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PanelLienDenied

Santana, Luis

LUIS SANTANA, Applicant vs. COCA-COLA, permissibly self-insured, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., Defendants

ADJ number: ADJ8051313
Decision date: Sep 14, 2023
District office: Long Beach
WCJ: Jim Zoellner
Claim administrator: Sedgwick Claims Management Services, Inc. (administrator for Coca-Cola, permissibly self-insured)
Commissioners: —

Injury / body parts: trunk, back, psyche, sleep

LC §4600LC §4616LC §5705LC §3202.5LC §4603.2

Summary

Luis Santana sustained an admitted industrial injury on September 30, 2011, while working as a merchandiser for Coca-Cola (permissibly self-insured, administered by Sedgwick). The case in chief was resolved by Compromise & Release for $22,500 in April 2013. Lien claimant RMS Medical Group sought payment for non-MPN chiropractic treatment provided by Dr. Nia, asserting defendant had denied care, justifying treatment outside the MPN. The WCJ found the lien claimant failed to meet its burden of proving a neglect or refusal to provide treatment, noting defendant had a valid MPN, served notice, and that applicant had twice stipulated to treat within the MPN. The WCAB denied reconsideration, adopting and incorporating the WCJ's report.

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.