Home/Case Law/MICAELA HERRERA vs. EL TORO TORTILLERIA, ENDURANCE INSURANCE COMPANY
Regular DecisionReconsideration

MICAELA HERRERA vs. EL TORO TORTILLERIA, ENDURANCE INSURANCE COMPANY

Filed: Sep 17, 2013
San Joaquin
ADJ444109

CompFox AI Summary

The Workers' Compensation Appeals Board denied a lien claimant's petition for reconsideration, affirming the judge's order that the lien claimant receive nothing. The Board found the lien claimant failed to prove the applicant sustained an industrial injury AOE/COE, as a Compromise and Release does not automatically stipulate to this. Even if injury AOE/COE were proven, the Board noted the treatment provided, including narcotics and "medical foods," was inconsistent with the QME's recommendation for non-narcotic pain medication. The lien claimant also failed to provide evidence of requested authorization for the disputed treatment.

Full Decision Text1 Pages

The Workers' Compensation Appeals Board denied a lien claimant's petition for reconsideration, affirming the judge's order that the lien claimant receive nothing. The Board found the lien claimant failed to prove the applicant sustained an industrial injury AOE/COE, as a Compromise and Release does not automatically stipulate to this. Even if injury AOE/COE were proven, the Board noted the treatment provided, including narcotics and "medical foods," was inconsistent with the QME's recommendation for non-narcotic pain medication. The lien claimant also failed to provide evidence of requested authorization for the disputed treatment.

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