California: WCAB Affirms Medical Treatment in the Form of Sleep Number i8 Bed

In Carnes v. Auto Zone, Inc., 2015 Cal. Wrk. Comp. P.D. LEXIS --, a split panel WCAB affirmed the WCJ’s order that the defendant authorize medical treatment in the form of a Sleep Number i8 bed based on the reporting of the applicant’s treating physician, Eldan Eichbaum, M.D.

The parties stipulated that the defendant’s utilization review was untimely and, therefore, under Dubon v. World Restoration, Inc. (2014) 79 Cal. Comp. Cases 1298 (Appeals Board en banc opinion) (Dubon II), the WCAB had jurisdiction to determine medical necessity based on substantial evidence. 

The WCAB found Dr. Eichbaum’s report was substantial evidence to support a finding that the Sleep Number i8 bed was reasonable and necessary to cure or relieve the applicant from the effects of his industrial injury. According to the WCAB, Dr. Eichbaum adequately explained that the applicant suffered from significant low back and leg pain, that his 15-year old mattress was “very poor,” that a new mattress was better suited for the applicant’s condition to alleviate the pain and allow the applicant to rest, and that the Sleep Number i8 mattress was ideal for the applicant post-lumbar surgery and would maximize his ability to recover.

Commissioner Zalewski, dissenting from the majority panel opinion, concluded that Dr. Eichbaum’s reporting was not substantial evidence to support an award of the Sleep Number i8 mattress, with an anticipated cost of $5,325.86. Commissioner Zalewski pointed out that while Dr. Eichbaum wrote that he was requesting authorization for the new bed to replace the applicant’s old mattress and to help the applicant sleep better following surgery, Dr. Eichbaum did not explain why the Sleep Number i8 bed in particular, as opposed to another brand of bed, was reasonably required as necessary medical treatment for the applicant’s industrial injury.

Read the Carnes noteworthy panel decision.

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