Lupe Herrera vs. Wal-mart, American Home Assurance, Administered By Frank Gates Service Company

In this case, lien claimants Westlake Spine and Outpatient Surgery Center and Channel Islands Orthopedic Medical Group sought reconsideration of the April 23, 2007 Joint Findings and Award, wherein the workers' compensation administrative law judge found that applicant, while employed by Wal-Mart, sustained industrial injury to her right knee and right wrist. The workers' compensation appeals board denied the petition for reconsideration, finding that the WCJ's decision was proper and consistent with the decision in Roberson v. Atlantic Mut. Ins. Co. (2006).

Wal-Mart, American Home Assurance, Administered By Frank Gates Service Company Lupe Herrera WORKERS-COMPENSATION APPEALS BOARDSTATE OF CALIFORNIALUPE HERRERA, Applicant,vs.WAL·MART, AMERICAN HOME ASSURANCE, administered by FRANK GATES SERVICE COMPANY, Defendant(s).Case Nos. OXN 0129630; OXN0129631OPINION AND ORDER DENYING PETITION FOR RECONSIDERATION            Lien claimants Westlake Spine and Outpatient Surgery Center (“WSOSC”) and Channel Islands Orthopedic Medical Group (“CIOMG”) collectively seek reconsideration of the April 23, 2007 Joint Findings and Award, wherein the workers’ compensation administrative law judge (“WCjJ”) found that applicant, while employed by Wal-Mart on October 24, 2000, sustained industrial injury to her right knee (OXN 0129630), and on September 4, 2002, sustained industrial injury to her right wrist (OXN 0129631). He found WSOSC entitled to reimbursement “pursuant to the fee schedule for ambulatory surgery centers as set forth in 8 Cal. Code of Reg. Sections 9789.30, g« 5£3-» effective January 1, 2004.” He found CIOMG entitled to additional reimbursement of $11.56 plus statutory interest.            Lien claimants contend that the WCJ improperly applied the 2004 Official Medical Fee Schedule to determine reimbursement for WSOSC’s services provided prior to the schedule’s effective date, that he misapplied the burden of proof under Kunz v. Patterson Floor Coverings, Inc. (2002) 67 Cal.Comp.Cases 1588 (Appeals Board en banc) and that WSOSC’s bill should be presumed reasonable, and that the testimony of the defense witness docs not constitute substantial evidence on the reasonableness of CIOMG’s bill. ,             We have considered the Petition for Reconsideration and defendant’s Answer, and we have reviewed the record in this matter. The WO prepared a Repon and Recommendation on Petition for Reconsideration (“Report”), recommending that the petition be dismissed as untimely or. failing that, denied on the merits.            For th

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