WCPanelIQ
PanelQMEMed-legalLienGranted in Part

Aamir Khan — ADJ8396740

AAMIR KHAN, Applicant vs. DENNY’S RESTAURANT; THE HARTFORD, Administered by GALLAGHER BASSETT SERVICES, INC., Defendants

ADJ number
ADJ8396740
Decision date
Apr 21, 2021
District office
Long Beach
WCJ
—
Claim administrator
Gallagher Bassett Services, Inc. (administering The Hartford)
Commissioners
DEIDRA E. LOWE, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: head, upper extremities, lower extremities, psyche

LC §5813LC §4620LC §4621LC §4622LC §4603.3LC §5906LC §5908LC §5313CCR §10451.1CCR §10786

Summary

QME psychologist Dr. Matthew Steiner billed $11,250 for an October 2013 psychological medical-legal evaluation. Defendant (The Hartford, administered by Gallagher Bassett) stipulated its Explanation of Review (EOR) was untimely, thereby waiving all objections to the billing except those under Labor Code sections 4620 and 4621. The WCJ found the billing reasonable and awarded the full amount plus a 10% penalty, 7% interest, costs, attorney's fees, and $500 in section 5813 sanctions for bad faith tactics. On reconsideration, the Board affirmed the reasonableness of the billing—finding the verified report and invoice constituted substantial evidence that defendant failed to rebut with any evidence—but deferred the sanctions, costs, and attorney's fees issues because the prior rescission of the F&O meant those issues had not been properly resubmitted with a complete record under Hamilton. The matter was returned to the trial level for proper proceedings on the deferred issues.

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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