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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. ADJ6669630
Regular
Jul 23, 2018

ROBERT SAXTON vs. SELECT A SERVICE RETAIL, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior decision regarding a lien claim by Western Imaging Services for copying services. The WCAB found that for most invoices, the defendant waived objections to reasonableness due to untimely and invalid objections. However, the WCAB noted potential issues with two specific invoices (82003-7 and 82003-8) and deferred the final determination of reimbursement for these and other contested invoices. The matter was returned to the administrative law judge for further proceedings on the validity of those specific invoices.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings and AwardWorkers' Compensation Administrative Law JudgeReimbursementFee ScheduleObjectionsInvoicesReasonable and Necessary
References
Case No. ADJ7390533
Regular
Dec 10, 2018

HADA RAMOS vs. PREMIER BUILDING MAINTENANCE SERVICES, CYPRESS INSURANCE COMPANY C/O BERKSHIRE HATHAWAY HOMESTATE COMPANIES

The Workers' Compensation Appeals Board granted reconsideration to address discrepancies regarding submitted invoices for lien claimant Med-Legal Photocopy. Previously, a decision disallowed certain invoices due to perceived missing documentation, but the lien claimant asserted these were submitted. The Board found good cause to rescind its prior order and the WCJ's award due to potential technical filing issues with EAMS. The case is returned to the WCJ to develop the record concerning the disputed invoices and issue a new decision.

Med-Legal PhotocopyPetition for ReconsiderationOpinion and Decision After ReconsiderationAdministrative Law JudgeFindings and AwardLien ClaimantInvoicesBurden of ProofRecord DevelopmentElectronic Adjudication Management System (EAMS)
References
Case No. ADJ9120523
Regular
Jan 25, 2018

Guillermo Reyes Perez vs. Colorama Wholesale Nursery, Zenith Insurance Company

This Workers' Compensation Appeals Board case concerns disputed payments for copying services provided by lien claimant Citywide Scanning Services, Inc. The Board granted reconsideration to amend the original decision based on the WCJ's report. While most of the lien claimant's invoices were deemed satisfied due to failure to request a second review after receiving Explanations of Review (EORs), two invoices were specifically addressed. The Board found the defendant failed to provide valid EORs for services related to Colorama Wholesale Nursery and the California Secretary of State. Therefore, the lien claimant is entitled to full payment for these two invoices, less any amounts already paid by the defendant.

EORLabor Code section 4622WCAB Rule 9794(c)Petition for ReconsiderationLien claimantCopying servicesSecond reviewInvoicesDefendant's answerReport and Recommendation
References
Case No. ADJ9838074 ADJ9838134
Regular
Nov 25, 2019

LEON SIMPSON vs. COLLEGE MEDICAL CENTER, NATIONAL CASUALTY INSURANCE, Administered by BROADSPIRE

The Workers' Compensation Appeals Board granted the lien claimant's petition for reconsideration regarding copy service invoices. The Board rescinded the prior decision, finding the administrative law judge's analysis inconsistent with Labor Code section 4622. The case is returned to the WCJ for further proceedings and a new decision consistent with the Board's en banc opinion in *Colamonico*, particularly addressing timely EOR submissions and the proper application of bill review statutes. Specifically, the WCJ must determine if defendants submitted timely explanations of review for all invoices.

Workers' Compensation Appeals BoardLien claimantMedical-legal expenseExplanation of Review (EOR)Labor CodePetition for ReconsiderationRescindFurther proceedingsColamonico v. Secure TransportationReasonable value
References
Case No. ADJ1952983
Regular
Mar 15, 2018

JUAN RIVERA vs. IMPORT EXPORT CACTUS, STATE COMPENSAITON INSURANCE FUND

In this workers' compensation case, the defendant sought reconsideration of a prior ruling that deemed them to have waived objections to a specific invoice from lien claimant Scandoc Imaging. The WCAB denied reconsideration, finding that the defendant's objection, if any, was untimely, having been filed approximately four years after the invoice was submitted. California regulations require objections to medical-legal billings within 60 days to avoid waiver. Therefore, the defendant waived their objections to the reasonableness of the services and charges for invoice #234447-3.

