HILTON; AMERICAN PROTECTION INSURANCE COMPANY JASMELITA ASPER WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAJASMELITA ASPER, Applicant,vs.HILTON; AMERICAN PROTECTIONINSURANCE COMPANY, Defendants,Case Nos. ADJ251564 (SAC 0318113)OPINION AND DECISION AFTER RECONSIDERATION In order to further study the factual and legal issues in this case, on December 27, 2011, we granted defendant’s petition for reconsideration of a workers’ compensation administrative law judge’s (WCJ) Findings of Fact and Order of October 14, 2011, wherein it was found that “Dr. Mata did provide treatment to the applicant and said treatment was reasonable and necessary to cure or relieve the effects of the industrial injury.” The WCJ ordered the parties to “adjust Dr. Mata’s billing for the period April 3, 2002 to January 16, 2003.” In this matter, in a Compromise and Release approved on March 8, 2004, inexchange for $40,000, applicant settled her claim that, while employed as a cafeteria attendant on October 10, 2001, she sustained industrial injury to her right shoulder, neck, right elbow, and in the form of headaches. In the Findings of Fact and Order of October 14, 2011, the WCJ found that the applicant indeed sustained industrial injury to her right shoulder, neck, and right elbow. Defendant contends that the WCJ erred in finding that Dr. Mata provided reasonable and necessary medical treatment to the applicant, and effectively allowing Dr. Mata’s lien. We have not received an answer, and the WCJ has filed a Report and Recommendation on Petition for Reconsideration. We will rescind the Findings of Fact and Order of October 14, 2011, and issue a new decision disallowing Dr. Mata’s lien. , Dr. Mata presented insufficient evidence for us to determine whether the medical treatment and his charges were reasonable and necessary. Although Dr. Mata apparently sought reimbursement for his lien in the amount of $7,607, he did not introduce any of his bills int
JASMELITA ASPER vs. HILTON; AMERICAN PROTECTION INSURANCE COMPANY
is a case in which the Workers' Compensation Appeals Board rescinded the Findings of Fact and Order of October 14, 2011, and issued a new decision disallowing Dr. Mata's lien. The WCJ found that the applicant sustained industrial injury to her right shoulder, neck, and right elbow, and that Dr. Mata provided reasonable and necessary medical treatment to the applicant. However, Dr. Mata failed to introduce any of his bills into the evidentiary record, nor did he itemize any of the treatment rendered to the applicant. As a result, the WCJ's order that the parties "adjust Dr. Mata's billing for the period April 3, 2002 to January 16, 2003" was rescinded and the lien of Abraham
- Filed On:
- Court: California, Sacramento
- Case No. ADJ251564
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