CompFox AI Summary
The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration, rescinding a prior finding that the Utilization Review (UR) denial and subsequent Independent Medical Review (IMR) upholding it were flawed. The Board found the applicant failed to prove by clear and convincing evidence that the IMR determination was based on a plainly erroneous factual finding not subject to expert opinion. Consequently, the Board affirmed the IMR determination, upholding the denial of the request for authorization of Fioricet medication. The original order for further record development was rescinded as not being the proper remedy under the relevant statute.
Full Decision Text1 Pages
The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration, rescinding a prior finding that the Utilization Review (UR) denial and subsequent Independent Medical Review (IMR) upholding it were flawed. The Board found the applicant failed to prove by clear and convincing evidence that the IMR determination was based on a plainly erroneous factual finding not subject to expert opinion. Consequently, the Board affirmed the IMR determination, upholding the denial of the request for authorization of Fioricet medication. The original order for further record development was rescinded as not being the proper remedy under the relevant statute.
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