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PanelQMEMed-legalLienRemanded

Rebollo, Maria Esther

MARIA ESTHER REBOLLO, Applicant vs. ATRIA SENIOR LIVING; SAFETY NATIONAL CASUALTY, administered by GALLAGHER BASSETT SERVICES, Defendants

ADJ number: ADJ17166141
Decision date: Jan 5, 2025
District office: Santa Ana
WCJ: —
Claim administrator: Gallagher Bassett Services (administering for Safety National Casualty)
Commissioners: KATHERINE A. ZALEWSKI, CHAIR, JOSÉ H. RAZO, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER

Injury / body parts: neck, back, right shoulder, shoulders, hernia

LC §59091LC §5909LC §5900LC §3600LC §3202.5LC §3202LC §4600LC §4060LC §4620LC §4064LC §4063.2LC §4622LC §4621LC §4603.3LC §139.2LC §5307.6LC §3209.3CCR §9793CCR §9785CCR §10786

Summary

Lien claimant Medland Medical sought reconsideration of a WCJ's Findings and Order that disallowed its lien for medical treatment and medical-legal services rendered to applicant Maria Esther Rebollo, a caregiver who claimed a cumulative trauma injury to her neck, back, shoulders, and hernia. The WCJ had found the lien claimant failed to prove its services were reasonable or necessary. The Appeals Board found that the threshold issue of injury AOE/COE had never been adjudicated and must be decided before determining defendant's liability for medical treatment. The Board further found that a PTP may issue a medical-legal report even where an AME/PQME exists, and that lien claimant appeared to have met its initial burden under sections 4620 and 4621. The Board granted reconsideration, rescinded the F&O, and remanded the matter to the WCJ for further proceedings.

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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Similar decisions

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Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.