Home/Case Law/JUAN MANUEL RESENDIZ vs. DANNY'S TRIMMING & BINDING CORP., STATE COMPENSATION INSURANCE FUND
Regular DecisionReconsideration

JUAN MANUEL RESENDIZ vs. DANNY'S TRIMMING & BINDING CORP., STATE COMPENSATION INSURANCE FUND

Filed: Jan 17, 2014
ADJ253443 (POM 0286361)

CompFox AI Summary

The Workers' Compensation Appeals Board granted reconsideration, rescinding the WCJ's finding that it lacked jurisdiction over a lien dispute between Good Samaritan Hospital and State Fund. The Board found the contracts between State Fund, Blue Cross, and Good Samaritan potentially created an "express agreement" under Labor Code Section 5304, divesting the Board of jurisdiction. However, the Board also noted Good Samaritan failed to meet its initial burden of proof regarding the necessity of its services and that State Fund may not have provided proper notice of its payor status under the contract. The case is returned to the trial level for further evidence development on these issues.

Full Decision Text1 Pages

The Workers' Compensation Appeals Board granted reconsideration, rescinding the WCJ's finding that it lacked jurisdiction over a lien dispute between Good Samaritan Hospital and State Fund. The Board found the contracts between State Fund, Blue Cross, and Good Samaritan potentially created an "express agreement" under Labor Code Section 5304, divesting the Board of jurisdiction. However, the Board also noted Good Samaritan failed to meet its initial burden of proof regarding the necessity of its services and that State Fund may not have provided proper notice of its payor status under the contract. The case is returned to the trial level for further evidence development on these issues.

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