Jerry Naranjo vs. Southern California Edison: A Comprehensive Overview

In this case, Jerry Naranjo, an employee of Southern California Edison, received medical treatment in the form of cervical epidural injections as a result of an October 16, 2001 industrial injury. The lien claimant, an outpatient surgery center, billed for the injections and Southern California Edison paid a portion of the billings. The Workers' Compensation Appeals Board granted reconsideration and amended the Findings and Award issued by a workers' compensation administrative law judge to include a 10 percent increase in compensation and interest due to Southern California Edison's failure to comply with Labor Code section 4603.2, as well as a credit to Southern California Edison for an overpayment of $372.22.

SOUTHERN CALIFORNIA EDISON; PSI SOUTHERN CAL EDISON ROSEMEAD, JERRY NARANJO, WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAJERRY NARANJO, Applicant,vs.SOUTHERN CALIFORNIA EDISON; PSI SOUTHERN CAL EDISON ROSEMEAD, Defendant(s).Case No. ADJ186123 (AHM 0101334)OPINION AND ORDER GRANTING PETITION FOR RECONSIDERATION AND DECISION AFTER PSI RECONSIDERATION            Defendant seeks reconsideration of the Findings and Award issued by a workers’ compensation administrative law judge (WCJ) on April 1, 2009, wherein the WCJ found that the reasonable value of the facility fee for lien claimant Long Beach Pain Center was in the amount of $1,485.00 for each date of service (DOS). The WCJ further found that lien claimant had been adequately compensated for the April 23, 2003 DOS, but that lien claimant had not beenadequately compensated for the April 16, 2003 DOS. The WCJ awarded reimbursement to lien claimant in the amount of $556.39 plus 10 percent penalty and interest at the civil judgment rate from the date of receipt of the bill. Applicant’s underlying claim involved the October 16, 2001 industrial injury to his shoulders and neck, while working as a Field service Representative for defendant.            Defendant contends that the WCJ erred in awarding a 10 percent penalty against it where lien claimant failed to meet its burden of proof to establish the basis for a penalty under Labor Code section 4603.2, and where the $928.61 payment defendant made for each injection was a reasonable payment which was more than that which would have been allowed by either Medicare ($356.07) or the later effective Official Medical Fee Schedule ($408.91). Defendant also contends that it is entitled to a credit for overpayment of $372.22 as it paid lien claimant twice for the procedure performed on April 23, 2003. No Answer was filed. ,             We have considered the allegations of defendant’s Petition for Reconsideration and the contents of the record. The WCJ did not prepar

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