What the panel ordered
The Appeals Board grants reconsideration, rescinds the March 5, 2024 Joint Findings and Order, and returns the matter to the trial level for further proceedings consistent with the opinion.
Applicant seeks reconsideration of the March 5, 2024 Joint Findings and Order where the WCJ found the retroactive predesignation of Optum and Dr. Marlowe as treating physician invalid under Labor Code section 4600(d). The WCJ recommended denial of the petition. The Appeals Board grants reconsideration and rescinds the March 5, 2024 decision, returning the matter to the trial level for further record development.
This docket was decided more than once. Shown here is the latest released decision; we also hold April 11, 2022.
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
The record lacked sufficient evidence to establish that the designated medical group 'Optum' met the statutory requirements under Labor Code section 4600(d)(2)(B). The WCJ found the retroactive predesignation invalid, but the Appeals Board found the record insufficiently developed and remanded for further evidence.
From the decision · page 4On March 5, 2024, the WCJ issued his F&O, determining in relevant part that applicant
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Applicant's predesignation form named 'Optum' as the medical group and insurance company, but no evidence established that Optum and Optumcare Medical Group were the same entity.
Favours Defendant prevailed
Without evidence connecting the two entities, the predesignation did not meet statutory requirements under Labor Code section 4600(d).
What the panel did with the medical opinions
The role the physician served, and the weight the opinion carried. Physicians are named here as the decision names them; we do not score them.
Dr. Marlowe was not applicant's treating physician prior to the January 5, 2016 injury and therefore cannot be predesignated.
Applicant sought to predesignate Dr. Marlowe, but he did not treat her prior to injury as required by Labor Code section 4600(d).
From the decision · page 7Dr. Marlowe was not applicant's treating physician prior to her January 5, 2016 injury and therefore cannot be predesignated. Applicant contends rather that she is predesignating the "Optum" medical group.
Dr. Frisch was applicant's primary care physician at Optumcare Medical Group prior to injury, but the record did not establish that Optumcare Medical Group and Optum are the same entity.
The medical records showed treatment by Dr. Frisch at Optumcare Medical Group, but insufficient evidence connected Optumcare Medical Group to Optum as the same medical group under Labor Code section 4600(d).
From the decision · page 5The only evidence submitted that remotely addresses this issue are the subpoenaed records from Optumcare Medical Group, JT Exh. 15. The court analyzed these records in its opinion on decision and found that they established the applicant's main treating physician at that group was Dr. Frisch. She had treated with Dr. Frisch since at least 4/18/13, see page 62 of the subpoenaed records.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Cal. Code Regs., tit. 8, § 9782(b)
Cal. Code Regs., tit. 8, § 9782(b)
Requires employer to notify employees of right to predesignate a personal physician.
From the decision · page 3On December 1, 2022, we issued our Opinion and Decision After Reconsideration. Therein, we determined that pursuant to section 4600(d), "an employer has an affirmative obligation to provide notice to its employees of their right to predesignate a physician in the event of workplace injury." (Opinion on Decision, dated December 1, 2022, at p. 7.) We further observed that pursuant to Administrative Director (AD) Rule 9782(b), "[e]very employer shall advise its employees in writing of an employee's right to predesignate a personal physician pursuant to subdivision (d) of Labor Code section 4600, and section 9780.1." (Cal. Code Regs., tit.
Labor Code section 4600(d)
Labor Code section 4600(d)
Sets requirements for predesignation of personal physician and medical group.
From the decision · page 6Section 4600 provides that "[i]f an employee has notified the employee's employer in
What proof carried it
The evidence the panel weighed, by kind.
Applicant's testimony and medical records showed treatment by Dr. Frisch at Optumcare Medical Group but no evidence connecting Optumcare Medical Group and Optum as the same entity.
From the decision · page 5The only evidence submitted that remotely addresses this issue are the subpoenaed records from Optumcare Medical Group, JT Exh. 15. The court analyzed these records in its opinion on decision and found that they established the applicant's main treating physician at that group was Dr. Frisch. She had treated with Dr. Frisch since at least 4/18/13, see page 62 of the subpoenaed records.
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About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
- The injured worker is not named here, and the case caption is not printed. Physicians appear as the decision names them, because a medical opinion is an act in a public proceeding.
- Issues, outcomes and weights were extracted by AI and released only where the source passage checked. Read the official decision before relying on anything here. Not legal advice.
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