Home/Case Law/EVALINA AGUILAR-RIVAS vs. K&H SUBWAY, INC., dba AAA SUBWAY INVESTMENT GROUP, INC.; EMPLOYERS ASSURANCE COMPANY
Regular DecisionRegular Panel Decision

EVALINA AGUILAR-RIVAS vs. K&H SUBWAY, INC., dba AAA SUBWAY INVESTMENT GROUP, INC.; EMPLOYERS ASSURANCE COMPANY

Filed: Apr 25, 2019
Los Angeles
ADJ10373550

CompFox AI Summary

The Workers' Compensation Appeals Board affirmed a prior decision denying recovery for three lien claimants: Kohanim Chiropractic, Metropolitan Health Group, and SoCal Interpreting. The lien claimants failed to prove their medical services or interpreting services were reasonable and necessary under the Medical Treatment Utilization Schedule (MTUS), as required by Labor Code section 5402(c). Specifically, they did not demonstrate that the treatment was consistent with MTUS guidelines or that interpreter invoices were properly submitted to the defendant. Therefore, the Board concluded the lien claimants did not meet their burden of proof for reimbursement.

Full Decision Text1 Pages

The Workers' Compensation Appeals Board affirmed a prior decision denying recovery for three lien claimants: Kohanim Chiropractic, Metropolitan Health Group, and SoCal Interpreting. The lien claimants failed to prove their medical services or interpreting services were reasonable and necessary under the Medical Treatment Utilization Schedule (MTUS), as required by Labor Code section 5402(c). Specifically, they did not demonstrate that the treatment was consistent with MTUS guidelines or that interpreter invoices were properly submitted to the defendant. Therefore, the Board concluded the lien claimants did not meet their burden of proof for reimbursement.

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