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Regular DecisionWorkers' Compensation

MENG TU vs. GLOBE COMMUNICATIONS, SUSSEX INSURANCE

Filed: Aug 29, 2017
Anaheim
ADJ8120854

CompFox AI Summary

The Workers' Compensation Appeals Board granted reconsideration, reversing a prior award to lien claimant Rehab Solutions. The Board found that lien claimant bears the burden to prove the reasonableness and necessity of its services, and this burden was not met. Partial payments by the defendant did not constitute authorization or shift the burden of proof, and the utilization review denial of the key treatment remained unchallenged by appeal. Therefore, lien claimant is entitled to no further payment.

Full Decision Text1 Pages

The Workers' Compensation Appeals Board granted reconsideration, reversing a prior award to lien claimant Rehab Solutions. The Board found that lien claimant bears the burden to prove the reasonableness and necessity of its services, and this burden was not met. Partial payments by the defendant did not constitute authorization or shift the burden of proof, and the utilization review denial of the key treatment remained unchallenged by appeal. Therefore, lien claimant is entitled to no further payment.

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MENG TU vs. GLOBE COMMUNICATIONS, SUSSEX INSURANCE (2017) – Anaheim | CompFox