The 3rd District Court of Appeal issued a ruling in Meadowbrook Ins. Co. v. WCAB [link below] that an interpreter bill for med-legal services will be barred if the provider does not seek a second review following denial by the defendant’s EOR under the IBR/non-IBR process located in LC4603.2(e).
Congratulations to Paul Zayat of the El Segundo office on obtaining an order of dismissal on a disputed lung cancer case! Ultimately the applicant relented and dismissed her case. At issue, should the PTP report have prevailed at trial, was 2 years of TTD, medical care, permanent disability and future medical care related to lung cancer.
Congratulations to Yan Falkinstein of our San Fernando Valley office on a hard-earned Take Nothing! Ultimately Yan was able to prove to the satisfaction of the court that the filing was based upon clerical error of the PTP’s office and there was no factual or medical evidence to support the allegation, but in the alternative the Statute of Limitations would apply.
Dr. Daniel Capen, a spinal surgeon in Huntington Beach, CA, was sentenced on Friday to 30 months in federal prison for conspiring to commit honest services fraud. He had received at least $5 million in kickbacks for performing surgeries at Pacific Hospital of Long Beach in a scheme coordinated by former Pacific Hospital owner Michael Drobot, and for referring patients for other medical services.
The WCAB has held en banc in Colamonico v. Secure Transportation that it is the lien claimant/provider’s (in this case a photocopy service) burden to prove that its services were both reasonable and necessary and that the defendant’s failure to cite reasonableness or necessity in its objection to a med-legal bill doesn’t act as waiver of those defenses at the time of the lien conference.
The owner of San Jose-based Advanced Vocational Institute (AVi), Rashad Said, has been charged with 11 felony counts involving workers’ comp fraud and kickbacks. Said, a former member of the San Jose Regional Workforce Development Board, is accused of illegally diverting over $650,000 in workers’ compensation insurance funds.