Opinion ID: 1801702
Heading Depth: 1
Heading Rank: 2

Heading: Smith's Request for Medical Treatment

Text: Dwight Smith sustained industrial injuries from cumulative trauma to his right shoulder, neck and psyche while working for the former California Youth Authority (now the Juvenile Justice section of the Department of Corrections and Rehabilitation). [2] In 1997, by stipulation, Smith was awarded partial permanent disability indemnity and future medical treatment. Eight years later, State Compensation Insurance Fund (SCIF) refused to authorize a request for epidural injections to his back. Smith contacted the attorney who filed his original workers' compensation claim and the attorney sought utilization review (§ 4610). Pursuant to court order, Smith was examined by an agreed medical examiner, who concluded he needed the injections to relieve his back pain, which was precipitated by his industrial injuries. SCIF authorized the injections without a formal hearing. Citing section 4607, Smith subsequently sought attorney fees. The workers' compensation judge denied the request, concluding the statute did not authorize an award because SCIF had not instituted proceedings to terminate Smith's award of medical treatment. In a split decision, the Board denied Smith's petition for reconsideration. The majority concluded fees would be available to an applicant who is forced to challenge an insurer's complete refusal to authorize future treatment covered by an award. But, because SCIF disputed only part of Smith's care, the statute did not authorize an award of fees.