Eastbay Municipal Utility District, Permissibly Self·Insured, Adjusted By Octagon Risk Services Jacquelene Sylvester WORKERS COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAJACQUELENE SYLVESTER, Applicant,vs.EASTBAY MUNICIPAL UTILITY DISTRICT, permissibly self·insured, adjusted by OCTAGON RISK SERVICES, Defendant,WEBSTER SURGERY CENTER, Lien Claimant.Case No. WCK 0063415OPINION AND DECISION AFTER RECONSIDERATION We previously granted defendant’s petition for reconsideration of the May 22, 2006 Findings and Order of the workers’ compensation administrative law judge (WCJ), wherein it was found that the reasonable value of medical treatment services provided by lien claimant Webster Surgery Center (Webster) was $10,750.1 Prior to the lien trial, defendant paid $2,162 of Webster’s $14,987.22 bill for services related to knee surgery performed on applicant at Webster on March 13, 2002. No finding was made regarding the licensure and/or accreditation of Webster. Applicant’s claim of industrial injury to her right lower extremity and back on July 13,2001, while working for defendant as a Housekeeper/Janitor, was earlier addressed on October 10, 2004, by entry of a stipulated award of 30% permanent disability and future medical treatment. Defendant contends that there was insufficient evidence to show that the amount allowed by the WCJ was reasonable and that Webster failed to meet its burden of proving that it was properly licensed and/or accredited. Webster filed a response to defendant’s petition for reconsideration that references an attached copy of its “licensure information,” but the attachment 1 Following the grant of reconsideration, the term of Commissioner Rabine expired and a Deputy Commissioner was appointed by the Chairman to take his place. , was not found in the file. We will rescind the May 22,2006 Findings and Order and return the matter to the trial level for further proceedings to address whether Webster was properly licens
Jacquelene Sylvester vs. Eastbay Municipal Utility District, Permissibly Self·insured, Adjusted By Octagon Risk Services
In this case, Jacquelene Sylvester, an applicant, was injured while working for Eastbay Municipal Utility District as a Housekeeper/Janitor. A stipulated award of 30% permanent disability and future medical treatment was entered on October 10, 2004. Webster Surgery Center, the lien claimant, provided medical treatment services related to knee surgery performed on applicant at Webster on March 13, 2002. The reasonable value of the medical treatment services was found to be $10,750. However, the issue of licensure and/or accreditation of Webster was not addressed. The Appeals Board granted the defendant's petition for reconsideration and rescinded the May 22, 2006 Findings and Order, returning the matter to the trial level for further proceedings
- Filed On:
- Court: California, San Francisco
- Case No. WCK0063415
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