What the panel ordered
Petition for Reconsideration denied
Petition for Reconsideration of the Findings of Fact issued by the WCJ on December 8, 2020
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 / IMRDefendant prevailedlumbar spine · lower extremities
The IMR determination was upheld because the medical guidelines do not recommend medial branch blocks for radiculopathy pain syndromes, and the applicant did not prove grounds to set aside the determination by clear and convincing evidence.
From the decision · page 4On July 6, 2020, IMR upheld the utilization review decision. The clinical case summary provides that Applicant sustained an industrial injury in 1992 and received treatment for failed back syndrome, lumbar spine spondylosis, and altered gait due to kyphotic posture from using a walker. On May 12, 2020, Applicant complained of lower back pain radiating into the left lower extremity. The provider reported that an epidural steroid injection helped in the past. The IMR rationale cited MTUS Low Back Disorders 2019 Guidelines and indicated diagnostic lumbar facet injections are not recommended. (Exhibit BB)