WCABPetition for ReconsiderationFindings and Orderslien claimantinvoice objectionwaiver of objectionreasonableness of servicesLabor Code section 4622Scandoc ImagingImport Export Cactus
References
Case No. ADJ9668315
Regular
Jan 10, 2020

MARTIN AMADOR vs. CAL CENTRAL HARVESTING, STAR INSURANCE COMPANY

This case concerns a lien claimant, Citywide Scanning, seeking payment for medical-legal discovery services. The Workers' Compensation Appeals Board (WCAB) affirmed the initial award but deferred the issue of the reasonable value of services. The WCAB found the defendant waived objections to the invoices by failing to provide timely explanations of review, thus incurring a penalty and interest. However, the WCAB returned the matter for further proceedings to establish a reasonable value, as the initial evidence was insufficient.

WCABReconsiderationLien ClaimantCitywide ScanningFindings of FactAward and OrderMedical-Legal Discovery ServicesCopy ServicesExplanation of Review (EOR)Labor Code Section 4622
References
Case No. ADJ3550667 (OXN 0149715)
Regular
Apr 08, 2009

Deanna Rasmussen vs. VIJAY GARG, M.D., INC., PREFERRED EMPLOYERS INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior finding that the applicant was an employee, determining she was an independent contractor. Key factors supporting this decision included the applicant's specialized skills, license, provision of her own malpractice insurance, billing via invoice, and receipt of a 1099 tax form. Unlike employees, she did not receive benefits like sick leave or paid holidays, and controlled the means by which her work was accomplished, despite the employer providing supplies and equipment. Therefore, her claim for workers' compensation benefits was denied.

Workers' Compensation Appeals BoardVijay Garg M.D. Inc.Preferred Employers Insurance CompanyDeanna Rasmussennuclear cardiology technologistindependent contractoremployeeright knee hip shoulder groin injuryspecialized skillslicense
References
Case No. ADJ8649778
Regular
Mar 18, 2019

Rand Sessor vs. AKH COMPANY, INC., THE HARTFORD INSURANCE COMPANY, Cannon Cochran Management Services, Inc.

This case concerns a lien claim by Med-Legal Photocopy for services rendered to applicant Rand Sessor. The Workers' Compensation Appeals Board (WCAB) granted Med-Legal's petition for reconsideration, reversing the WCJ's finding that the lien was untimely. The WCAB held that the lien was timely filed within the 18-month statutory period under Labor Code section 4903.5, as the date of service was established by an invoice and accompanying records sent on September 11, 2013. Consequently, Med-Legal's lien was found to be valid.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationLabor Code section 4903.5Statute of limitationsDate of serviceIndustrial injuryCompromise and ReleaseSubpoena duces tecumInvoice
References
Case No. ADJ8992728
Regular
Nov 15, 2017

Matthew Greene vs. HCI ENVIRONMENTAL ENGINEERING, GALLAGHER BASSETT

The Workers' Compensation Appeals Board denied Med-Legal Photocopy's petition for reconsideration, upholding the administrative law judge's decision. The lien claim was found to be untimely and barred by the 18-month statute of limitations under Labor Code section 4903.5(a) because the services were rendered on September 25, 2013, and the lien was filed on June 29, 2015. The Board found that an invoice dated December 30, 2013, did not constitute a new date of service as the underlying work was performed earlier. Therefore, the lien claimant took nothing on its claim.

Lien claimantReconsiderationStatute of limitationsLabor Code section 4903.5(a)Untimely filingDate of servicePetition for ReconsiderationWCJWorkers' Compensation Appeals BoardAdministrative law judge
References
Case No. ADJ1660426 (FRE 0225153)
Regular
Jul 19, 2012

Barbara Haskin vs. Fresno Unified School District

The Workers' Compensation Appeals Board granted reconsideration for lien claimant Access Mediquip against Fresno Unified School District. The WCJ had previously ruled that the lien claimant take nothing, finding the defendant had no obligation to them. However, the Appeals Board found the record deficient, lacking admitted evidence necessary for a fair adjudication. Consequently, the prior decision was rescinded, and the case was returned for further proceedings and a new decision.

Access MediquipPinnacle Lien Servicesspinal surgeryimplantable devicesSynthes invoiceadmitted evidenceevidentiary recordFileNetEAMSHamilton v. Lockheed
References
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