What the panel ordered
The WCAB panel affirmed the WCJ's Findings and Order denying the medical necessity of the requested Temperpedic adjustable king size bed and denied the Applicant's Petition for Reconsideration.
Petition for Reconsideration filed by Applicant after WCJ decision denying medical treatment for a requested Temperpedic adjustable king size bed; WCAB granted reconsideration to review medical necessity and evidence; WCJ report adopted and incorporated by WCAB panel.
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
The WCJ found that Dr. Nick's reports did not constitute substantial medical evidence to prove the medical necessity of the requested bed, and the Applicant failed to meet the burden of proof. The WCAB panel adopted and affirmed this finding.
From the decision · page 7The requested medical treatment at issue in this case is Primary Treating Physician Dr. Saeed Nick's request for a Temperpedic adjustable king size bed. The parties stipulated that Defendant did not issue a timely Utilization Review determination for this requested treatment. Thus, the undersigned WCALJ was tasked with determining the medical reasonableness and necessity of the requested bed. The undersigned now reiterates his finding that Dr. Nick's reporting is not substantial medical evidence as it relates to the issue of medical reasonable and necessity of the requested bed. Therefore, Applicant has failed to meet his burden of proof.