John Del Pinto vs. City Of Los Angeles Permissibly Self-insured

(LAO 0844306)This case involves a dispute between the City of Los Angeles and the City of Glendale over reimbursement for medical treatment and cost-containment expenses. The Workers' Compensation Appeals Board affirmed the October 22, 2013 Findings and Award, which found that the City of Glendale is entitled to reimbursement from the City of Los Angeles of fifty percent of the total amount of payments for medical treatment, but not for reimbursement of its cost-containment expenses including medical bill review costs and utilization review expenses.

CITY OF LOS ANGELES Permissibly Self-Insured JOHN DEL PINTO WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAJOHN DEL PINTO, Applicant,vs.CITY OF LOS ANGELES, Permissibly Self-Insured, Defendants.Case No. ADJ2185374 (LAO 0844306)OPINION AND DECISIONAFTER RECONSIDERATION            On December 27, 2013, the Workers’ Compensation Appeals Board (Appeals Board) granted reconsideration of the October 22, 2013 Findings and Award to further study the factual and legal issues. This is our Decision After Reconsideration.            In the October 22, 2013 Findings and Award, the workers’ compensation arbitrator found that lien claimant City of Glendale is entitled to reimbursement from the City of Los Angeles of fifty percent of the total amount of payments for medical treatment. The arbitrator also found that the City of Glendale is not entitled to reimbursement of its cost-containment expenses including medical bill review costs and utilization review expenses.            Lien claimant, City of Glendale contends that the arbitrator erred by allowing a 50% lien recovery on its lien, arguing that the arbitrator should have followed the apportionment determination of the agreed medical evaluator. Lien claimant also contends that the arbitrator erred by disallowing reimbursement for medical bill review and utilization review costs.            We have considered the Petition for Reconsideration and we have reviewed the record in this matter. The arbitrator prepared a Report on Recommendation (Report), recommending that we deny reconsideration.            For the reasons stated by the arbitrator in his Report, which we adopt and incorporate by reference, we will affirm the arbitrator’s decision. ,             For the foregoing reasons,            IT IS ORDERED, as the Decision After Reconsideration of the Workers’ Compensation Appeals Board, that the October 22, 2013 Findings and Award is AFFIRMED.WORKERS’ COMPENSATION APPEALS BOARD    ___________________________________

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