WINCHELL’S DONUT HOUSE; U.S. FIRE INSURANCE; CRUM & FORSTER, TERRIE O’SHAUGHNESSY, WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIATERRIE O’SHAUGHNESSY, Applicant,vs.WINCHELL’S DONUT HOUSE; U.S. FIRE INSURANCE; CRUM & FORSTER, Defendants.Case No. ADJ552885 (SRO 136772)OPINION AND ORDER GRANTING RECONSIDERATION AND DECISION AFTERRECONSIDERATION Defendant has filed a petition for reconsideration of a workers’ compensation Ij administrative law judge’s (WCJ) Findings and Award of August 31, 2009, wherein it was found that, while employed as a sales clerk, applicant sustained industrial injury to her low back, bilateral hips, knees, and right foot. The WCJ found that lien claimant Alta Bates Medical Center was “entitled to reimbursement for the reasonable cost of bills” and that “[d]efendant unreasonably delayed payment on the reasonable cost of line claimant’s bills.” The WCJ found that the lien claimant was entitled to reimbursement in the amount of “87% of the $136,442.43 in bills, less previous payments of $21,484.40.” Previously in this case, by way of Compromise & Release approved on March 3, 2009, applicant settled her claims against defendant in exchange for $70,000. The Compromise & Release contained a provision stating that the defendant would hold the applicant harmless against the lien of Alta Bates Medical Center. Defendant contends that the WCJ erred in finding that lien claimant was due “87% of the $136,442.43 in bills,” and in finding that the defendant “unreasonably delayed the payment of the reasonable cost of lien claimant’s bills.” We have received an answer from the lien claimant and the WCJ has filed a Report and Recommendation on Petition for Reconsideration. After filing the petition for reconsideration, on October 21, 2009, the defendant sent the WCJ a letter which read as follows: , “The matter of the lien of Alta Bates Medical Center in the underlying case of Terri O’Shaughnessy was heard
Terrie O’shaughnessy, vs. Winchell’s Donut House; U.s. Fire Insurance; Crum & Forster,
In this case, Terrie O'Shaughnessy, an employee of Winchell's Donut House, sustained an industrial injury to her low back, bilateral hips, knees, and right foot. The Workers' Compensation Appeals Board granted reconsideration of the Findings and Award of August 31, 2009, which found that lien claimant Alta Bates Medical Center was entitled to reimbursement for the reasonable cost of bills and that defendant had unreasonably delayed payment. The defendant and lien claimant then reached a settlement, and the Board rescinded the Findings and Award and returned the matter to the trial level for further proceedings.
- Filed On:
- Court: California, Santa Rosa
- Case No. ADJ552885
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