John Moler, vs. Western Utilities; Ciga By Cambridge Integrated Services For ‘i Fremont Insurance In Liquidation,

(FRE0184900)In this case, John Moler, the applicant, was seeking reimbursement for medical services provided by Sierra Pacific Surgery Center. The Workers' Compensation Administrative Law Judge issued a Findings and Award, finding that the trial record must be made adequate for a finding on reasonable facility fee costs for the services provided. Western Utilities; CIGA by Cambridge Integrated Services for Fremont Insurance in liquidation, the defendant, filed a timely petition for removal, requesting that the appeals board remove the matter to themselves and issue an order denying the lien. The petition was denied and the petition for reconsideration filed by lien claimant Summit Surgical Center was dismissed.

WESTERN UTILITIES; CIGA by CAMBRIDGE INTEGRATED SERVICES for ‘I FREMONT INSURANCE in liquidation, JOHN MOLER, WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAJOHN MOLER, Applicant,vs.WESTERN UTILITIES; CIGA by CAMBRIDGE INTEGRATED SERVICES forFREMONT INSURANCE in liquidation, Defendant(s).Case No. ADJ3112081 (FRE0184900)OPINIONS AND ORDERS DENYING PETITION FOR REMOVAL AND DISMISSING PETITION FOR RECONSIDERATION            On October 31, 2008, the Workers’ Compensation Administrative Law Judge (WCJ) issued a Findings and Award, finding that “[t]he trial record must be made adequate for a finding on reasonable facility fee costs for the services provided by Sierra Pacific Surgery Center [LC] to applicant on 8/1/2002.”‘1 In his Opinion on Decision, he stated: “Lien claimant has provided evidence of comparable charges by surgery centers including hospitals in other areas for the period services were provided here…. But here, it is not relevant what was paid in San Diego County or another state for similar services because applicant would not have had access to such facilities… Accordingly, the best evidence in this case is what similar facilities in the Fresno area that applicant had reasonable access to were paid for similar services at the time the services here were provided by Sierra Surgery Center [sic]. (08/01/02)” [emphasis in original].            Defendant has filed a timely petition for removal, requesting that the appeals board remove the matter to ourselves and issue an order denying the lien. Defendant contends that lien claimant has not sustained its burden of proving that its charges are reasonable, as required by Tapia v. Skill Master Staffing (2008) 73 Cal.Comp.Cases 1338, 1340 (appeals board en banc) and that a decision on the lien should be made on the present record. ,             January 5, 2009, lien claimant, now known as Summit Surgical Center, filed a Petition, for Reconsideration and Objection to Petition for Removal by Defendant.

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