Experience

• The Workers’ Compensation Appeal Board affirmed the decision of a Worker’s Compensation Judge to terminate an employee’s workers' compensation benefits upon medical testimony of full recovery and corroborating surveillance evidence. The Board affirmed the decision of the Judge to deny the employee’s petition to add mental injuries and the decision that chiropractic treatment was unreasonable and unnecessary following a Utilization Review Determination. There will be recourse to seek reimbursement from the Supersedeas Fund for benefits already paid that were retroactively deemed unwarranted by the litigation.

• The Worker’s Appeal Board affirmed the denial of an employee’s Petitions for Review and Reinstatement, despite her third lumbar surgery. The employee sought to reinstate total disability benefits years after they were modified to partial following an Impairment Rating Evaluation. The Judge found that lumbar disc surgery unrelated to her prior work injury and prior surgeries based upon the testimony of the employer’s medical expert, which the Judge credited over that of the employee’s expert who performed all three surgeries.

• The Workers' Compensation Appeal Board affirmed the denial of a claim petition for disability, disfigurement and medical benefits for cervical fusion surgery. The Board rejected  the claimant’s argument that the Judge had capriciously disregarded evidence when he rejected the claimant’s testimony about the injury and chose to believe the employer’s fact witness instead. There was an unusual issue in that a prior carrier participated in the appeal to challenge the Judges finding that the claimant’s disability and need for treatment was causally related to an earlier injury. The Board found that statement of the Judge to be dicta and not binding on the carrier which was not a party to our case.