ACOEM Applies To Old Stipulation With Request For Award

This is a significant decision even though it is not a published case. It gives an indication of a course of action to take when this issue arises.

The applicant entered in a Stipulation With Request for Award in 1985. Under future medial care it indicated there “may be” need for the back and hip care upon reasonable demand.

The applicant continued to treat over the years. In July 2006 the applicant filed a Declaration of Readiness to Proceed because the employer did not provide chiropractic services.

The Workers’ Compensation Judge (WCJ) awarded the applicant chiropractic care. The defendant petitioned the Workers’ Compensation Appeals Board for Reconsideration (WCAB). The WCAB overturned the WCJ and indicated applicant did not need treatment within the ACOEM guidelines. The applicant filed for a writ that brought the case to the appellate court.

The appellate court indicated that under Labor Code Section 5307.27, ACOEM guidelines are presumptively correct, regardless of the date of injury.

The court also reviewed section 4604.5 and indicated that the standard of care used to determine whether the treatment is reasonable is not the standard of care in 1985, but the standard of care that is reasonable today. This is very important. Because the injury occurred prior to 2004 the 24-visit chiropractic limitation did not apply, however.

Case: Sutton v. WCAB
This is an appellate decision that was not published

Harvey Brown
3501 Jamboree Rd. Suite 602
Newport Beach, CA 92660

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