Cecilia Macias, vs. Good Shepherd Convalescent Hospital; And State Compensation Insurance Fund,

In this case, Good Shepherd Convalescent Hospital and the State Compensation Insurance Fund were defendants in a workers' compensation case brought by Cecilia Macias. Wilshire Surgicenter, the lien claimant, sought reconsideration of and removal from an order disallowing its $18,148 lien claim for medical treatment it provided to Macias for admitted industrial injuries. The Workers' Compensation Appeals Board denied the reconsideration and removal, finding that Wilshire had not proven that its lien claim was reasonable.

GOOD SHEPHERD CONVALESCENT HOSPITAL; and STATE COMPENSATION INSURANCE FUND, CECILIA MACIAS, WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIACECILIA MACIAS, Applicant,vs.GOOD SHEPHERD CONVALESCENT HOSPITAL; and STATE COMPENSATION INSURANCE FUND, Defendant.Case No. ADJ988798 (VNO 0472280)ADJ1479665 (VNO 0472281)ADJ2424544 (VNO 0472282)ADJ3975160 (VNO 0472283)OPINION AND ORDER DENYING RECONSIDERATION AND REMOVAL            Lien claimant, Wilshire Surgicenter (Wilshire), seeks reconsideration of, and removal from, the Order of March 12, 2009, wherein the workers’ compensation judge (WCJ) disallowed the remainder1 of Wilshire’s $18,148 lien claim for medical treatment it provided to applicant for the admitted industrial injuries she sustained to her right foot, toe, and upper extremity, back, and hip in November and December 2002 and during a period through March 7, 2003, while employed as a certified nursing assistant by Good Shepherd Convalescent Hospital, State Compensation Insurance Fund’s insured on the dates of injury.            Wilshire ostensibly contends that it is entitled to an additional $9,965.09, arguing that it provided evidence that that was the average amount received in 18 other cases and that the WCJ improperly, pursuant to Kunz v. Patterson Floor Coverings, Inc. (2002) 67 Cal.Comp.Cases 1588 (Appeals Board en banc2) (hereafter “Kunz”), considered the Official Medical Fee Schedule (OMFS). Wilshire further contends that we should remove this case from the WCJ and reassign 1It appears that defendant paid Wilshire $2,520 on its original $19,408 bill.2The Appeals Board’s en banc decisions are binding precedent on all Appeals Board panels and WCJs. (Cal. Code Regs., tit. 8, § 10341; City of Long Beach v. Workers’ Comp. Appeals Bd. (Garica) (2005) 126 Cal.App.4t” 298, 313, fn. 5 (70 Cal.Comp.Cases 109, 120, fn. 5); Gee v. Workers’ Comp. Appeals Bd. (2002) 96 Cal.App.4t’ 1418, 1425, fn. 6 (67 Cal.Comp.Cases 236, 239, fn. 6); see also Gov. Code, § 11425

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