Aaron Hemmings recently secured a win in a case where the applicant alleged a CT which was initially denied. The applicant then self procured treatment outside of the defendant’s Medical Provider Network. Subsequently the claim was deemed compensable by the orthopedic panel QME and the case then concluded via Stipulated Award. However, the applicant continued to treat outside the MPN. Transfer of Care notices were issued to bring the applicant back into the MPN, yet she continued to treat outside of the MPN. Objections were interposed and Aaron even wrote to Dr. Haronian to see if there was any sort of exception to transfer of care per CCR 9767.9(e)(2). When no response was received, a declaration of readiness to proceed was asserted requesting a MSC on the issue. This matter came on for MSC at which time applicant’s counsel still refused to transfer of care into the MPN. Applicant’s counsel was of the position that the PTP had unlimited time in which to issue a report regarding an exception to transfer of care into the MPN. Aaron’s position was that Dr. Haronian had 20 days under CCR section 9767.9(g) to issue such a report.
At trial, applicant’s counsel attempted to introduce a report from the doctor dated subsequent to the MSC date for the proposition that the applicant had a condition which was an exception to transfer of care. Aaron noted that this report was not timely per CCR section 9767.9(g) based upon the letter he had sent to Dr. Haronian. Ultimately the judge ruled that the recently discovered report was not timely to Aaron’s letter asking the PTP to address the issue of transfer of care exceptions and ordered that the defendant shall have no liability for treatment outside of the MPN. This win not only saved the defendant substantial costs on the issue of liens and non-MPN treatment, but coincides with the applicant seeking to reopen her award for new/further disability. Undoubtedly the non-MPN PTP would have found both new disability and further disability. Now the new PTP in the MPN will have to address that issue. The TPA, employer and broker are all very happy with this outcome.