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 in which Teodoro Larios, the applicant, sought compensation for a psychiatric injury related to a physical injury he sustained while employed by the defendants. The defendants sought reconsideration of the Findings and Orders issued by the workers' compensation administrative law judge, arguing that the applicant's claim of injury to the psyche was barred because he was not employed for at least six months. The Workers' Compensation Appeals Board granted the defendants' Petition for Reconsideration and rescinded the December 30, 2016 Findings and Orders, returning the matter to the trial level for further proceedings.

Eastbay Equities, Inc. dba Wendy’s Old Fashioned Hamburgers; Amtrust North America, Teodoro Larios, WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIATEODORO LARIOS,Applicant,vs.EASTBAY 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 (F&O) issued on December 30, 2016, by the workers’ compensation administrative law judge (WCJ), which, in pertinent part, ordered defendant to pay lien claimant, Mission Family Therapy and California Psychiatric Specialists, $5,270.00 for medical treatment provided to applicant, along with interest, penalties, and reimbursement of the lien filing fee.            Defendant contends that pursuant to Labor Code! section 3208.3(d), applicant’s claim of injury to the psyche is barred because applicant was not employed for at least six months and thus, defendant is not liable to lien claimant for the services provided. Defendant further contends that the WCI erred in calculating the amount due on the lien because lien claimant billed in excess of the Official Medical Fee Schedule and did not proceed with the Independent Bill Review process.            We have not received an answer from lien claimant or applicant. We received a Report and Recommendation on Petition for Reconsideration (Report) from the WCJ recommending that we deny reconsideration.            We have considered the allegations of the Petition for Reconsideration and the contents of the WCJ’s Report with respect thereto. Based on our review of the record and for the reasons discussed 1 All future references are to the Labor Code unless noted. , below, we will grant defendant’s Petition for Reconsideration and as our Decision After Reconsideration we will rescind the December 30, 2016 F&O and return this matter to the trial level

To continue reading ... start a FREE Trial for 10 days

Discover the cases you didn’t know you were missing!

Copyright © 2023 - CompFox Inc.