WCPanelIQ
PanelMed-legalLienGranted in Part

Johnson, David, Jr.

DAVID JOHNSON, JR., Applicant vs. DIVERSITECH HOLDINGS, INC.; TRAVELERS AND EMPLOYBRIDGE, insured by XL INSURANCE, administered by BROADSPIRE, Defendants

ADJ number
ADJ16511003
Decision date
Aug 1, 2024
District office
San Bernardino
WCJ
—
Claim administrator
Broadspire (administering XL Insurance for Employbridge); Travelers for Diversitech Holdings, Inc.
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER
LC §4060LC §4064LC §4620LC §5904

Summary

Lien claimant Medland Medical sought reconsideration of a WCJ's Findings and Order that denied its lien in its entirety, covering both medical treatment services and medical-legal charges for evaluations performed by Dr. Omid Haghighinia, the applicant's primary treating physician. The WCJ had found that the lien claimant failed to prove AOE/COE and thus could not establish reasonableness and necessity of treatment, and separately denied the medical-legal report as defective because it used an incorrect injury date and lacked proof of when the claim was made. The Board granted reconsideration in part, finding that a 'contested claim' existed under section 4620 and that an incorrect injury date alone did not render the medical-legal report useless. The Board amended the F&O to find Medland entitled to reimbursement for the reasonable and necessary medical-legal evaluation (with the amount deferred), but affirmed the denial of medical treatment reimbursement because the lien claimant did not challenge the AOE/COE finding in its petition and thereby waived the issue under Labor Code section 5904. The matter was returned to the WCJ for further proceedings on the amount owed.

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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