CompFox AI Summary
The Workers' Compensation Appeals Board denied reconsideration of a decision finding applicant Jedediah Keltner was adequately compensated for temporary disability. The Board affirmed the administrative law judge's reliance on the Agreed Medical Examiner's opinion that applicant reached permanent and stationary status after lumbar surgery was denied by Utilization Review. Applicant argued the AME's opinion was insufficient without considering the UR denial and sought further development of the record, but the Board found the AME's opinion on permanent and stationary status to be substantial medical evidence in the absence of ongoing treatment likely to improve his condition. The dissenting opinion argued for granting reconsideration to clarify whether applicant was truly temporarily disabled, given the AME's conflicting statements and the nuances of his reporting.
Full Decision Text1 Pages
The Workers' Compensation Appeals Board denied reconsideration of a decision finding applicant Jedediah Keltner was adequately compensated for temporary disability. The Board affirmed the administrative law judge's reliance on the Agreed Medical Examiner's opinion that applicant reached permanent and stationary status after lumbar surgery was denied by Utilization Review. Applicant argued the AME's opinion was insufficient without considering the UR denial and sought further development of the record, but the Board found the AME's opinion on permanent and stationary status to be substantial medical evidence in the absence of ongoing treatment likely to improve his condition. The dissenting opinion argued for granting reconsideration to clarify whether applicant was truly temporarily disabled, given the AME's conflicting statements and the nuances of his reporting.
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