ADJ16554524 · June 9, 2025

The services by cost petitioner to obtain records from San Diego Orthopedic Associates Medical Group were reasonable and necessary and cost petitioner is entitled to payment; cost petitioner did not meet burden for subpoena to Sedgwick; no bad faith or frivolous conduct by cost petitioner; issue of defendant's bad faith deferred.

From the decision · page 9Accordingly, we grant cost petitioner's Petition for Reconsideration, rescind the F&O and substitute a new decision that finds that the services provided by cost petitioner to obtain records from San Diego Orthopedic Associates Medical Group were reasonable and necessary at the time they were performed and that cost petitioner is entitled to payment for the services; that cost petitioner did not meet its burden to show that it was entitled to payment for the cost of the subpoena to Sedgwick; and that cost petitioner did not engage in bad faith or frivolous conduct and sanctions are not warranted; and defers the issue of whether defendant's conduct was in bad faith or frivolous, thereby subjecting it to sanctions, costs and attorney's fees.

Cost petitioner provided services to obtain records from San Diego Orthopedic Associates Medical Group that were reasonable and necessary at the time performed.

Favours Applicant prevailed

This fact supported the finding that cost petitioner is entitled to payment for these services.

From the decision · page 9Accordingly, we grant cost petitioner's Petition for Reconsideration, rescind the F&O and substitute a new decision that finds that the services provided by cost petitioner to obtain records from San Diego Orthopedic Associates Medical Group were reasonable and necessary at the time they were performed and that cost petitioner is entitled to payment for the services; that cost petitioner did not meet its burden to show that it was entitled to payment for the cost of the subpoena to Sedgwick; and that cost petitioner did not engage in bad faith or frivolous conduct and sanctions are not warranted; and defers the issue of whether defendant's conduct was in bad faith or frivolous, thereby subjecting it to sanctions, costs and attorney's fees.

Cost petitioner failed to meet burden to show entitlement to payment for subpoena to Sedgwick.

Favours Defendant prevailed

This fact supported the finding that the invoice for cancellation of subpoena services to Sedgwick is not recoverable.

From the decision · page 104. Document Analyst Group failed to meet its burden as to the services related to obtaining records by subpoena from Sedgwick, therefore the invoice of $75 for cancellation of such services is not recoverable as a medical-legal expense.

Cost petitioner did not engage in bad faith or frivolous conduct.

Favours Applicant prevailed

This fact supported the denial of sanctions, costs, or attorney's fees against cost petitioner.

From the decision · page 105. Document Analyst Group did not engage in bad faith or frivolous conduct, and defendant is not entitled to sanctions, costs, or attorney's fees.

Labor Code sections 4620, 4621, 4622(f); Colamonico v. Secure Transport (2019) 84 Cal.Comp.Cases 1059 (Appeals Board en banc)

A lien claimant/cost petitioner must establish that a contested claim existed at the time the expenses were incurred, the expenses were incurred for the purpose of proving or disproving the contested claim, and the expenses were reasonable and necessary at the time they were incurred.

Applied to determine entitlement to payment for medical-legal expenses.

From the decision · page 6III. A lien claimant/cost petitioner holds the burden of proof to establish all elements necessary

AD Rule 9982(e) (Cal. Code Regs., tit. 8, 9982(e)(1))

The claims administrator is not liable for payment of records previously obtained by subpoena and served from the same source.

Applied to evaluate duplicative subpoenas and payment liability.

From the decision · page 7AD Rule 9982(e) states in pertinent part that: "The claims administrator is not liable for payment of: (1) records previously obtained by subpoena... and served from the same source." (Cal. Code Regs., tit. 8, § 9982(e)(1).)

Defendant admitted receipt of subpoena to Sedgwick and refusal to provide documents, conduct appearing in bad faith and bordering on frivolous

From the decision · page 9However, we emphasize that in letters submitted into evidence by defendant, and in a verified pleading by defendant, it admits that it received the subpoena to Sedgwick and that it refused to provide responsive documents. While we do not consider the issue of whether defendant should have been sanctioned with respect to this conduct, we observe that defendant's conduct in admitting to its receipt of the subpoena and its refusal to comply with it, and threatening sanctions and then seeking sanctions against cost petitioner for the subpoena appears to be in bad faith and borders on frivolous.