SOUTHERN CALIFORNIA EDISON permissibly self-insured RUDY GALLARDO WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIARUDY GALLARDO, Applicant,vs.SOUTHERN CALIFORNIA EDISON,permissibly self-insured, Defendants.HUNTINGTON HOSPITAL, Lien Claimant.Case No. ADJ2200226(Pomona District Office)OPINION AND ORDERDENYING LIEN CLAIMANT’SPETITION FORRECONSIDERATION Lien claimant Huntington Hospital (Huntington) seeks reconsideration of our earlier April 8, 2014 Opinion and Decision After Reconsideration (Decision) wherein we reversed the December 23, 2013 Findings of Fact of the workers’ compensation administrative law judge (WCJ) who found that “no express contract has been established which would deny jurisdiction to the WCAB pursuant to Labor Code Section 5304,” that “the provisions of Labor Code Section 4609(c)(2) have not been met,” that the “WCAB does have jurisdiction” over the dispute concerning the lien claim of Huntington, and that the $43,870 amount claimed by Huntington pursuant to the Official Medical Fee Schedule in addition to the $18,050 already paid by defendant constitutes a reasonable fee for the hospital services Huntington provided applicant. We reversed the WCJ’s December 23, 2013 decision because the $18,050 fee paid to Huntington by way of a chain of contracts was pursuant to an “express agreement fixing the amounts to be paid” as described in Labor Code section 5304, and under that section the WCAB does not have jurisdiction over the fee dispute and Huntington’s related claims regarding Labor Code section 4609 and breach of contract. , Huntington contends that the WCAB has jurisdiction to adjudicate the breach of contract and Labor Code section 4609 issues it raised in this case, and the WCJ’s December 23, 2013 decision should be reinstated. A response to Huntington’s petition was received from defendant. We have carefully reviewed Huntington’s petition, defendant’s response, and re-reviewed o
Rudy Gallardo vs. Southern California Edison Permissibly Self-insured
In this case, the Workers' Compensation Appeals Board denied the petition of Huntington Hospital for reconsideration of an earlier decision. The Board found that the $18,050 fee paid to Huntington by way of a chain of contracts was pursuant to an "express agreement fixing the amounts to be paid" as described in Labor Code section 5304, and under that section the WCAB does not have jurisdiction over the fee dispute and Huntington's related claims regarding Labor Code section 4609 and breach of contract. The Board concluded that a different forum must be used by Huntington to adjudicate its breach of contract claims.
- Filed On:
- Court: California, Pomona
- Case No. ADJ2200226
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