McElvain, 040919 WIWC, 2013-012085

• Case Date: April 09, 2019
• Court: Wisconsin

ROSALYN H MCELVAIN Applicant MILWAUKEE BOARD OF SCHOOL DIRECTORS Employer MILWAUKEE BOARD OF SCHOOL DIRECTORS Insurer No. 2013-012085 Wisconsin Workers Compensation State of Wisconsin Labor and Industry Review Commission April 9, 2019           Attorney Patrick D. Kern           Asst. City Attorney Heidi A. Wick Spoerl           WORKER’S COMPENSATION DECISION 1           DAVID B. FALSTAD, CHAIRPERSON          ORDER          The commission affirms in part and sets aside in part the decision of the administrative law judge (ALJ) issued in this matter on March 12, 2018. The finding of a compensable work injury sustained on April 25, 2013, as well as the finding of the necessity of certain medical treatment provided by Dr. Vance Masci, are affirmed. The finding of the reasonableness of Dr. Masci's treatment fees is set aside and remanded for further proceedings as detailed below. Additionally, the ALJ's decision is modified as set forth below.          Accordingly, the medical treatments Dr. Vance Masci provided for the applicant's cervical and lumbar spine related symptoms, as set forth in the applicable WKC-3 through the date of October 28, 2015, were all treatments made necessary by the compensable work injury of April 25, 2013. The self-insured employer, Milwaukee Board of School Directors, is liable for the reasonable cost of such treatments.          The reasonableness of the fees charged by Dr. Masci for said medical treatments remains in dispute, and the commission hereby remands that issue for dispute resolution in accordance with the provisions of Wis. Stat. §102.16(2), and Wis. Admin. Code § 80.72.          In accordance with the provisions of Wis. Stat. § 102.23(1), Milwaukee Board of School Directors has 30 days from the date of this decision to file a circuit court appeal to the commission's finding of necessity of treatment. Absent such appeal, the commission's finding of necessity of treatment shall become final, and the remand of the issue of the reasonableness of Dr. Masci's fees shall proceed to dispute resolution.          Modifications          Delete the last two sentences of the second full paragraph on page 8 of the ALJ's decision and substitute the following two paragraphs therefor:

On page 2 of the compromise agreement it was stated that the respondent employer denied that the applicant sustained any disability over and above that for which the applicant

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