WCPanelIQ
PanelIBRLienDenied

Maria Gil Soto — ADJ11122688

MARIA GIL SOTO, Applicant vs. ABBOTT LABORATORIES; TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA, adjusted by MATRIX, Defendants

ADJ number
ADJ11122688
Decision date
Sep 23, 2021
District office
Oakland
WCJ
Jeffrey Friedman
Claim administrator
Matrix Absence Management Inc. (TPA for Travelers Property Casualty Company of America)
Commissioners
—

Injury / body parts: right ankle, low back, bilateral wrists

CCR §9795.3

Summary

Lien claimant Central Coast Interpreters (CCI) provided interpreting services for applicant Maria Gil Soto during a Functional Restoration Program. CCI billed $20,197.50 (135.65 hours at $150/hour), which Matrix reduced or partially paid. CCI requested second bill review on some charges but never requested Independent Bill Review (IBR) on any charge. The WCJ found, relying on Meadowbrook Ins. Co. v. WCAB, that the WCAB lacked jurisdiction over 76.15 hours where CCI failed to pursue IBR, retained jurisdiction over 59.5 hours, and applied a market rate of $110/hour rather than the $150 demanded. The WCAB adopted the WCJ's report and denied reconsideration.

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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