ADJ10966476 · May 29, 2026

The WCAB found that the widow was entitled to reimbursement for home health care services from July 4, 2018 to October 17, 2019 based on medical prescriptions and defendant's failure to investigate the need for such care, consistent with Labor Code and case law requirements.

From the decision · page 8performed any investigation into the need for home health care services during that period. Therefore, the record confirms the need for home health care services during the period July 4, 2018 to October 17, 2019. We also conclude that the evidentiary record supports the reasonableness of the services in accordance with the medical treatment utilization schedule for home health care services.

Decedent sustained traumatic brain injury on July 29, 2017 while employed as farm laborer

Favours Applicant prevailed

Established industrial injury triggering medical treatment rights

From the decision · page 2Applicant was working as a farm laborer for SA Farm Labor Service on July 29, 2017 when he fell six feet off a ladder and sustained a traumatic brain injury. Applicant was 71 years old at the time of injury. After the fall, he was taken to Community Regional Medical Center (CRMC) in Fresno, California. He remained there until his care was transferred to Centre for Neuro Skills (CNS) in Bakersfield, California on August 10, 2017. He was diagnosed with an occipital skull fracture and bilateral frontal hemorrhagic contusions. He remained at CNS until he was discharged on January 31, 2018 to his home in Orange Cove, California.

Medical prescriptions for home health care services were made by treating physicians Sorensen, Cantrell, and Brodie

Favours Applicant prevailed

Supported entitlement to home health care reimbursement

From the decision · page 7Here, in his report of April 3, 2018, treating physician Frank L. Cantrell, M.D., referenced a request for authorization by John Edwards, M.D., dated March 19, 2018, recommending a "specialist in home health services." (App. Ex. 11, p. 4.) Moreover, in Dr. Cantrell's report dated June 5, 2018, he explained, "the patient is clearly, in my opinion, unable to care for himself." (App. Exh. 12, p. 4.)

Defendant did not investigate the need for home health care services during July 4, 2018 to October 17, 2019

Favours Applicant prevailed

Employer's failure to investigate established liability for reimbursement

From the decision · page 8performed any investigation into the need for home health care services during that period. Therefore, the record confirms the need for home health care services during the period July 4, 2018 to October 17, 2019. We also conclude that the evidentiary record supports the reasonableness of the services in accordance with the medical treatment utilization schedule for home health care services.

Recommended 24/7 home care and in-patient neurological rehabilitation; noted patient sent away home care providers.

Supports the need for home health care services.

From the decision · page 7In addition, in treating physician Ian Dallas Brodie, M.D.'s first report of occupational injury dated March 14, 2019, he referenced a history and physical report from Dr. Edwards dated August 30, 2017. (Joint Ex. ZZ.) In that report, Dr. Edwards wrote that applicant's "girlfriend may need to be paid for a minimum of four hours per day, to assist in his caregiving process and ensure that he will be safe in the home." (Id. at p. 6.)

Requested authorization for home health care services for 5 days a week, 6 hours per day, later increased to 7 days a week, 8 hours per day.

Supports the need for home health care services.

From the decision · page 7Finally, in treating physician Eric Sorensen, M.D.'s report dated April 2, 2018, he wrote, "we need to put forth an RFA for him for in-home care, five days a week per week for 6 hours per day or something to that effect." (Def. Ex. E, p. 2.) Attached to the exhibit was a request for authorization by Brian Belanger, D.C., dated August 7, 2018, requesting authorization for home health care services for seven days per week, eight hours per day from July 28, 2018 to August 17, 2018.

Indicated patient unable to care for himself and referenced request for authorization for home health care services.

Supports the need for home health care services.

From the decision · page 7Here, in his report of April 3, 2018, treating physician Frank L. Cantrell, M.D., referenced a request for authorization by John Edwards, M.D., dated March 19, 2018, recommending a "specialist in home health services." (App. Ex. 11, p. 4.) Moreover, in Dr. Cantrell's report dated June 5, 2018, he explained, "the patient is clearly, in my opinion, unable to care for himself." (App. Exh. 12, p. 4.)

Labor Code section 4600

Labor Code section 4600 requires employer to provide reasonable medical treatment to cure or relieve effects of industrial injury

Employer liable for home health care services as medical treatment

From the decision · page 5Labor Code section 46002 requires the employer to provide reasonable medical treatment to

Labor Code section 4600(h)

Labor Code section 4600(h) includes home health care services in medical treatment definition, must be prescribed and received by defendant

Home health care services require physician prescription and employer receipt

From the decision · page 6defendant can be liable for reasonable and necessary medical treatment in the form of home health care services for both skilled and unskilled care, including household tasks that are incidental to the medical treatment. (Smyers v. Workers' Comp. Appeals Bd. (1984) 157 Cal.App.3d 36 [49 Cal.Comp.Cases 454]; see Lab. Code, § 4600(h).)

Ramirez v. Workers' Comp. Appeals Bd. (1970) 10 Cal.App.3d 227

Employer has duty to investigate need for medical treatment upon notice

Defendant failed to investigate need for home health care services

From the decision · page 6In Ramirez v. Workers' Comp. Appeals Bd. (1970) 10 Cal.App.3d 227 [35 Cal.Comp.Cases 383], the Court observed that:

Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd. (1983) 34 Cal.3d 159

Employer must actively bring necessary relief to injured employee or lose right to control medical care

Defendant did not instruct employee on medical care, liable for self-procured treatment

From the decision · page 7Similarly, in Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd. (Bolton) (1983) 34 Cal.3d 159 [48 Cal. Comp. Cases 566], the Supreme Court wrote as follows:

Defendant did not investigate the need for home health care services during July 4, 2018 to October 17, 2019 period

From the decision · page 8performed any investigation into the need for home health care services during that period. Therefore, the record confirms the need for home health care services during the period July 4, 2018 to October 17, 2019. We also conclude that the evidentiary record supports the reasonableness of the services in accordance with the medical treatment utilization schedule for home health care services.