EFREY GUZMAN, Petitioner,
v.
IFA and WCF MUTUAL INSURANCE COMPANY, Respondents.
No. 20-0095
Utah Workers Compensation Decisions
Utah Labor Commission
December 23, 2020
ORDER
AFFIRMING ALJ’S DECISION
Jaceson R. Maughan, Utah Labor Commissioner
IFA and
its insurance carrier, WCF Mutual Insurance Company,
(collectively referred to as “IFA”) ask the Utah
Labor Commission to review Administrative Law Judge
Decker’s award of medical benefits to Efrey Guzman
under the Utah Workers’ Compensation Act, Title 34A,
Chapter 2, Utah Code Annotated.
The
Labor Commission exercises jurisdiction over this motion for
review pursuant to §63G-4-301 of the Utah Administrative
Procedures Act and §34A-2-801(4) of the Utah
Workers’ Compensation Act.
BACKGROUND
AND ISSUE PRESENTED
Mr.
Guzman claims workers’ compensation benefits related to
a right-hand injury he suffered while working for IFA on
February 6, 2013. Specifically, Mr. Guzman claims entitlement
to the cost of a custom prosthesis for his right hand
different from the one that was provided to him. IFA does not
dispute that Mr. Guzman suffered a compensable work injury as
a result of the accident, but it disputes that the prosthesis
he requests is medically necessary.
Judge
Decker held a hearing on Mr. Guzman’s claim and left
the medical record open for 30 days to allow for evidence
regarding a different right-hand prosthesis. No additional
medical records were presented within the 30-day period.
Judge Decker then issued his decision awarding Mr. Guzman the
cost of the new custom prosthesis for his right hand that he
requested. IFA now seeks review of Judge Decker’s
decision by arguing that the medical record should be
reopened to admit an opinion it obtained regarding the
necessity of the custom prosthesis. IFA submits that such
opinion presents a conflict that should be referred to an
impartial medical panel.
FINDINGS
OF FACT
The
Commission adopts Judge Decker’s findings of fact,
which are summarized as follows. On February 6, 2013, Mr.
Guzman was working for IFA when he...