Eastbay Equities, Inc. dba Wendy’s Old Fashioned Hamburgers; Amtrust North America, Teodoro Larios, WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIATEODORO LARIOS,Applicant,vs.EASTBA Y EQUITIES, INC. dba WENDY’S OLD FASHIONED HAMBURGERS; AMTRUST NORTH AMERICA,Defendants.Case No. ADJ9162432(San Francisco District Office)OPINION AND ORDER GRANTING PETITION FOR RECONSIDERATION AND DECISION AFTER RECONSIDERATION Defendant seeks reconsideration of the Findings and Orders With Opinion on Decision on Remand After Reconsideration (F&O) issued by the workers’ compensation administrative law judge (WCJ) on August 4, 2017. By the F&O, the WCJ ordered defendant to pay lien claimant, Mission Family Therapy, $5,270.00 along with interest, penalties, and reimbursement of the lien filing fee and to pay lien claimant, California Psychiatric Specialists, $2,645.00 along with interest, penalties, and reimbursement of the lien filing fee. Defendant contends that the lien claims are barred pursuant to Labor Code1 section 3208.3(d) and that the Appeals Board’s prior opinion on this issue is res judicata, Defendant further contends that lien claimants’ treatment was not necessary to cure or relieve from the effects of the injury, there is no evidence that the treatment complied with the Medical Treatment Utilization Schedule (MTUS), and the WCJ erred in awarding full value of the liens without consideration for the Official Medical Fee Schedule (OMFS) or the requirements of the independent bill review process. Lastly, defendant contends that there is no evidence to support reimbursement of the lien filing fee to the lien claimants. We did not receive an answer from lien claimants or applicant. The WCJ submitted a Report and Recommendation on Petition for Reconsideration (Report) recommending that we deny reconsideration. 1 All future references are to the Labor Code unless noted. , We have considered the allegations of defendant’s Petiti
Teodoro Larios, vs. Eastbay Equities, Inc. Dba Wendy’s Old Fashioned Hamburgers; Amtrust North America,
In this case, Eastbay Equities, Inc. dba Wendy's Old Fashioned Hamburgers and Amtrust North America were defendants in a workers' compensation case. The applicant, Teodoro Larios, had two lien claimants, Mission Family Therapy and California Psychiatric Specialists, who were seeking reimbursement for treatment. The defendants argued that the lien claims were barred by Labor Code section 3208.3(d) and that the treatment was not necessary to cure or relieve from the effects of the injury. The Workers' Compensation Appeals Board granted the defendants' petition for reconsideration, rescinded the decision of the workers' compensation administrative law judge, and returned the matter to the trial level for further proceedings and decision consistent with the opinion.
- Filed On:
- Court: California, San Francisco
- Case No. ADJ9162432
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