CompFox AI Summary
The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for reconsideration, reversing a prior decision. The WCAB found that it lacks jurisdiction over medical treatment payment disputes when an express agreement exists between the parties, as stipulated by Labor Code section 5304. In this case, a chain of contracts, including one between the hospital and Blue Cross Life and Health, and another between Blue Cross and the defendant insurer, created an express agreement. This contractual arrangement precluded the WCAB from determining the payment due to the medical provider.
Full Decision Text1 Pages
The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for reconsideration, reversing a prior decision. The WCAB found that it lacks jurisdiction over medical treatment payment disputes when an express agreement exists between the parties, as stipulated by Labor Code section 5304. In this case, a chain of contracts, including one between the hospital and Blue Cross Life and Health, and another between Blue Cross and the defendant insurer, created an express agreement. This contractual arrangement precluded the WCAB from determining the payment due to the medical provider.
Read the full decision
Join + legal professionals. Create a free account to access the complete text of this decision and search our entire database.