2. The utilization review (UR) undertaken by defendant over one year after the treating physician requested home health care and after the defendant had already initiated the agreed medical examiner/qualified medical evaluator process inLabor Code § 4062(a), was an improper proc...
Contrary to the defendant’s assertion, UR isnot“presumed correct on the issue of the extent and scope of medical treatment,” as the presumption created by Labor Code § 4604.5(a) only applies to “medical treatment utilization schedule,” explained the Appeals Board. The A...
rescinded WCJ’s finding that defendant’s request for qualified medical evaluator panel was valid even though request was incorrectly made pursuant to statutory procedure set forth in Labor Code § 4060, applicable to disputed injury cases, rather than Labor Code § 4062, a...
The WCAB basically followed the judge’s line of reasoning on this issue, but noted thatLabor Code section 4062was the appropriate Labor Code section andnotLabor Code section 4060. The WCAB also noted that “this does not create a violation ofdue processfor a...