John Padilla vs. Ramada Plaza Hotel; State Compensation Insurance Fund

In this case, John Padilla, an employee of Ramada Plaza Hotel, filed an application for adjudication of claim alleging that he incurred an industrial injury to his right knee while employed by the hotel. On May 14, 2004, Padilla and the hotel, represented by the State Compensation Insurance Fund (SCIF), stipulated to an award of 32% permanent disability and future medical treatment. The lien claim of Post Street Surgery Center (PSSC) for $16,179 was reserved. At the pre-trial conference, SCIF asserted that the lien claim should be disallowed because PSSC did not possess a fictitious-name permit from the Medical Board. The WCJ disallowed the lien claim based on the lack of

Ramada Plaza Hotel; State Compensation Insurance Fund John Padilla WORKERS COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAJOHN PADILLA, Applicant,vs.RAMADA PLAZA HOTEL; STATE COMPENSATION INSURANCE FUND, Defendants,POST STREET SURGERY CENTER, Lien Claimant.Case No. SFO 0456846OPINION ANDDECISION AFTER RECONSIDERATION            We previously granted the petition of lien claimant, Post Street Surgery Center (PSSC), for reconsideration of the August 17, 2006 Findings and Order of the workers’ compensation administrative law judge wherein he ordered that the lien claim of PSSC be disallowed based upon his Finding that PSSC had not demonstrated that it “had the requisite pharmacy permit at the time when its services were performed.” Prior to the lien trial herein, defendant paid $1,071 of PSSC’s $17,250 bill for services related to applicant’s knee surgery on December 10, 2002, leaving a balance claimed of $16,179. Applicant’s claim of industrial injury to his right knee while employed by defendant as a doorman on April 15, 2001, was addressed on May 14, 2004, by entry of a stipulated award of 32% permanent disability and future medical treatment. As part of the stipulations, defendant agreed to adjust or litigate the lien of PSSC and jurisdiction was reserved. Thereafter, on November 14, 2005, the WCJ approved a compromise and release of applicant’s claim, but jurisdiction over the PSSC’s lien claim continued to be reserved.            PSSC contends that the issue of a pharmacy permit was not timely raised by defendant and that it did not have a fair opportunity to be heard on the issue.            We will rescind the August 17, 2006 Findings and Order and return the matter to the trial level for further proceedings and decision regarding PSSC’s compliance with applicable licensure, , accreditation and/or permit requirements, and, if appropriate, the reasonableness of the amount claimed by PSSC.            On May 3, 2002. applicant filed an Application for Adjudicati

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