WCPanelIQ
PanelQMEIBRLienDenied

Valerio, Bertha

BERTHA VALERIO, Applicant vs. KIMCO STAFFING SERVICES, INC.; XL INSURANCE; administered by SEDGWICK CMS, Defendants

ADJ number
ADJ15329380
Decision date
Aug 4, 2025
District office
Anaheim
WCJ
—
Claim administrator
Sedgwick CMS (administering for XL Insurance)
Commissioners
LISA A. SUSSMAN, DEPUTY COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER

Injury / body parts: trunk, back, hips

LC §4600LC §4603.2LC §4604.5LC §5811LC §5900LC §5909CCR §9767.5CCR §9767.12CCR §9795.3CCR §10600

Summary

Applicant Bertha Valerio, a packer, sustained injury AOE/COE to the trunk, back, and hips on September 9, 2021. Lien claimant Joyce Altman Interpreting, Inc. sought recovery for interpreting services provided during applicant's medical treatment with Dr. Marina Russman. The WCJ found defendant failed to prove applicant improperly treated outside the MPN and that Dr. Russman's pre-August 9, 2022 RFAs were defective, and awarded the lien claimant $7,930 at established market rates without penalties or interest. Defendant petitioned for reconsideration arguing the treatment was unreasonable due to non-MPN treatment, failure to address MTUS/ACOEM compliance, and improper market rate establishment. The Appeals Board denied reconsideration, holding defendant failed to meet its burden of proof on the MPN issue, the MTUS/ACOEM issue was not raised at trial, and lien claimant adequately established market rate without rebuttal evidence.

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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