MIRNA CABADA, Applicant
v.
FAMILY RANCH, INC.; ARCH INSURANCE COMPANY, administered by SEDGWICK, Defendants
No. ADJ11417486
California Workers Compensation Decisions
Workers’ Compensation Appeals Board State of California
January 26, 2022
Van
Nuys District Office
OPINION
AND ORDER
GRANTING
PETITION FOR REMOVAL
AND
DECISION AFTER REMOVAL
Applicant
seeks removal in response to the workers’ compensation
administrative law judge’s (WCJ) November 3, 2021
Minutes of Hearing (MOH) and Order converting the matter to a
mandatory settlement conference (MSC) and setting the matter
for hearing (Order). Applicant contends that she will be
significantly prejudiced and/or will suffer irreparable harm
if the matter proceeds to an MSC rather than an Expedited
Hearing and that the WCJ should have issued an order in
response to a previous notice of intention (NIT) regarding
medical treatment.
We did
not receive an Answer from defendant. The WCJ issued a Report
and Recommendation on the Petition for Removal (Report)
recommending that we deny removal.
We have
considered the allegations of the Petition for Removal and
the contents of the Report of the WCJ with respect thereto.
Based on our review of the record, we will grant the Petition
for Removal, affirm the Order, except that we will amend it
to clarify how the parties should proceed, and return this
matter to the WCJ for further proceedings.
FACTUAL
BACKGROUND
On June
28, 2021, applicant filed a Declaration of Readiness to
Proceed to Expedited Hearing (DOR). In the DOR, applicant
contends she is entitled to receive medical treatment with a
provider outside of defendant’s Medical Provider
Network (MPN). A hearing was held on July 28, 2021. While it
is unclear from the MOH what transpired at that hearing, the
Expedited Hearing was continued to September 27, 2021.
At the
September 27, 2021 hearing, the MOH state, in relevant part,
“Defendant did not appear at 2:45 call time until 3:10
to resolve issue of [Primary Treating Physician]. [Notice of
Intention] re: Order to allow applicant to treat outside of
the MPN for denial of care to issue.” The WCJ issued a
Notice of Intent to Issue Award of Medical Treatment Outside
Employer’s Medical Provider Network (NIT) on September
28, 2021. The NIT states, in relevant part:
NOTICE IS HEREBY GIVEN of intention to issue Order of Medical
Treatment allowing applicant MIRNA CABADA to designate as her
primary treating physician and obtain medical treatment,
pursuant to Labor Code section 4600, outside of the Employer,
FAMILY RANCH, INC.’s medical provider network.
(September 28, 2021 NIT, p. 1)
On
October 6, 2021, applicant filed a Declaration of Readiness
to Proceed to Expedited Hearing. In her DOR, applicant
contends that defendant failed to authorize medical treatment
outside of its Medical Provider Network
[1]. (DOR, p. 7)
Defendant filed an objection to the DOR on various grounds.
The
matter was set for Expedited Hearing on November 3, 2021
before a different WCJ. The MOH state, in...