MERLYN CAROLINA FERMAN, Applicant vs. HI D HI BAR; CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for TOWER/CASTLEPOINT NATIONAL INSURANCE, in liquidation, Defendants
ADJ number
ADJ8107286
Decision date
Oct 21, 2021
District office
Anaheim
WCJ
—
Claim administrator
California Insurance Guarantee Association for Tower/Castlepoint National Insurance, in liquidation
Lien claimant Premier Psychological Services sought reconsideration of a WCJ's Findings and Order that applicant did not sustain an industrial injury and that Dr. Michaels' reports were not substantial medical evidence nor properly obtained. Dr. Michaels' November 19, 2012 report was characterized as a 'request for authorization' but did not arrive at a diagnosis, found no treatment recommended, no permanent psychological injury, and did not address industrial causation (AOE/COE). The WCAB analyzed the lien as both a potential medical treatment lien and a medical-legal lien, finding it failed under both theories. The Board held the lien claimant did not prove industrial injury (for a treatment lien), did not establish a presumption of compensability (no evidence of claim form filing date), and did not show the evaluation qualified as a compensable medical-legal evaluation. The petition for reconsideration was denied.
Issues
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Holding
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Analysis
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Applicant takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Defense takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Provider takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Similar decisions
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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