WCPanelIQ
PanelLienDenied

Mendez Montiel, Eugenio

EUGENIO MENDEZ MONTIEL, Applicant vs. TARGET CORP., permissibly self-insured, adjusted by SEDGWICK, Defendants

ADJ number
ADJ17559319
Decision date
Nov 21, 2024
District office
Oakland
WCJ
—
Claim administrator
Sedgwick (administering for Target Corp., permissibly self-insured)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER

Injury / body parts: head (laceration)

LC §112LC §115LC §110LC §111LC §4709LC §5301LC §5315LC §5701LC §5705LC §5901LC §5906LC §5908LC §5908.5LC §5909LC §5911LC §5950LC §5951LC §5952LC §5953LC §4600LC §4610LC §4610.5CCR §10320CCR §10330CCR §10961CCR §10962CCR §10995CCR §10205CCR §10205.4CCR §10880CCR §9792.9.1

Summary

John Muir Hospital, a lien claimant, sought reconsideration of a WCJ's Findings and Order that denied recovery on its $284,284.32 lien for emergency hospital services rendered to applicant Eugenio Mendez Montiel (deceased) from November 20-24, 2021. The claim was accepted only for a head laceration; defendant disputed the nature and extent of injury and denied liability for all other body parts. The Appeals Board first addressed timeliness, finding its time to act was equitably tolled because the WCJ failed to transmit the case file until September 16, 2024, through no fault of the parties. On the merits, the Board held the lien claimant failed to meet its burden of proof by neither establishing that its treatment fell within the accepted nature and extent of injury nor proving the treatment was reasonable and necessary. The Board denied reconsideration.

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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