What the panel treated as outcome-determinative, and which side it favoured.
Applicant sustained injury arising out of and in the course of employment to the trunk, back, and hips on September 9, 2021.
Favours Applicant prevailed
This fact established compensability of the injury, which was upheld by the WCAB panel.
Defendant failed to prove that applicant improperly treated outside the MPN due to lack of evidence that Dr. Greene was in the MPN and no objection served on Dr. Russman.
Favours Applicant prevailed
This failure meant the medical treatment and corresponding interpreter fees were reasonable and recoverable.
From the decision · page 6(Lab. Code, § 5811(b)(2).)
Here, defendant contends that the medical treatment given by Dr. Russman, during which
time the disputed interpreting services were used, was not reasonable and necessary because
applicant improperly treated outside the defendant's MPN, and, as a result, lien claimant's services
are similarly unreasonable, unnecessary, and non-recoverable. (Petition, p. 2.) As parties are well
aware, it is defendant's burden to establish the existence of the MPN, and that written notification
of the MPN, and all other requisite information under AD Rule 9767.12, was provided to applicant,
both before and after the subject injury. (Cal. Code Regs., tit. 8, § 9767.12.) Treatment through the
MPN must also be accessible, not neglectful, and actually available to applicant. (See Cal. Code
Regs., tit. 8, § 9767.5; Lab. Code, § 4600(a); see also McCoy v. I.A.C. (1966) 64 Cal.2d 82, 87 [31
Cal.Comp.Cases 93] ["the employer is required to provide treatment which is reasonably necessary
to cure or relieve the employee's distress, and if he neglects or refuses to do so, he must reimburse
the employee for his expenses in obtaining such treatment"].) Although notice of the MPN was
apparently given to applicant after the injury (Defense Exhibit C), defendant failed to produce
evidence that Dr. Greene was in fact listed within the MPN and provided actual treatment to
applicant.
Lien claimant established the market rate for interpreting services and defendant failed to rebut this evidence.
Favours Applicant prevailed
This supported the lien claimant's entitlement to payment at the established market rate.
From the decision · page 8Here, defendant failed to submit any evidence rebutting the market rate outlined by lien
claimant. As such, we agree with the WCJ that lien claimant "was entitled to be paid at the market
rate." (Report, p. 5.)