CompFox AI Summary
The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award of physical therapy. The Board held that the prior award did not preclude the defendant from challenging subsequent requests for medical treatment through the Utilization Review (UR) process. Defendant argued that changed circumstances, supported by a UR physician's opinion citing ACOEM guidelines, justified challenging the current physical therapy request. The case was returned to the trial level for further proceedings to determine the reasonableness of the requested treatment and the timeliness of the defendant's UR decision.
Full Decision Text1 Pages
The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award of physical therapy. The Board held that the prior award did not preclude the defendant from challenging subsequent requests for medical treatment through the Utilization Review (UR) process. Defendant argued that changed circumstances, supported by a UR physician's opinion citing ACOEM guidelines, justified challenging the current physical therapy request. The case was returned to the trial level for further proceedings to determine the reasonableness of the requested treatment and the timeliness of the defendant's UR decision.
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