WCPanelIQ
PanelMed-legalLienGranted

Verdeja, Natalie

NATALIE VERDEJA, Applicant vs. TARGET CORPORATION, permissibly self-insured, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, Defendants

ADJ number
ADJ15691107
Decision date
Aug 12, 2024
District office
Santa Ana
WCJ
—
Claim administrator
Sedgwick Claims Management Services (administering for Target Corporation, permissibly self-insured)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER

Injury / body parts: back, thigh, psyche, nervous system, multiple body parts

LC §4600LC §4601LC §4060LC §4620LC §4064LC §4621LC §4622LC §3600LC §3208.3LC §3209.3LC §139.2LC §4603.3CCR §9793CCR §10451.1

Summary

Lien claimant Omid Haghighinia, D.C., sought reconsideration of a WCJ's Findings and Order finding he was not a primary treating physician (PTP) and that his lien was not recoverable. The WCJ had reasoned that Dr. Haghighinia could not be a PTP because he saw applicant only once and did not monitor treatment, and that his report could not prove or disprove a disputed medical fact because he reviewed no records and evaluated applicant more than a year after the injury. The Appeals Board rejected this reasoning, holding nothing in the Labor Code requires a physician to provide treatment before being designated a 'treating' physician, and that delay or failure to review records does not automatically invalidate a medical-legal report. Applying Colamonico, the Board found the lien claimant met its initial burden under sections 4620 and 4621. The Board granted reconsideration, rescinded the F&O, substituted findings that lien claimant qualified as a PTP and met its burden, and remanded to the WCJ to determine the reasonable value of the report.

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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