What the panel ordered
Petition for reconsideration granted; Findings and Order of September 12, 2023 amended; lien issue deferred with jurisdiction reserved.
Lien claimant Medland Medical Group petitioned for reconsideration of the WCJ's Findings and Order of September 12, 2023, which disallowed its lien; the WCAB granted reconsideration and deferred the lien issue for further analysis.
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.
The WCJ disallowed the lien claim based on the discharge of care by the primary treating physician and the requirement to go through the QME or AME process for further care; the WCAB granted reconsideration to analyze the applicability of the discharge and designation of a new primary treating physician.
From the decision · page 1Lien claimant Medland Medical Group seeks reconsideration of a workers' compensation administrative law judge's (WCJ) Findings and Order of September 12, 2023, wherein it was found that, while employed as a machine operator during a cumulative period ending May 27, 2022, applicant sustained industrial injury to the elbow and back, but not to the arm, wrist, or other body parts. As relevant to the instant Petition, it was found that lien claimant was not entitled to reimbursement for its lien. The basis behind the disallowance was the purported fact that applicant had been discharged from care by his primary treating physician, and that any further care from a new treating physician was only available after going through the qualified medical evaluator or agreed medical evaluator process. (Cal. Code Regs., tit. 8, § 9785; Tenet/Centinela Hospital Medical Center v. Workers' Comp. Appeals Bd. (Rushing) (2000) 80 Cal.App.4th 1041 [65 Cal.Comp.Cases 477.)