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Case No. ADJ10127986

Regular

May 28, 2019

SAMANTHA SILVA vs. HILMAR CHEESE, SAFETY NATIONAL INSURANCE

This case concerns the compensability of Voltaren gel prescribed for the applicant's bilateral hand, wrist, and trigger finger injuries. The Workers' Compensation Appeals Board granted reconsideration, rescinding the original findings. The Board found that the critical issue was whether the generic equivalent of Voltaren gel was exempt from utilization review (UR), not solely the brand name's formulary status. The matter was returned for further proceedings to clarify the issues and for a new decision on the eligibility of the generic Voltaren gel.

Workers' Compensation Appeals BoardUtilization ReviewMedical Treatment Utilization ScheduleMTUSDrug FormularyExempt DrugGeneric DrugBrand Name DrugVoltaren GelFindings of Fact

References

Case No. ADJ13220426

Regular

Mar 10, 2023

MARICELA RODRIGUEZ vs. SOFT GEL TECHNOLOGIES, INC., CALIFORNIA INSURANCE COMPANY, APPLIED RISK SERVICES, INC.

The Workers' Compensation Appeals Board denied reconsideration of an amended findings and award, upholding the Workers' Compensation Judge's (WCJ) decision. The Board deferred to the WCJ's credibility determinations, finding no substantial evidence to overturn them. The WCJ's report, which was adopted by the Board, concluded that the applicant's arguments regarding the substantiality of medical evidence and claims for additional body parts were not raised at trial. The Board also affirmed that a single physician's opinion can constitute substantial evidence, even if it conflicts with other medical opinions.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ credibility determinationsubstantial medical evidencephysician's opinionbilateral wristscarpal tunnel syndromeneck injuryback injuryupper extremity injury

References

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SAMANTHA SILVA vs. HILMAR CHEESE, SAFETY NATIONAL INSURANCE

Workers' Compensation Appeals BoardUtilization ReviewMedical Treatment Utilization ScheduleMTUSDrug FormularyExempt DrugGeneric DrugBrand Name DrugVoltaren GelFindings of Fact

MARICELA RODRIGUEZ vs. SOFT GEL TECHNOLOGIES, INC., CALIFORNIA INSURANCE COMPANY, APPLIED RISK SERVICES, INC.