WCPanelIQ
PanelMed-legalLienDenied

Santana, Brigida

BRIGIDA SANTANA, Applicant vs. BARON HR WEST/GRAPHIC INK CORP./TRION SOLUTIONS; STATE COMPENSATION INSURANCE FUND; UNITED WISCONSIN INSURANCE COMPANY administered by NEXT LEVEL ADMINISTRATORS, Defendants

ADJ number
ADJ11626536
Decision date
Jan 1, 2024
District office
Santa Ana
WCJ
Marco Famiglietti
Claim administrator
Next Level Administrators (administering United Wisconsin Insurance Company)
Commissioners
—

Injury / body parts: psyche

LC §3208.1LC §3208.3LC §4903.05LC §4903.8CCR §10964

Summary

Lien claimant Psychological Assessment Services, on behalf of treating physician Dr. Nelson Flores, sought payment for treatment and medical-legal services provided to applicant Brigida Santana for a psychiatric injury. After trial, the WCJ found that the applicant sustained a compensable psychiatric injury, that Dr. Flores's treatment was reasonable and necessary, and that the medical-legal services were appropriate, awarding payment plus penalty and interest. Defendant United Wisconsin Insurance Company petitioned for reconsideration, arguing for the first time that the lien was invalid due to non-compliance with Labor Code sections 4903.05 and 4903.8, alleging the section 4903.8(d) declaration was fraudulent because the attached billing did not match the lien amount. The WCAB adopted the WCJ's report and denied reconsideration because that argument was never raised at trial and was therefore waived. The Board emphasized that allowing un-litigated issues to be raised for the first time on appeal would deprive the opposing party of due process.

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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