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PanelLienDenied

Sharon Eleby — ADJ2341059

SHARON ELEBY, Applicant vs. COUNTY OF LOS ANGELES / MARTIN LUTHER KING HOSPITAL DEPARTMENT #225, PERMISSIBLY SELF-INSURED, ADMINISTERED BY SEDGWICK CLAIMS MANAGEMENT SERVICES, INCORPORATED, Defendants

ADJ number: ADJ2341059
Decision date: Feb 12, 2023
District office: Long Beach District Office
WCJ: Dewayne P. Marshall
Claim administrator: Sedgwick Claims Management Services, Incorporated (administering for County of Los Angeles / Martin Luther King Hospital Department #225, permissibly self-insured)
Commissioners: —

LC §3202.5LC §4600LC §4604.5LC §4610CCR §9785CCR §9792.9CCR §9792.9.1CCR §9792.27.9

Summary

Park Compounding, a compound medication lien claimant, sought reconsideration of a December 15, 2022 Findings of Fact and Order finding it should take nothing further on its lien (balance $9,592.58, with $2,107.96 previously paid) related to applicant Sharon Eleby's 2009 award. The WCJ found that the lien claimant failed to meet its burden of proof that it properly requested authorization for the medications and failed to prove the medications were reasonable and necessary. The Board adopted and incorporated the WCJ's report and denied reconsideration. The WCJ emphasized that the PR-2 reports and prescriptions lacked proofs of service, date stamps, or DWC Form RFAs, and that Dr. Latteri's reports failed to document applicant's symptoms, medication side effects, or scientific evidence justifying compound medications.

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.