Guzman v. IFA, 122320 UTWC, 20-0095

Case DateDecember 23, 2020
CourtUtah
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...

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