Jonathan Norton, vs. Navigator Yachts, Inc.; Intercare Insurance Services,

This case is about a lien claimant, Mehdi Habibi, M.D., who sought reconsideration of a July 20, 2009 Findings and Orders issued by a workers' compensation administrative law judge (WCJ). The WCJ found that lien claimant had not shown good cause as to why the Official Medical Fee Schedule (OMFS) should not apply and allowed lien claimant payment in the amount of $3,970.35, less credit for amount previously paid. The WCJ also allowed lien claimant an increase of 10 percent penalty ($253.19) on the outstanding balance of $2,531.91, plus interest. The Petition for Reconsideration argued that the WCJ's decision did not reflect the

NAVIGATOR YACHTS, INC.; INTERCARE INSURANCE SERVICES, JONATHAN NORTON, WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAJONATHAN NORTON, Applicant,vs.NAVIGATOR YACHTS, INC.; INTERCARE INSURANCE SERVICES, Defendant(s).Case No. ADJ1159851 (LAO 0793456)OPINION AND ORDER GRANTING PETITION FOR RECONSIDERATION AND DECISION AFTER RECONSIDERATION            Lien claimant Mehdi Habibi, M.D., seeks reconsideration of the July 20, 2009 Findings and Orders issued by a workers’ compensation administrative law judge (WCJ), wherein the WCJ found that lien claimant had not shown good cause as to why the Official Medical Fee Schedule (OMFS) should not apply. The WCJ allowed lien claimant payment in the amount of $3,970.35, less credit for amount previously paid. The WCJ also allowed lien claimant an increase of 10 percent penalty ($253.19) on the outstanding balance of $2,531.91, plus interest. Applicant’s underlying claim for back injury on April 10, 2001, was resolved by way of an Award issued on May 15, 2008, based on the parties’ stipulations. Applicant’s injury caused permanent disability of 90 percent.            In his Petition for Reconsideration, lien claimant contends that the WCJ’s decision does not reflect the facts which were submitted to the WCJ. Lien claimant argues that the factors set forth in Gould v. Workers’ Comp. Appeals Board (1992) Cal.App.4th, 1059 [57 Cal.Comp.Cases 1571 should be considered in this matter to determine the reasonableness of lien claimant’s fees for medical treatment which are in excess of the OMSF. No Answer was found in FileNet in the Electronic Adjudication Management System (EAMS) or in the file forwarded to us.            We have considered the allegations of lien claimant’s Petition for Reconsideration and the contents of the record, including the WCJ’s Report and Recommendation on Petition for , Reconsideration (Report). Based on our review of the record, and for the reasons stated herein, we will grant reconsideration.        

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