Home/Case Law/DAVID ZUBIA vs. EARTHWISE TRUCKING, GALLAGHER BASSETT SCOTTSDALE
Regular DecisionReconsideration

DAVID ZUBIA vs. EARTHWISE TRUCKING, GALLAGHER BASSETT SCOTTSDALE

Filed: Jun 17, 2009
San Francisco
ADJ4653538

CompFox AI Summary

The Appeals Board granted reconsideration to amend a prior decision, but otherwise affirmed it. The employer, Earthwise Trucking, appealed a penalty and interest assessed on an unpaid medical bill, arguing they paid at the "rate in effect" and the bill was not "properly documented." The Board found that the employer's stipulation of an outstanding balance meant they did not pay the full amount due under the Official Medical Fee Schedule (OMFS) within the statutory timeframe. The Board clarified that timely payment is required according to the OMFS rate in effect on the date of service, not based on the employer's internal bill review.

Full Decision Text1 Pages

The Appeals Board granted reconsideration to amend a prior decision, but otherwise affirmed it. The employer, Earthwise Trucking, appealed a penalty and interest assessed on an unpaid medical bill, arguing they paid at the "rate in effect" and the bill was not "properly documented." The Board found that the employer's stipulation of an outstanding balance meant they did not pay the full amount due under the Official Medical Fee Schedule (OMFS) within the statutory timeframe. The Board clarified that timely payment is required according to the OMFS rate in effect on the date of service, not based on the employer's internal bill review.

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