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PanelMed-legalLienGranted in Part

Huitron, Jose

JOSE LUIS HUITRON, Applicant vs. CUSTOM METAL FINISHING INC.; EMPLOYERS PREFERRED INSURANCE COMPANY, administered by EMPLOYERS INSURANCE GROUP, Defendants

ADJ number: ADJ16468047
Decision date: Apr 1, 2024
District office: Anaheim
WCJ: —
Claim administrator: Employers Insurance Group
Commissioners: JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: arm, wrist, shoulder, body systems

LC §4060LC §4060(b)LC §4064(a)LC §4620(a)LC §4600LC §4603LC §5904CCR §9793(h)CCR §9783

Summary

Lien claimant Spectrum Medical Group sought reconsideration of a WCJ's F&O denying its lien in its entirety, which had found that the lien claimant failed to prove AOE/COE and failed to meet AD Rule 9793(h) for medical-legal reimbursement. The case-in-chief had settled by Compromise and Release with injury AOE/COE listed as a disputed good-faith issue. The Board affirmed the denial of reimbursement for medical treatment because the lien claimant did not address the threshold AOE/COE finding in its petition (waiver under section 5904). However, the Board granted reconsideration on the medical-legal evaluation issue, finding the WCJ failed to consider sections 4060(b), 4064(a), and 4620(a), and that AD Rule 9793(h) may not properly preclude recovery for medical-legal reporting by a PTP. The Board deferred the medical-legal reimbursement issue 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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Similar decisions

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Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.