Rudy Flores vs. Hyatt West Hollywood; Insurance Company Of The State Of Pennsylvania, Administered By Broadspire

This case is about a worker, Rudy Flores, who was injured while employed at the Hyatt West Hollywood. The Insurance Company of the State of Pennsylvania, administered by Broadspire, was responsible for providing workers' compensation benefits. Cedars-Sinai Medical Center provided medical treatment to Flores for the injury, and sought payment for the treatment. The Workers' Compensation Appeals Board found that the treatment provided from September 25, 2003 to October 13, 2003 was provided to cure or relieve the effects of the industrial injury, and that Cedars-Sinai was entitled to payment for the period, less 20 percent. The Board also found that the treatment provided from October 14, 2003 to November 21, 2003 was for non-industrial conditions. The

Hyatt West Hollywood; Insurance Company Of The State Of Pennsylvania, administered by Broadspire Rudy Flores WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIARUDY FLORES, Applicant,vs.HYATT WEST HOLLYWOOD; INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA, administered by BROADSPIRE, Defendants.Case No. ADJ614580 (VNO 0484100)OPINION AND DECISION AFTER RECONSIDERATION            Both defendant and lien claimant Cedars-Sinai Medical Center (Cedars-Sinai) sought reconsideration of the October 22, 2009 Findings and Award, wherein the workers’ compensation administrative law judge (WCJ) found that applicant’s treatment at Cedars-Sinai during the period from September 25, 2003, to October 13, 2003, was provided to cure or relieve applicant from the effects of the industrial injury and that Cedars-Sinai was entitled to payment in the amount of the actual charges for the period, less 20 percent, to be adjusted by the parties. The WCJ further found that applicant’s treatment at Cedars-Sinai for the period from October 14, 2003, to November 21, 2003, was provided for non-industrial conditions. The WCJ deferred the issue of defendant’s claim for reimbursement of an overpayment. The parties stipulated that, while employed on September 25, 2003, applicant sustained industrial injury to his head, psyche, left leg, and syndrome of inappropriate anti-diuretic hormone.            On January 11, 2010, we granted the Petitions for Reconsideration to allow time for further study and to complete our review of the record. On January 19, 2010, we issued an Opinion and Decision After Reconsideration, which we incorporate herein.1 In that opinion, we summarized the parties’ contentions and the relevant evidence. We vacated the WCJ’s October 22, 2009 Findings and Award, vacated our January 11, 2010 grant of Cedars-Sinai’s Petition for Reconsideration, and denied Cedars- 1            The inclusion of the word “not” at page 2, line 20 of our January 19, 2010 opinion is a clerical error. ,

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