What the panel ordered
The WCAB panel affirmed the WCJ's April 8, 2021 decision that defendant may not unilaterally cease inpatient care services at Casa Colina until a change in circumstances warrants a new utilization review determination.
Defendant sought reconsideration of the Findings and Order re: Ongoing Treatment at Casa Colina issued by a WCJ on April 8, 2021, which was affirmed after reconsideration by the WCAB panel on November 2, 2022.
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.
The WCJ and WCAB found that under Patterson, once treatment is authorized, it must continue until a change in circumstances warrants a new utilization review determination. Defendant failed to show such a change.
From the decision · page 1We granted reconsideration1 to further study the factual and legal issues in this case. This is our Opinion and Decision After Reconsideration. Defendant sought reconsideration of the Findings and Order re: Ongoing Treatment at Casa Colina issued by a workers' compensation administrative law judge (WCJ) on April 8, 2021. The WCJ found that applicant, while employed on August 16, 2018, as an electrician, sustained an admitted industrial injury to his head, both knees, upper back, lower back, and fingers of his left hand, and claimed injury to other body parts. The WCJ found defendant may not unilaterally cease to provide applicant's inpatient care services at Casa Colina Transitional Living Center (Casa Colina), until there is a change in circumstance that would warrant a new utilization review determination. The WCJ ordered that defendant continue to provide the services until there is a change in circumstances.