Morales, Maria

Applicant Maria Morales sustained an accepted industrial injury on 9/6/13 while working as a laborer for Care Homes Registry. The underlying dispute concerned the reasonable value of inpatient hospital services provided by lien claimant Monrovia Memorial Hospital, a long-term care hospital exempt from the Official Medical Fee Schedule. After multiple submissions and rescissions, the WCJ ultimately found the reasonable value of services to be $110,973.73 using a range-of-evidence approach incorporating Kunz acceptance-rate data, geographic comparable rates, and cost-to-charge ratios. Defendant petitioned for reconsideration arguing the Kunz study was inapplicable and that bill reviewer Sue Choi's testimony was wrongly disregarded. The Appeals Board adopted the WCJ's report and denied reconsideration, also addressing the timeliness of its decision under amended Labor Code section 5909.