CompFox AI Summary
This case concerns an applicant who sustained industrial injuries to her knees, left ankle, and left hip. The administrative law judge found the employer failed to provide proper notice of its Medical Provider Network (MPN) prior to the injury. This failure was determined to have resulted in a denial of care, making the employer responsible for treatment obtained outside the MPN. The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, affirming the original award of benefits for out-of-network treatment.
Full Decision Text1 Pages
This case concerns an applicant who sustained industrial injuries to her knees, left ankle, and left hip. The administrative law judge found the employer failed to provide proper notice of its Medical Provider Network (MPN) prior to the injury. This failure was determined to have resulted in a denial of care, making the employer responsible for treatment obtained outside the MPN. The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, affirming the original award of benefits for out-of-network treatment.
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