On Wednesday, the California Supreme Court denied the petition for review and multiple depublication requests in the case of Meadowbrook Insurance Co. v. WCAB (DFS Interpreting). The Court of Appeals’ November 2019 ruling will stand and be published and citable as a rule of law.
DFS Interpreting had provided interpreting for two workers’ compensation claims filed by Spanish-speaking workers, in which Meadowbrook Insurance Co. was the carrier for the employers, and accepted liability. Meadowbrook declined payment of DFS’ invoice, to which DFS objected but did not request a second review of the bill, instead seeking a hearing before an administrative law judge. The Workers’ Compensation Judge found for DFS, and DFS’ entitlement to payment was affirmed by the WCAB. When Meadowbrook sought review by the 3rd District Court of Appeal, the court ruled that DFS was not, in fact, entitled to payment. The court’s determination holds that Labor Code Section 4603.2 allows an interpreter services provider 90 days to request a second review of a disputed bill. If the provider does not request the second review within 90 days, and the only dispute is over the payment amount, the bill “shall be deemed satisfied.” In such case, the employer or carrier would not be liable for payment.
Regarding billing amounts, Code of Regulations Section 9792.5.4 defines “amount of payment” for a second review as authorized services “for which there exists an applicable fee schedule.” 2013’s Senate Bill 863 required the adoption of a fee schedule by the Division of Workers’ Compensation, but such a schedule has yet to be adopted. The court ruled that Code of Regulations Section 9795.3, which had previously been adopted by the administrative director, meets the requirements of an “applicable fee schedule” for the purposes of 9792.5.4. Therefore, DFS’s failure to request a second review rendered it unable to claim further payment.