Systems
Surgery Center Billing
decision of the
WCAB
decision from the
Workers'
(WCAB).
lien went to trial because the
defendant disputed the charges.
The Workers' Compensation
Judge (WCJ) allowed the full
amount of the lien. The WCJ
raise the reasonableness and
necessity of treatment in the
Stipulations and Issues framed at
the trial.
would have raised the
reasonableness issue, the
defendant did not meet the
burden of proving the lien was
unreasonable. The defendant filed
a petition for reconsideration
which resulted in this en banc
decision.
Kunz v. Patterson Floor
Covering. They also cited another
case for the proposition that the
burden of proof lies with party or
lien claimant holding the
affirmative on the issue. In this
case, the surgery center. The
WCAB indicated that the
defendant does not have the
center bill was unreasonable.
their holding in Kunz.
has to be reasonable on its face.
It wont be presumed reasonable
as several in the industry had
contended. It must be reasonable
on its face even if the defendant
doesn't challenge it. In this case
the defendant never even raised
the reasonableness at trial level
and it was still sent back to the
WCJ for evaluation of the bills
reasonableness. Therefore, even
though there may have been no
defense the defendant prevailed.
Firm: Samuelsen, Gonzalez,
Valenzuela and Brown
Click here for printable version