What the panel ordered
The en banc decision of April 20, 2011, holding that non-MPN medical reports are inadmissible where unauthorized treatment is obtained outside a validly established and properly noticed MPN, is affirmed. Petition for reconsideration by applicant is denied. Petition for reconsideration/removal by Saldivar is dismissed.
Applicant sought reconsideration of an en banc decision holding that non-MPN medical reports are inadmissible where unauthorized treatment is obtained outside a validly established and properly noticed MPN. The Board granted reconsideration to further study the issues and now affirms its prior decision.
This docket was decided more than once. Shown here is the latest released decision; we also hold July 14, 2011, April 20, 2011.
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.
Where unauthorized treatment is obtained for an industrial injury outside a validly established and properly noticed MPN, the resulting non-MPN treatment reports are inadmissible and may not be relied upon to award benefits.
From the decision · page 115 held that, where unauthorized treatment is obtained for an industrial injury outside a validly established
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Applicant obtained treatment from a non-MPN physician without following MPN procedures or establishing that the MPN was invalid or not properly noticed.
Favours Defendant prevailed
This fact led to the exclusion of the non-MPN physician's reports from evidence, resulting in denial of benefits based on those reports.
From the decision · page 212 following MPN procedures, applicant began treating with Dr. Nario, a non-MPN physician, upon referral
What the panel did with the medical opinions
The role the physician served, and the weight the opinion carried. Physicians are named here as the decision names them; we do not score them.
Dr. Nario, a non-MPN physician, found applicant temporarily disabled, but the WCAB held his reports inadmissible because treatment was outside a validly established and properly noticed MPN.
Non-MPN physician's reports are inadmissible where unauthorized treatment is obtained outside a validly established and properly noticed MPN.
From the decision · page 217 reports of Dr. Nario, the WCJ found that applicant was temporarily disabled from November 2, 2009
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Lab. Code § 4616.6
Where unauthorized treatment is obtained for an industrial injury outside a validly established and properly noticed MPN, the resulting non-MPN treatment reports are inadmissible and may not be relied upon to award benefits.
Applied to exclude non-MPN medical reports from evidence and deny benefits based on them.
From the decision · page 115 held that, where unauthorized treatment is obtained for an industrial injury outside a validly established
What proof carried it
The evidence the panel weighed, by kind.
Applicant began treating with Dr. Nario, a non-MPN physician, upon referral from her attorney, without following MPN procedures.
From the decision · page 212 following MPN procedures, applicant began treating with Dr. Nario, a non-MPN physician, upon referral
The same issues, filtered across the whole corpus — or paste your own facts and let the search rank by factor match.
About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
- The injured worker is not named here, and the case caption is not printed. Physicians appear as the decision names them, because a medical opinion is an act in a public proceeding.
- Issues, outcomes and weights were extracted by AI and released only where the source passage checked. Read the official decision before relying on anything here. Not legal advice.
- If you are named in this decision and want this page removed, write to privacy@similarcase.com.