WCPanelIQ
PanelMed-legalLienGranted

Gilliland, Anthony

ANTHONY GILLILAND, Applicant vs. WALMART, INC.; ACE AMERICAN INSURANCE CO., as administered by SEDGWICK CMS, Defendants

ADJ number
ADJ12880191
Decision date
Nov 17, 2024
District office
Pomona
WCJ
—
Claim administrator
Sedgwick CMS (administering ACE American Insurance Co.)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, LISA A. SUSSMAN, DEPUTY COMMISSIONER

Injury / body parts: right knee, left eye, cervical spine, thoracic spine, lumbar spine, bilateral upper extremities, knees, neuro, sleep

LC §5909LC §5900LC §5503LC §5307LC §5307.4LC §5813LC §4903.5LC §5502LC §5313CCR §10600CCR §10774.5CCR §10815CCR §10816CCR §10880CCR §10832CCR §10875CCR §10888CCR §10628CCR §10625CCR §10761CCR §10400CCR §10401

Summary

Lien claimant Medland Medical sought reconsideration of Joint Findings of Fact in which the WCJ found that Medland failed to appear at the June 11, 2024 lien trial, failed to submit evidence, and failed to meet its burden of proof on reasonableness and necessity of medical treatment and med-legal reporting, ordering the lien take nothing. The lien claimant's hearing representative had called in the morning of trial requesting to appear electronically due to illness, but the WCJ denied the request based on a purported '14 day rule' for ADA accommodations. The Board found this 'rule' was an unenforceable underground regulation, that the WCJ violated due process by failing to issue a Notice of Intention before dismissing the lien, by proceeding without the lien claimant, and by failing to serve the decision on the lien claimant. The Board also found it was clear error to assert the lien claimant submitted no evidence, since Exhibits 1-9 (medical bills, treating physician reports) had been admitted at the October 19, 2023 trial. The Board granted reconsideration, rescinded the Joint Findings of Fact, and returned the matter to the WCJ for further proceedings.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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