Mainstay Business Solutions, Permissibly Self-Insured Patricia Nunez WORKERS-COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAPATRICIA NUNEZ, Applicant,vs.MAINSTAY BUSINESS SOLUTIONS, permissibly self-insured, Defendant,FRED HAFEZI, M.D., INC.; WHITTIER/ANAHEIM PHYSICAL THERAPY CENTER, Lien claimants.Case No. ADJ603509OPINION AND ORDER GRANTING RECONSIDERATION AND DECISION AFTER RECONSIDERATION Defendant seeks reconsideration of the May 19, 2010 Findings and Award of the workers’ compensation administrative law judge (WCJ) who found that applicant reasonably and necessarily secured medical treatment services from lien claimants Fred Hafezi, M.D., Inc., and Whittier/Anaheim Physical Therapy Center (WAPTC), and awarded Dr. Hafezi $10,623.82 and WAPTC SI.046.29 on their lien claims. The WCJ further found that defendant had “a valid MPN (Medical Provider Network],” but that the liens were not “disallowable” because of that. Applicant’ claim of industrial injury to her hips, back, leg and other body pans while working for defendant Mainstay Business Solutions as a laborer/housekeeper on May 22, 2008, was earlier settled by compromise and release on October 26, 2009. with a lump sum payment of $40,500.00. , Defendant contends that liens should have been disallowed by the WCJ because the lien claimants were not in defendant’s MPN at the time services were provided, and for that reason the services were not reasonable or necessary medical treatment. We grant reconsideration and as our decision after reconsideration reverse the May 19, 2010 Findings and Award, and enter a new order directing that lien claimants take nothing by way of their lien claims. The WCJ properly found that applicant was within a valid MPN as she stipulated in the October 26, 2009 compromise and release, but failed to consider defendant’s evidence of the notices it sent to lien claimants regarding the MPN, and failed to recognize that it was lien claimants’ b
Patricia Nunez vs. Mainstay Business Solutions, Permissibly Self-insured
Patricia Nunez was injured while working for Mainstay Business Solutions as a laborer/housekeeper on May 22, 2008. The claim was settled by compromise and release on October 26, 2009. Fred Hafezi, M.D., Inc., and Whittier/Anaheim Physical Therapy Center filed lien claims, but the Workers' Compensation Appeals Board reversed the decision of the WCJ and ordered that the lien claimants take nothing by way of their lien claims, as they did not prove that they were within the employer's Medical Provider Network at the time they provided services.
- Filed On:
- Court: California, Los Angeles
- Case No. ADJ603509
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