Evangelina Medina — ADJ11404325

Lien claimant Kinetix Surgery Center sought payment on its lien for surgical services provided to applicant Evangelina Medina, who sustained continuous trauma injury from April 6 to May 4, 2018. The parties stipulated that the proper Official Medical Fee Schedule value of the services was $5,418.04, leaving the disputed issue of whether a Preferred Provider Organization (PPO) contract governed the reimbursement amount. The WCJ found, and the WCAB agreed, that defendant Berkshire Hathaway failed to meet its burden of proving the existence of a valid and applicable PPO contract because it never produced or specifically identified such a document. The Board granted reconsideration to amend the award to allow credit for the $1,471.90 previously paid, reducing the net principal to $3,946.14, and to adjust penalties down to $591.92, but otherwise affirmed the WCJ's decision. Interest under Labor Code § 4603.2(b)(2) was ordered from the date of service of the bill.