CompFox AI Summary
This case concerns a workers' compensation applicant seeking medical treatment for his knees and compensation for gastrointestinal injury. The Appeals Board granted the applicant's petition for reconsideration, finding the defendant's utilization review process for left knee treatment was procedurally deficient. As a result, the issue of left knee treatment is deferred for further determination at the trial level. The applicant's claims of new and further gastrointestinal disability are not time-barred, but any permanent disability that existed prior to a 2011 settlement is barred by estoppel and res judicata.
Full Decision Text1 Pages
This case concerns a workers' compensation applicant seeking medical treatment for his knees and compensation for gastrointestinal injury. The Appeals Board granted the applicant's petition for reconsideration, finding the defendant's utilization review process for left knee treatment was procedurally deficient. As a result, the issue of left knee treatment is deferred for further determination at the trial level. The applicant's claims of new and further gastrointestinal disability are not time-barred, but any permanent disability that existed prior to a 2011 settlement is barred by estoppel and res judicata.
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