MICHAEL THOMAS, vs. SAFEWAY STORES, INC. Permissibly Self-Insured,
This case involved an applicant seeking treatment from a highly specialized surgeon, Dr. Matsen, located in Seattle, for a complex shoulder revision. The original decision denied authorization for Dr. Matsen, deeming Seattle outside a reasonable geographic area, and excluded a crucial report from the applicant's treating physician, Dr. Osborn. The Appeals Board granted reconsideration, admitting Dr. Osborn's report, which strongly supported Dr. Matsen's expertise and the inadequacy of local Bay Area surgeons for this complex case. Based on the applicant's medical history and the availability of specialized treatment, the Board reversed the original decision, finding Dr. Matsen to be within a reasonable geographic area.