CompFox AI Summary
The applicant, Arnoldo Galvan, sustained a cumulative trauma during his employment. The defendant, Donaghy Sales, LLC, along with its insurer Sentinel Insurance Company, Ltd., and administrator Gallagher Bassett, failed to provide the correct fax number for Request for Authorization (RFA) forms to utilization review for treating physician Dr. William Foxley. The Workers' Compensation Appeals Board (WCAB) has granted the defendant's petition for reconsideration of the June 30, 2025 Findings of Fact, Award, and Orders. The WCAB found that the record was not sufficiently developed regarding the timeliness of UR determinations and the application of the Medical Treatment Utilization Schedule (MTUS). Consequently, a final decision after reconsideration has been deferred for further review of the factual and legal issues.
Full Decision Text1 Pages
The applicant, Arnoldo Galvan, sustained a cumulative trauma during his employment. The defendant, Donaghy Sales, LLC, along with its insurer Sentinel Insurance Company, Ltd., and administrator Gallagher Bassett, failed to provide the correct fax number for Request for Authorization (RFA) forms to utilization review for treating physician Dr. William Foxley. The Workers' Compensation Appeals Board (WCAB) has granted the defendant's petition for reconsideration of the June 30, 2025 Findings of Fact, Award, and Orders. The WCAB found that the record was not sufficiently developed regarding the timeliness of UR determinations and the application of the Medical Treatment Utilization Schedule (MTUS). Consequently, a final decision after reconsideration has been deferred for further review of the factual and legal issues.
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