What the panel ordered
Petition for reconsideration granted; WCJ Findings and Order rescinded; matter returned for further proceedings.
Applicant petitioned for reconsideration of a WCJ Findings and Order dated January 2, 2026, which found the UR determination timely and no jurisdiction to overrule the denial of lumbar fusion surgery.
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 UR was required to act within five business days of receiving the RFA; there was no evidence of written notice for additional information as required by statute, and the WCJ improperly relied on repealed law to extend the deadline.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
RFA for lumbar fusion surgery was received on September 4, 2025; UR denial issued September 12, 2025, outside the five business day window without evidence of written notice for additional information.
Favours Applicant prevailed
Statute required UR action within five business days or written notice for extension; absence of such notice rendered UR untimely.