Calico Building Materials, Inc.; Insurance Company Of The West San Diego Valentin Reyes WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAVALENTIN REYES, Applicant,vs.CALICO BUILDING MATERIALS, INC.; INSURANCE COMPANY OF THE WEST SAN DIEGO, Defendant(s).Case No. ADJ2743306 (LBO 0373515)OPINION AND ORDER GRANTING RECONSIDERATION AND DECISION AFTER RECONSIDERATION Lien claimant, California Pharmacy Management (CPM), seeks reconsideration of the June 7, 2010 Findings, Award, and Order wherein the workers’ compensation administrative law judge (WCJ) found that the applicant sustained an industrial injury to his thoracic and lumbar spine and left shoulder. The WCJ also found that lien claimant rendered treatment outside of the employer’s Medical Provider Network subsequent to the November 7. 2005 MPN notice and ordered that C’PM’s Her. be disallowed. Lien claimant contends that the WCJ erred in disallowing a portion of its lien, arguing that defendant did not provide applicant with proper notice of a Medical Provider Network (MPN). and. therefore, applicant was entitled to procure, medical treatment outside of the MPN and that the treatment it provided was reasonable and necessary. CPM filed its petition for reconsideration on July 2. 2010. However, the petition was not received by the Reconsideration Unit until September 20, 2010. CPM’s petition was not timely acted upon by the Appeals Board, which has 60 days from the filing of a petition for reconsideration to act on that petition. (Lab. Code. § 5909.) Here, however, through no fault of petitioner, the timely-filed petition did not come to the attention of the Appeals Board until after , The expiration of the statutory time period. Consistent with fundamental principles of due process, therefore, and in keeping with common sensibilities, we arc persuaded, under these circumstances, that the running of the 60-day statutory period for reviewing and acting upon a petition for rec
Valentin Reyes vs. Calico Building Materials, Inc.; Insurance Company Of The West San Diego
This case is about Valentin Reyes, an employee of Calico Building Materials, Inc., who sustained an industrial injury to his thoracic and lumbar spine and left shoulder. The worker's compensation administrative law judge found that lien claimant, California Pharmacy Management, provided treatment outside of the employer's Medical Provider Network and ordered that the lien be disallowed. The Appeals Board granted reconsideration and amended the June 7, 2010 Findings, Award, and Order to defer the issue of CPM's lien, and return this matter to the trial level for further proceedings and a new decision.
- Filed On:
- Court: California, Long Beach
- Case No. adj2743306
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