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PanelMed-legalLienGranted in Part

Lee, Young

YOUNG J. LEE, Applicant vs. MILITARY DELI AND BAKERY SERVICES, INC. and UNITED STATES FIRE INSURANCE COMPANY administered by CRUM & FORSTER, Defendants

ADJ number: ADJ11273405
Decision date: Oct 2, 2022
District office: Riverside
WCJ: —
Claim administrator: Crum & Forster (administering for United States Fire Insurance Company)
Commissioners: PATRICIA A. GARCIA, DEPUTY COMMISSIONER

Injury / body parts: neck, right shoulder, right arm, right wrist, right hand/fingers

LC §4060LC §4061LC §4062LC §4064LC §4628LC §139.2CCR §9793CCR §9795CCR §9785CCR §10682

Summary

Lien claimant RMS Medical Group sought reconsideration of a WCJ's Findings and Order that denied payment for a medical-legal report prepared by applicant's primary treating physician (PTP), Dr. Omid Haghighinia, on April 11, 2018, after defendant denied the underlying injury claim. The WCAB granted reconsideration and affirmed the F&O in part but amended it to find RMS entitled to payment. The Board held that a medical-legal evaluation performed by the employee's treating physician is an evaluation obtained pursuant to Labor Code section 4060, for which the employer is liable under section 4064. The Board reduced the awarded amount from the $1,250.00 originally charged to $625.00 based on the Medical-Legal Fee Schedule, and ordered defendant to pay RMS $625.00 in payment of its lien.

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.

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