WCPanelIQ
PanelLienDenied

Angela Banks Robinson — ADJ9918605, ADJ8732256

ANGELA BANKS ROBINSON, Applicant vs. BERKELEY UNIFIED SCHOOL DISTRICT; adjusted by INTERCARE SERVICES, INC., Defendants

ADJ number
ADJ9918605, ADJ8732256
Decision date
Jan 17, 2023
District office
Oakland
WCJ
—
Claim administrator
Intercare Services, Inc.
Commissioners
KATHERINE WILLIAMS DODD, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER
LC §4610.5

Summary

Lien claimant Integrated Pain Care provided an 8-week functional restoration program to applicant Angela Banks Robinson and sought payment of $56,005.01. After two trials, the WCJ awarded $35,757.40 in outstanding charges, a $150 filing fee reimbursement, a 15% penalty of $5,363.61 for delayed payment, and interest. Defendant sought reconsideration, arguing the WCJ erroneously ignored an August 22, 2016 IMR determination denying medical necessity of $32,000 in charges, and that the WCJ failed to set forth findings of fact. The Board affirmed, holding that an April 20, 2016 IMR had already authorized the entire program (which was completed by May 9, 2016), so the later June 17, 2016 untimely UR and August 22, 2016 IMR could not retroactively rescind defendant's payment obligation, and the Order substantially complied with the requirement to set forth findings.

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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