Bodam v. San Bernardino County (11/20/2014)
WCAB Significant Decision
Timothy Bodam v. San Bernardino County/ Department of Social Services legally uninsured (Nov. 20, 2014)
- Case No. ADJ8120989 (SBR 0041910)
- 79 Cal. Comp. Cases 1519
In affirming the Workers’ Compensation Judge’s finding that defendant’s Utilization Review (UR) decision was not timely communicated to the requesting physician and the employee as required by Labor Code section 4610(g)(3)(A) and Administrative Director’s Rule 9792.9.1(e)(3), the Appeals Board held: (1) A defendant is obligated to comply with all time requirements in conducting a UR, including the timeframes for communicating the UR decision; (2) A UR decision that is timely made but is not timely communicated is untimely; (3) When a UR decision is untimely and, therefore, invalid, the necessity of the medical treatment at issue may be determined by the WCAB based upon substantial evidence.
DaisyBill’s easy billing software guarantees that RFAs are always submitted compliantly. For more information about California’s workers’ comp electronic billing, book a demo and see how easily DaisyBill solves workers' comp billing problems.
Was this article helpful?
DaisyBill is a trusted authority on workers’ comp billing. Thousands of work comp professionals attend our webinars and state agencies and professional organizations turn to us for our expertise. We created this blog to help everyone involved in workers’ compensation; sharing news, tips, and data of interest to the community.
Drop us a line with any news you would like us to share or any issue that concerns you.