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Silvia Romo — ADJ12308686, ADJ14631476

SILVIA ROMO, Applicant vs. DAMCO DISTRIBUTION SERVICES, INC.; ACE AMERICAN INSURANCE COMPANY, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., Defendants

ADJ number
ADJ12308686, ADJ14631476
Decision date
Jun 10, 2026
District office
Los Angeles
WCJ
—
Claim administrator
Sedgwick Claims Management Services, Inc. (administering for ACE American Insurance Company)
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: head, right shoulder, low back, coccyx, left wrist

LC §4600LC §4616LC §4616.3LC §3202.5LC §5705CCR §9767.3CCR §9767.5CCR §9767.6CCR §9785

Summary

Applicant Silvia Romo sustained industrial injuries to her head, right shoulder, low back, coccyx, and left wrist, with PQME Dr. Navab recommending treatment for post-concussion syndrome and post-traumatic vertigo. She designated Casa Colina Hospital as her primary treating physician and sought to treat outside defendant's MPN, claiming the MPN lacked specialized brain injury rehabilitation facilities. The WCJ found applicant could not designate a facility (rather than an individual physician) as her PTP, that defendant did not deny care, and that applicant failed to meet her burden to treat outside the MPN where qualified neurologists were available. On reconsideration, the Board affirmed, holding that a PTP must be an actual physician and that board-certified neurologists are qualified to treat brain injuries, so the MPN met access standards.

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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