What the panel ordered
Petition for reconsideration granted in part; lien claimant entitled to reimbursement for medical-legal services but not for medical treatment services; WCJ's Findings and Order of October 31, 2023 amended accordingly.
Lien claimant Medland Medical seeks reconsideration of a WCJ's Findings and Order of October 31, 2023, denying its lien in entirety.
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
Although the medical-legal report was not ultimately convincing, it was not worthless and had the potential to affect a disputed matter, thus reimbursement was allowed.
From the decision · page 2However, we will grant reconsideration and find that lien claimant is entitled to reimbursement for medical-legal services. A "medical-legal expense is ordinarily allowable if it is capable of proving or disproving a contested claim, if the expense was reasonably necessary at the time incurred, and if the cost incurred was reasonable." (Brower v. David Jones Constr. (2014) 79 Cal.Comp.Cases 550, 556 [Appeals Bd. en banc].) An injured worker is generally entitled to request a medical-legal report from their primary treating physician. (Ibid.) Although payment should not be authorized if the report is "worthless" or "incapable of proving or disproving a disputed fact," costs are generally reimbursable if, at the time the report is produced it has "the potential to affect" a disputed matter. (Costa, 72 Cal.Comp.Cases at pp. 1498-1499 [dealing with vocational reporting, which Costa held should follow the same standard as medical-legal costs].)