WCPanelIQ
PanelMed-legalLienGranted

Bailon Martinez, Raul

RAUL BAILON MARTINEZ, Applicant vs. VILLA PARK LANDSCAPE; OAK RIVER INSURANCE, Defendants

ADJ number
ADJ16834660
Decision date
Mar 27, 2025
District office
Anaheim
WCJ
—
Claim administrator
Oak River Insurance
Commissioners
ANNE SCHMITZ, DEPUTY COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER

Injury / body parts: bilateral upper extremities

LC §3600LC §3550LC §4600LC §4616LC §4616.3LC §4620LC §5313LC §5402LC §5705LC §5803LC §5900LC §5901LC §5902LC §5903LC §5907LC §5908LC §5908.5LC §5909LC §5950CCR §9767.6

Summary

Lien claimant Medland Medical sought reconsideration of a December 31, 2024 F&O in which the WCJ found applicant sustained an industrial injury to his bilateral upper extremities while working as a landscaper, but denied reimbursement for medical treatment and medical-legal reporting costs rendered before the January 13, 2023 claim denial, while finding the record inadequate to value treatment rendered after denial. The lien claimant argued entitlement to reimbursement during the delay period under section 5402(c), asserting the employer failed to provide MPN notice and neglected its statutory treatment obligations, and that Dr. Haghighinia's reporting was a valid medical-legal expense addressing compensability. The Appeals Board granted reconsideration as a preliminary matter to allow further review of the merits and the entire record. The Board highlighted the applicable legal framework governing MPN notice, self-procurement of treatment, and medical-legal expenses, and noted that further development of the record may be appropriate. A final decision was deferred.

Issues

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Holding

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Analysis

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Applicant takeaway

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Defense takeaway

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Provider takeaway

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