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Here's a summary of the case for a lawyer:
The Workers' Compensation Appeals Board denied Sherman Oaks Hospital's petition for reconsideration of a decision disallowing their lien. The Administrative Law Judge found the hospital failed to prove the reasonableness of their charges, specifically an additional $$24,512.31$ beyond the agreed $$49,024.00$. The Board affirmed that the lien claimant bore the burden of proving reasonableness, which was not met by simply submitting bills or relying on expert testimony from someone not qualified to address specific fee schedule interpretations. Furthermore, the hospital failed to present evidence demonstrating they qualified for any trauma center exceptions or the application of specific burn case fee schedules under Labor Code Section 5307.1.
Full Decision Text1 Pages
Here's a summary of the case for a lawyer:
The Workers' Compensation Appeals Board denied Sherman Oaks Hospital's petition for reconsideration of a decision disallowing their lien. The Administrative Law Judge found the hospital failed to prove the reasonableness of their charges, specifically an additional $$24,512.31$ beyond the agreed $$49,024.00$. The Board affirmed that the lien claimant bore the burden of proving reasonableness, which was not met by simply submitting bills or relying on expert testimony from someone not qualified to address specific fee schedule interpretations. Furthermore, the hospital failed to present evidence demonstrating they qualified for any trauma center exceptions or the application of specific burn case fee schedules under Labor Code Section 5307.1.
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