Home/Case Law/ALEX ORTEGA vs. AWHS, INC., VIRGINIA SURETY COMPANY, APPLIED RISK SERVICES (Claims Administrator)
Regular Decision

ALEX ORTEGA vs. AWHS, INC., VIRGINIA SURETY COMPANY, APPLIED RISK SERVICES (Claims Administrator)

Filed: Jan 12, 2012
San Francisco
ADJ2585403

CompFox AI Summary

This case involves a dispute over Trazamine medication for an industrial injury. The Appeals Board affirmed the Workers' Compensation Judge's award of Trazamine, finding the defendant's utilization review denials were legally invalid. The Board determined that Labor Code section 4062 procedures were not triggered by the invalid denials and dismissed the defendant's ex-parte communication claim as inapplicable to pre-2005 injuries. Consequently, the applicant is entitled to Trazamine as prescribed by his treating physician.

Full Decision Text1 Pages

This case involves a dispute over Trazamine medication for an industrial injury. The Appeals Board affirmed the Workers' Compensation Judge's award of Trazamine, finding the defendant's utilization review denials were legally invalid. The Board determined that Labor Code section 4062 procedures were not triggered by the invalid denials and dismissed the defendant's ex-parte communication claim as inapplicable to pre-2005 injuries. Consequently, the applicant is entitled to Trazamine as prescribed by his treating physician.

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