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ADJ15315840 — California WCAB decision · SimilarCase

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California WCABPanel decision

ADJ15315840 · February 12, 2024

Petition for Reconsideration granted; Findings of Fact rescinded; matter returned to trial level for further proceedings consistent with decision

Issues decided: 1
Medical opinions weighed: 1
Authorities named: 1
District office: San Bernardino

What the panel ordered

Petition for Reconsideration granted; Findings of Fact rescinded; matter returned to trial level for further proceedings consistent with decision

Petition for Reconsideration of Findings of Fact issued on November 17, 2023 granted; Findings of Fact rescinded and matter returned to trial level for further proceedings

Read the official decision →

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.

Medical treatment / UR / IMRRemandedhead · groin · psyche · left upper extremity · lower back · pelvis · left lower extremity · neck · right shoulder

The WCJ misconstrued the stipulation regarding LVN treatment duration and failed to find defendant's obligation to provide home care and LVN treatments after the stipulated period; the record lacks evidence on communication and authorization of treatments before the stipulation; further record development is needed to determine defendant's obligation and compliance with legal standards.

From the decision · page 4We turn first to applicant's contention that the WCJ erroneously failed to find that

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

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Applicant's wife testified she was paid to provide home healthcare from January 27, 2023 through April 27, 2023

Favours Applicant prevailed

Supports applicant's claim that home care was provided and relevant to the dispute over treatment obligation

From the decision · page 3The Defendant stipulated to provide home healthcare services for a period of 90 days. The Applicant's wife testified she was paid to provide home healthcare from January 27, 2023 through April 27, 2023. (See MOH/SOE September 7, 2023, p. 2 ll. 23§ 24) The Defendant, pursuant to the terms of the stipulations terminated payments for home healthcare service, and LVN care after the 90 day period expired.

The January 3, 2023 Stipulation explicitly required defendant to provide home care for 90 days and LVN care for an indeterminate period

Favours Applicant prevailed

The WCJ misconstrued the stipulation to require LVN treatment for only 90 days and found no obligation to continue treatment after that period, which was unsupported by the record

From the decision · page 5However, the Stipulation provides that defendant shall: (1) "pay a family member of the Applicant, $17.00 an hour, or hire an outside agency, for up to 28 hours per week of Home Care, for [90 days]"; and (2) "allow a once per week visit by an LVN to refill medications/pill box for the applicant." (Ex. 5, Stipulation and Order, January 3, 2023, pp. 1:14-2:22.) Thus, the Stipulation explicitly requires defendant to provide home care for a ninety-day period and to provide LVN care for an unstated, indeterminate period.

No evidence showed that home care and LVN treatments were requested or authorized before the January 3, 2023 Stipulation

Favours Applicant prevailed

This lack of evidence prevented a clear finding on defendant's obligation to provide treatments and whether Patterson's burden to show a change in condition applied

From the decision · page 5In addition, we are unable to discern support for the finding that defendant was not required to provide home care and LVN treatments on the grounds that the ninety-day period had expired in the first instance because, regardless of whether or not the treatments were limited to ninety days, the record fails to show how, if at all, the treatments were requested or authorized.