Home/Case Law/LUIS TOLENTINO vs. LUKE'S ROOFING, REDWOOD FIRE INSURANCE COMPANY
Regular DecisionRegular Panel Decision

LUIS TOLENTINO vs. LUKE'S ROOFING, REDWOOD FIRE INSURANCE COMPANY

Filed: Nov 20, 2018
Van Nuys
ADJ11314069

CompFox AI Summary

This case concerns the proper designation of a primary treating physician within a Medical Provider Network (MPN). The applicant selected Dr. Huang, who was employed by Casa Colina. The defendant argued this was improper because Casa Colina was only listed for ancillary services and Dr. Huang was not individually listed in the MPN. The Board affirmed the WCJ's decision, holding that Dr. Huang's designation was proper as long as he acted through Casa Colina, which was included in the MPN without restriction. Regulations permit an entity in the MPN to have its employee physicians considered part of the network, unless specifically excluded.

Full Decision Text1 Pages

This case concerns the proper designation of a primary treating physician within a Medical Provider Network (MPN). The applicant selected Dr. Huang, who was employed by Casa Colina. The defendant argued this was improper because Casa Colina was only listed for ancillary services and Dr. Huang was not individually listed in the MPN. The Board affirmed the WCJ's decision, holding that Dr. Huang's designation was proper as long as he acted through Casa Colina, which was included in the MPN without restriction. Regulations permit an entity in the MPN to have its employee physicians considered part of the network, unless specifically excluded.

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