WCPanelIQ
PanelQMEMed-legalLienGranted

Hernandez, Silvestre

SILVESTRE HERNANDEZ, Applicant vs. NAPA AUTO PARTS; OAK RIVER INSURANCE COMPANY, administered by BERKSHIRE HATHAWAY HOMESTATE COMPANIES, Defendants

ADJ number
ADJ8294635
Decision date
Aug 12, 2024
District office
Anaheim
WCJ
—
Claim administrator
Berkshire Hathaway Homestate Companies (administering for Oak River Insurance Company)
Commissioners
ANNE SCHMITZ, DEPUTY COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: head, arm, neck, wrist, diabetes, cervical spine, psyche

LC §4600LC §5803LC §5900LC §5901LC §5903LC §5907LC §5908LC §5908.5LC §5950CCR §9795CCR §10605CCR §10615CCR §10617

Summary

Lien claimant Nogales Psychological Counseling, Inc. sought reconsideration of a WCJ's May 20, 2024 F&O disallowing its lien for medical-legal/treatment services provided to applicant Silvestre Hernandez, who sustained a 2011 industrial injury including a psyche component. The WCJ found there was no valid medical-legal dispute when charges were incurred, that the second date of service was disallowed because lien claimant was not the primary treating physician, and that lien claimant never requested a second bill review for the initial date of service. The Appeals Board granted reconsideration solely to issue a Notice of Intention to Dismiss because EAMS records showed discrepancies regarding the filing date and time of the petition—an EAMS batch date of June 14, 2024 at 6:31 p.m. (after the 5:00 p.m. cutoff) and a FileNet received date of June 17, 2024. The Board did not reach the merits and deferred a final decision. Lien claimant was ordered to produce documentation (EAMS Batch ID, etc.) proving timely filing on or before June 14, 2024, or the petition will be dismissed as untimely.

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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