WCDefenseCA

It looks like the Workers’ Compensation Appeals Board really is getting fed up with the lien problem that is crippling California’s workers’ compensation system.  In the case of Ronald Houghton v. All Brands Sewing and Vacuum (that’s right, the same one from Wednesday), the WCAB dismissed the petition for reconsideration filed by lien claimant California Physicians Network for transportation costs.

After a trial, the workers’ compensation Judge awarded the lien claimant $8,820.00 of a $22,942.40 lien.  The lien claimant petitioned for reconsideration, arguing that it was entitled to the full amount.  But, in filing its petition, the lien claimant failed to provide verification in accordance with Labor Code section 5902.  Normally, the WCAB will roll their eyes at this lapse in procedure and will continue on to the meat of the matter.

The WCAB recognized that it has discretion to dismiss (or not dismiss) an unverified petition.  But it also noted that defendant had pointed out this lapse in procedure in its answer, and the lien claimant failed to cure.  And so the petition was dismissed, but the fun doesn’t end there…

The WCAB also adopted and incorporated the WCJ’s report and recommendation, and would have denied the petition on the merits.  The WCJ had found that, based on the testimony of a bill reviewer, the $145 dollars in transportation charged to defendant for applicant’s 11-mile trip to the doctor was excessive.  Furthermore, the panel Qualified Medical Evaluator testified, at his deposition, that applicant was fully capable of driving himself.

The WCJ even went so far as to opine that applicant could have gotten taxi service for $15 each way, which would have adequately served for the purposes of his visits.  At $145 for 11 miles, applicant should have been enjoying the therapeutic effects of luxury limousine service with the limousine itself being airlifted by an equally luxurious helicopter to his destination.  Your humble blogger is unaware of the reason why the defense did not seek reimbursement in this case, but it appears that the WCJ would have been inclined to award it had the issue been raised.

Every bill is worth reviewing, and perhaps reimbursement is worth pursuing.  Frankly, even if the cost of litigating the question of reimbursement meets or exceeds the cost of recovery, it may be worthwhile just to discourage frivolous bills in the future.