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PanelLienDenied

Lopez, Charlston

CHARLSTON LOPEZ, Applicant vs. MODATIVE, INC.; STATE COMPENSATION INSURANCE FUND, Defendants

ADJ number: ADJ11626597
Decision date: Dec 28, 2023
District office: Long Beach
WCJ: Barbara Toy
Claim administrator: State Compensation Insurance Fund
Commissioners: —

Injury / body parts: upper back, thoracic spine

LC §5705CCR §9767.12

Summary

Optimal Health Institute filed a lien against State Compensation Insurance Fund for treatment provided by Dr. Shen and Dr. Kan to applicant Charlston Lopez from October 26, 2018, to May 15, 2019. The WCJ denied recovery on the lien because the providers were outside SCIF's MPN (State Fund MPN by Harbor Health) and the lien claimant failed to meet its burden of proving any legal or factual basis to treat outside the MPN. On reconsideration, the lien claimant argued for the first time that SCIF had denied certain body parts and that the MPN was invalid—issues not raised at trial. The Board denied reconsideration, adopting the WCJ's report, and found the newly raised issues were forfeited under Schultz because they were not litigated at trial.

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.