Jessie Rafols — ADJ19682404

Lien claimant Medland Medical, through PTP/med-legal evaluator Dr. Omid Haghighinia, sought reconsideration after a WCJ denied its lien in its entirety, finding applicant failed to prove injury AOE/COE and that the med-legal charges were not proven or properly served. The applicant alleged a June 17, 2024 spider bite to his right hand while working as a caregiver, which led to infection and two surgeries; defendant denied the claim and the parties later settled by C&R for $20,000 while stipulating the claim remained denied AOE/COE and waiving a QME report. The WCAB granted reconsideration, rescinded the F&O, and remanded, holding the WCJ improperly analyzed AOE/COE (conflating nature/extent with occurrence), ignored that applicant reported the bite and was driven to the hospital by his employer (matters within lay testimony), and erroneously found Dr. Haghighinia's report was not a compensable medical-legal evaluation. The Board found Exhibits 1 and 2 should be admitted, the report qualifies as a medical-legal report under section 4620, and that the lien claimant met its initial burden under sections 4620 and 4621, leaving only defendant's liability under section 4622 in dispute. The Board also criticized the WCJ's approval of the C&R without insisting on medical evidence and its tacit approval of the parties waiving the QME report, citing its recent en banc decision in Gaines.