CompFox AI Summary
The Workers' Compensation Appeals Board granted reconsideration, reversing a prior administrative law judge decision that denied an applicant's appeal of an Independent Medical Review (IMR). The Board found the IMR determination was based on a plainly erroneous factual finding regarding the necessity of the applicant's prescribed medication, Vimovo, which violated Labor Code section 4610.6(h)(5). Because the IMR acted in excess of its powers due to this error, the case is remanded for a new IMR review by a different reviewer.
Full Decision Text1 Pages
The Workers' Compensation Appeals Board granted reconsideration, reversing a prior administrative law judge decision that denied an applicant's appeal of an Independent Medical Review (IMR). The Board found the IMR determination was based on a plainly erroneous factual finding regarding the necessity of the applicant's prescribed medication, Vimovo, which violated Labor Code section 4610.6(h)(5). Because the IMR acted in excess of its powers due to this error, the case is remanded for a new IMR review by a different reviewer.
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