WCPanelIQ
PanelLienGranted

Salazar, Juan

JUAN SALAZAR, Applicant vs. MAYWOOD PLAZA MARKET; STATE COMPENSATION INSURANCE FUND, Defendants

ADJ number
ADJ10344309
Decision date
Sep 28, 2025
District office
Oxnard
WCJ
—
Claim administrator
State Compensation Insurance Fund
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, JOSÉ H. RAZO, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER

Injury / body parts: abdomen, groin, internal system, hernia, low back, shoulders, legs, knees, arms, hands

LC §4903.8LC §4903.5LC §4903LC §3208.3

Summary

Lien claimants Industrial Healthcare PMG, Complete Interpreting, and Peralta Hills-Mission Valley Imaging sought reconsideration of a WCJ's June 1, 2021 Findings and Orders that dismissed their liens for failing to comply with Labor Code section 4903.8(d), based on the deposition testimony of declarant Ilona Kulikova. The WCJ found Ms. Kulikova lacked personal knowledge because she could not testify how charges were determined or entered into billing. The WCAB panel applied a burden-shifting analysis from Lopez v. Marromac, holding that a declaration in the proper statutory form constitutes prima facie evidence, shifting the burden to defendant to prove incompetency. The panel concluded that the statute only requires competency to attest that services were actually provided and that billing accurately describes them—not knowledge of how charges were calculated. Because Ms. Kulikova testified she had access to medical reports and billing through a linked computer system, defendant failed to overcome the prima facie showing. The Board rescinded the F&O and substituted findings that the declarations are valid, returning the matter for further proceedings.

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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