WCPanelIQ
PanelMed-legalLienGranted

Maravilla, Richard Alfredo

RICHARD ALFREDO MARAVILLA, Applicant vs. POOL TIME POOL SERVICE, INC., INSURANCE COMPANY OF THE WEST, Defendants

ADJ number
ADJ19183500
Decision date
Jun 12, 2025
District office
Sacramento
WCJ
—
Claim administrator
Insurance Company of the West
Commissioners
JOSEPH V. CAPURRO, COMMISSIONER, LISA A. SUSSMAN, DEPUTY COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: neck, back, both shoulders, upper extremities, right wrist/hand, thoracic spine, lumbar spine, cervical spine, bilateral elbows, bilateral wrists, bilateral hands

LC §4600LC §4060LC §4620LC §4621LC §4622LC §4064LC §4061.5LC §5307.6LC §3205.5LC §5705LC §5900LC §5909LC §139.2LC §3209.3CCR §9793CCR §9785CCR §10964

Summary

Lien claimant Spectrum Medical Group sought reconsideration of a WCJ's Findings and Order denying its lien for a medical-legal report prepared by Dr. Amin Nia, the applicant's designated primary treating physician. The WCJ had concluded the June 19, 2024 report was not a valid medical-legal report because there was no Doctor's First Report, and denied the $3,351.44 lien. The Appeals Board disagreed, holding that the lack of a Doctor's First Report does not invalidate the PTP designation or the request for a medical-legal report. The Board found that a contested claim existed (the CT claim was denied AOE/COE), that the report was properly requested under section 4060, and that lien claimant met its burden under sections 4620 and 4621. The Board granted reconsideration, rescinded the F&O, and substituted new findings, deferring the section 4622 liability amount and returning the matter to the WCJ.

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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