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Regular DecisionWorkers' Compensation Appeal

GREG CALLAHAN vs. ROSS & BARROWS, STATE COMPENSATION INSURANCE FUND

Filed: Oct 28, 2015
ADJ2223312 (ANA 0409909)

CompFox AI Summary

This case concerns a lien claimant, Western Medical Center, seeking payment for medical services rendered to applicant Greg Callahan. The Workers' Compensation Appeals Board (WCAB) denied reconsideration of an administrative law judge's ruling that the WCAB lacks jurisdiction to determine the lien dispute. This is because an "express agreement," established through a chain of contracts between Western Medical Center, Blue Cross, and the defendant insurer (SCIF), fixed the payment rates. Labor Code section 5304 divests the WCAB of jurisdiction when such an agreement exists, and section 5307.11 does not grant jurisdiction in this scenario.

Full Decision Text1 Pages

This case concerns a lien claimant, Western Medical Center, seeking payment for medical services rendered to applicant Greg Callahan. The Workers' Compensation Appeals Board (WCAB) denied reconsideration of an administrative law judge's ruling that the WCAB lacks jurisdiction to determine the lien dispute. This is because an "express agreement," established through a chain of contracts between Western Medical Center, Blue Cross, and the defendant insurer (SCIF), fixed the payment rates. Labor Code section 5304 divests the WCAB of jurisdiction when such an agreement exists, and section 5307.11 does not grant jurisdiction in this scenario.

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