AFTER NORTH COUNTY FORD; and STATE COMPENSATION INSURANCE FUND, DANIEL STREETER, WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIADANIEL STREETER, Applicant,vs.NORTH COUNTY FORD; and STATE COMPENSATION INSURANCE FUND, Defendant.Case No. ADJ4469041 (SDO 0329027)OPINION AND ORDER GRANTING RECONSIDERATION AND DECISION AFTER RECONSIDERATION Defendant seeks reconsideration of the Amended1 Findings of Fact of December 5, 2008, wherein the workers’ compensation judge (WCJ) found that the Workers’ Compensation Appeals Board (Appeals Board) has jurisdiction, pursuant to Labor Code section 53042, to determine the amount of money to be paid by defendant, State Compensation Insurance Fund (SCIF), to lien claimant, Tri-City Medical Center (Tri-City), for medical treatment it provided to applicant to cure or relieve him from the effects of the admitted industrial injury that he sustained to his right shoulder on October 30, 2002, while employed as a parts counter worker by North County Ford, SCIF’s insured on the date of injury. Defendant contends that the Appeals Board lacks jurisdiction to determine the allowable 191 amount of Tri-Center’s lien claim and, instead, that it is subject to an “express agreement,” within the meaning of section 5304, between Tri-City and Blue Cross and between Blue Cross and SCIF regarding the fees to be paid for the medical treatment provided, arguing that a “chain of contracts” links Tri-City and SCIF, that the contracts provide the medical treatment fees allowed or require arbitration to resolve disputes over same, and that SCIF is a third-party beneficiary to the contract b between Tri-City and Blue Cross. 1The amendment, pursuant to Appeals Board Rule 10858 (Cal. Code Regs., tit. 8, § 10858), merely corrected the date on which the decision was issued. The initial decision was inadvertently and incorrectly dated “‘6-5-08.”2All further statutory references are to the Labor Code, unless otherwise noted. , Tri-
Daniel Streeter, vs. After North County Ford; And State Compensation Insurance Fund,
In this case, North County Ford and the State Compensation Insurance Fund (SCIF) were in dispute over the amount of money to be paid to Tri-City Medical Center for medical treatment provided to an employee of North County Ford. The Workers' Compensation Appeals Board found that SCIF was a third-party beneficiary to a contract between Tri-City and Blue Cross and between Blue Cross and SCIF, and that this contract constituted an "express agreement" fixing the amount of compensation that Tri-City was entitled to receive, and SCIF required to pay, for the medical treatment. The Appeals Board concluded that it lacked jurisdiction over the medical treatment expense controversy, pursuant to Labor Code section 5304, and ordered that Tri-City take nothing on its l
- Filed On:
- Court: California, San Diego
- Case No. ADJ4469041
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