The WCAB has issued an opinion supplementing the Court's prior opinion in Dubon, that a Utilization Review (UR) decision to deny medical treatment must be communicated to the required parties (ie. treating physician, injured worker etc.) within the required time frame or it will be deemed untimely. Bodam v. San Bernardino County (2014) 79 Cal. Comp. Cases 1519.

This means that if an insurer timely completes a UR denial for the treatment requested by an injured worker's treating physician, it still must be communicated to the physician and injured worker within the required timeframes. If the UR is not timely, then the UR is invalid pursuant to Dubon and the injured worker may pursue an order from the WCAB that the treatment be authorized.

It should be noted that this opinion has been designated as a significant panel decision. Therefore, even though it is not binding on lower courts, it is does provide a strong indication as to how the WCAB will decide this particular issue.

The Court, in an en banc decision, held that where an injured worker sustains a new work related injury, he/she is not required to return to the same AME and/or QME's that were utilized to evaluate the prior injury. Navarro v. City of Montebello (2015, Appeals Board en banc) 79 Cal. Comp. Cases 418.

When the Workers' Compensation Appeals Board decides a case en banc, it becomes binding on the lower workers' compensation courts. While the Court's holding in Navarro does not mean an injured worker is entitled to a different AME or Panel QME for every date of injury they sustain, it does mean that an injured worker is not forever shackled to the same one for subsequent distinct injuries.

Many insurers attempt to preclude an injured worker from asserting this right to reduce the potential compensation due for an injury, an injured worker is usually wise to assert this right where applicable.