Pepsi Bottling Group, permissibly self-insured, administered by Sedgwick Claims Management Services, Inc. Joseph Martinez WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAJOSEPH MARTINEZ, Applicant,vs.PEPSI BOTTLING GROUP, permissibly self-insured, administered by SEDGWICK CLAIMSMANAGEMENT SERVICES, INC., Defendants.Case No. ADJ2166955 (VNO 0493715)OPINION AND ORDER GRANTING RECONSIDERATION AND DECISION AFTER RECONSIDERATION Defendant petitions for reconsideration of the February 20, 2013 Findings of Fact, Award and Orders. In that decision, the workers’ compensation administrative law judge (WCJ) found that applicant sustained industrial injury to his left knee on December 10, 2003, while he was employed as a delivery driver. The WCJ disallowed multiple liens but found that the medical treatment provided by lien claimants Diane Miller, D.C., PhyMed, Inc., Physical Rehabilitation Services and The Wellness Center was “medically reasonable.” The WCJ awarded Diane Miller $38,182.04 and interest, awarded PhyMed, Inc. $1,642.10 and interest, awarded Physical Rehabilitation Services $670.25 and interest, and awarded The Wellness Center $10,551.85 and interest. Defendant contends that the WCJ erred by admitting exhibits offered by the Wellness Center and Dr. Miller, because the exhibits were not listed on the pretrial conference statement or served on defendant before trial. If those exhibits had been excluded, defendant argues, the liens would have been dismissed. Defendant further contends that it denied the requests for treatment from Dr. Miller and The Wellness Center through the utilization review process; Dr. Miller and The Wellness Center did not seek authorization for all of their services; and Dr. Miller and The Wellness Center provided care far in excess of the limited physical therapy recommended by the panel qualified medical evaluator (PQME). Defendant also contends that PhyMed’s lien should have been disallowed, because PhyMed provi
Joseph Martinez vs. Pepsi Bottling Group: A Self-Insurance Dispute
(VNO 0493715)This case is about Pepsi Bottling Group, which was permissibly self-insured and administered by Sedgwick Claims Management Services, Inc. Joseph Martinez was an employee of Pepsi Bottling Group and sustained an industrial injury to his left knee on December 10, 2003. The workers' compensation administrative law judge found that the medical treatment provided by lien claimants Diane Miller, D.C., PhyMed, Inc., Physical Rehabilitation Services and The Wellness Center was "medically reasonable" and awarded them the respective amounts of $38,182.04, $1,642.10, $670.25 and $10,551.85. The defendant petitioned for reconsideration of the decision
- Filed On:
- Court: California, Van Nuys
- Case No. ADJ2166955
To continue reading ... start a FREE Trial for 10 days
Discover the cases you didn’t know you were missing!
Copyright © 2023 - CompFox Inc.