WCPanelIQ
PanelMed-legalLienRemanded

Alcaraz, Tomas

TOMAS ALCARAZ, Applicant vs. PSLQ, INCORPORATED; CALIFORNIA CONTRACTORS NETWORK, administered by ATHENS ADMINISTRATORS, Defendants

ADJ number
ADJ15462224
Decision date
Jul 28, 2024
District office
Anaheim
WCJ
—
Claim administrator
Athens Administrators
Commissioners
JOSÉ H. RAZO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: left shoulder, lumbar spine, neck, left hand, left knee, left index finger, left middle finger, left wrist, left arm

LC §4060LC §4064LC §4600LC §4616.3LC §4620LC §4621LC §4622LC §3205.5LC §5307.6LC §5705LC §5900LC §5903LC §5909LC §5952CCR §9793CCR §9794CCR §9795CCR §10964

Summary

Lien claimant Medland Medical sought reconsideration of a WCJ's F&O that disallowed its entire lien for medical treatment and medical-legal services provided by Dr. Haghighinia, applicant's designated PTP. The WCJ had found a compensable left shoulder injury but no other claimed body parts, and disallowed the lien on the basis that treatment was provided outside defendant's MPN. The Board granted reconsideration, finding it appeared the March 7, 2022 report was a medical-legal report, that a contested claim existed when the cumulative injury was denied, and that defendant's MPN-based denial of treatment was problematic where the cumulative injury was denied. The Board rescinded the F&O and remanded for the WCJ to determine in the first instance whether the medical-legal expenses are recoverable, whether the report constitutes substantial evidence of cumulative injury, and whether the treatment was reasonable and necessary.

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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