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Florianman kleinman

Insurance Defense at statue of liberty
Phone 8053878605 ext 2
Email flofloflo@floflo.com
Website -
Address 123 moliere avenue
thousand oaks
CA, 91360

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Supreme Court Won't Review Award to Worker for Disability After Self-Procured Treatment

By WorkCompCentral

Friday, February 23, 2018 | 896 | 4 | 19 min read

The California Supreme Court will not review an employer’s challenge to an award of benefits to a worker for her temporary period of disability after she underwent surgery at her own expense. Belinda Go had injured her neck in 2013 while working for the Sutter Solano Medical Center. In May 2015, her doctor requested authorization for a cervical spine surgery. The hospital, which was self-insured, submitted the request for utilization review. The UR provider recommended that authorization be denied. Go sought review of the denial via independent medical review, but the IMR doctor ...

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Stuart Baron Feb 23, 2018 11:01 AM

It would appear to be a valid denial by the court. You will notice that they did not say that the carrier had to pay for the surgery (LC4605). What they did say is that since it was successful and she recovered, providing her with TD and potential PD makes sense and is in line with the statute....

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Anne Bazel Feb 23, 2018 01:10 PM

They should've paid for the surgery. Since it was successful, obviously it was medically necessary.

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Cliff Bernstein Feb 24, 2018 12:19 AM

The UR doctor should state whether or not they reviewed the patients records

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Stuart Green Feb 26, 2018 08:55 AM

What if the surgery made her worse, or at least no better?

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