Lien Claimant as Applicant (California)

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Lien Claimant as Applicant (California)

Postby DASF22 on Sat Nov 21, 2009 2:18 pm

Situation:

Applicant refused to prosecute and WCJ dismisses applicant. However, lien claimant, with 1 million dollar lien, steps into shoes of applicant.

Question: the medical-legal process!

While there is case authority that lien claimant, as applicant, is not entitled to be reimbursed its medical-legal costs, is the lien claimant, now applicant, compelled to go through the 4060 process, offer an AME and then in the absence of an agreement, use a Panel QME? Does the same hold true for defendant: is defendant bound by the same rules of 4060-4062, especially where defendant already denied the case under the fact pattern and therefore would be barred against obtaining requesting a Panel QME because of the denial/

Any thoughts appreciated here. It is important to note that applicant is OUT OF CASE, refuses to prosecute do to intimate family reasons.

thanks!
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Re: Lien Claimant as Applicant (California)

Postby davidd on Sat Nov 21, 2009 2:56 pm

My .02: No. 4060 does not say "applicant". 4060 says "employee" and I don't believe that a lien claimant steps in the shoes of an employee, like a carrier does the employer. The only time a lien claimant becomes an applicant is when the lien claimant files an Application.
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Re: Lien Claimant as Applicant (California)

Postby jonbrissman on Sat Nov 21, 2009 9:29 pm

Whereas the underlying claim was denied, why did your facility rack up a million bucks in charges on a lien basis? Sounds like a death wish.

It seems like the discussion about the medical-legal process is a moot point if the injured claimant won't cooperate and attend an evaluation.

Any employee claiming a workers' compensation injury who obtains treatment on a lien basis and then refuses to prosecute his/her case has defrauded the medical provider. Bill him directly, then file suit when he does not pay. (L.C. Sect. 3751(b) does not apply when the employee's claim is no longer pending.) Obtain a judgment, ruin his credit, garnish his wages. Show no sympathy to someone who obtained services with a representation upon which you relied, when that person later chose not to follow through.

JCB
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Re: Lien Claimant as Applicant (California)

Postby steve appell on Mon Nov 23, 2009 7:13 pm

While there is case authority that lien claimant, as applicant, is not entitled to be reimbursed its medical-legal costs


What case is this?
Steve

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