San Antonio Village Hoa; State Farm Insurance Companies Guadalupe Carrillo WORKERS-COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAGUADALUPE CARRILLO, Applicant,vs.SAN ANTONIO VILLAGE HOA; STATE FARM INSURANCE COMPANIES, Defendants.Case Nos. ADJ2904305; ADJ1827151OPINION AND ORDER DENYING PETITION FOR RECONSIDERATION Lien claimant Mark L. Duell Sr., D.C. seeks reconsideration of a workers’ compensation administrative law judge’s (WCJ) Joint f inding and Order of May 5, 2010, wherein the WCJ disallowed the $9,349.46 balance of Dr. DucIPs lien. Previously in this case, by way of a Compromise and Release agreement approved on August 8, 2005, in exchange for $30,000, applicant settled his claims that, while employed as a gardener on June 17, 2003, and during a cumulative period from August 1, 2003 to September 22, 2003, he sustained industrial injury- to his back, spine, left foot, and ankle. Pursuant to Paragraph 7 of the Compromise and Release, the defendant agreed to responsibility for various liens, including Dr. Duell’s lien. Lien claimant contends that the WCJ erred disallowing the balance of his lien. We have not received an answ-cr, and the WCJ has filed a Report and Recommendation on Petition for Reconsideration.In his Opinion on Decision, the WCJ explained his disallowance of the balance of Dr. Duell’s lien as follows:“Defendant contends that Duell had no written authorization for those sessions billed under CPT Code 97545 as work hardening and/or work conditioning and that prior authorization was required. In his deposition, Duell testified that he had verbal authorization from Defendant on October 1, 2003 for his course of treatment. “Defendant contends that Duell had no written authorization for those sessions billed under CPT Code 97545 as work hardening and/or work conditioning and that prior authorization was required. In his deposition, Duell testified that he had verbal authorization from Defendant on October 1, 2003 for
Guadalupe Carrillo vs. San Antonio Village Hoa; State Farm Insurance Companies
In this case, Guadalupe Carrillo, an applicant, settled his claims that he sustained industrial injury to his back, spine, left foot, and ankle while employed as a gardener on June 17, 2003, and during a cumulative period from August 1, 2003 to September 22, 2003. The defendant agreed to responsibility for various liens, including Dr. Duell’s lien. The Workers' Compensation Appeals Board denied the lien claimant's petition for reconsideration of the Joint Finding and Order of May 5, 2010, which disallowed the balance of Dr. Duell's lien. This was because there was no evidence of written authorization for work hardening/work conditioning, which was required.
- Filed On:
- Court: California, San Francisco
- Case No. ADJ2904305
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