applicant Julie Gartz sustained a stipulated specific injury on August 12, 2021 to her bilateral wrists, shoulders, neck, and elbows while working as a customer service representative. Her PTP, Dr. Timothy Lo, submitted an RFA for an 80-hour functional restoration program (FRP), which was non-certified by UR and upheld by IMR. Dr. Lo resubmitted a February 24, 2025 RFA claiming a change of material facts, but defendant cancelled the UR referral, and the WCJ found no documented change of material facts, no UR obligation, and no WCAB jurisdiction over medical necessity. The Appeals Board granted reconsideration to further review the merits, particularly the contentions regarding delay, penalties, UR obligations, and whether a change of circumstances was shown, and deferred a final decision.

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.