What the panel ordered
The April 20, 2023 Findings of Fact is AFFIRMED; WCAB lacks jurisdiction due to an express agreement fixing payment amounts for medical treatment between lien claimant and defendant.
Lien claimant Stanford/Valley Care Health Systems petitioned for reconsideration of the WCJ's April 20, 2023 Findings of Fact, which found an express agreement between lien claimant and defendant precluded WCAB jurisdiction over the billing dispute. The WCAB granted reconsideration to issue a notice of intention to dismiss and further study the issues, then affirmed the WCJ's decision.
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.
There was an express agreement between lien claimant and defendant fixing the amounts to be paid for medical treatment, which under Labor Code § 5304 divests the WCAB of jurisdiction over the dispute.
From the decision · page 8Accordingly, we concur with the WCJ's conclusion that the WCAB lacks jurisdiction over this dispute because the reimbursement issues herein arose out of treatment rendered pursuant to sections 4600 to 4605 inclusive, and there is an express agreement between lien claimant and defendant fixing the amounts to be paid for medical, surgical or hospital treatment. In so finding, we offer no opinion as to the merits of lien claimant's assertions with respect to reimbursement for services provided to the applicant. The parties remain free to pursue any remedy afforded under the law in an appropriate forum. We will affirm the Findings of Fact, accordingly.