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Meadowbrook Insurance Co. v. Workers' Compensation Appeals Board

California Court of Appeals, Third District, Butte

November 21, 2019

MEADOWBROOK INSURANCE COMPANY, Petitioner,
v.
WORKERS' COMPENSATION APPEALS BOARD and DFS INTERPRETING et al., Respondents.

          ORIGINAL PROCEEDING: Petition for writ of review. Petition annulled. Sharyn Lynne Sala, Judge. W.C.A.B. Nos. ADJ10348591, ADJ10349019

          Bradford & Barthel and Louis A. Larres for Petitioner Meadowbrook Insurance Company.

          Law Offices of John D. Moloney and John D. Moloney for Respondent DFS Interpreting.

          No appearance for Respondent Workers' Compensation Appeals Board.

          No appearance for Respondents Miguel Velazquez and Servando Velazquez.

          Duarte, J.

         Petitioner Meadowbrook Insurance Company (Meadowbrook), administrator for Star Insurance Company, petitioned for writ of review of the Workers' Compensation Appeal Board's (WCAB) decision on reconsideration that liens held by DFS Interpreting (DFS) against Meadowbrook regarding unpaid invoices for interpreter services DFS provided to Meadowbrook's insureds were not foreclosed by DFS's failure to follow procedural rules.

         We issued the writ, and we now hold that DFS's failure to comply with required procedures resulted in DFS's bills being deemed satisfied. This result means Meadowbrook is not liable for further payment. Accordingly, we annul the WCAB's decision to the contrary and remand for further proceedings.

         FACTS AND PROCEDURAL BACKGROUND

         In separate incidents, Miguel Velazquez and Servando Velazquez (claimants) suffered injuries within the scope of their employment, and each required Spanish language interpreting services in connection with their medical care. Meadowbrook was the workers' compensation carrier for the claimants' employers and accepted both claims and administered benefits.

         DFS, which provided interpreter services to each claimant, timely submitted invoices to Meadowbrook for the services provided. Meadowbrook issued explanations of review pursuant to Labor Code section 4603.3, [1] explaining that it refused to pay the invoices DFS submitted. DFS objected to those explanations of review, but did not request a second review pursuant to section 4603.2, subdivision (e) or California Code of Regulations, title 8, section 9792.5.5.[2]

         Each underlying case resolved as to all issues but for DFS's liens, and the cases were consolidated to determine whether DFS properly contested Meadowbrook's explanations of review in accordance with the relevant statutes and regulations, and, if not, whether the WCAB had jurisdiction to award further payment to DFS. The parties stipulated that the interpreters were necessary at all medical treatment appointments, DFS timely submitted the invoices, Meadowbrook timely issued the explanations of review, and DFS objected to the explanations of review but did not request a second review.

         At the conclusion of trial, the workers' compensation judge (WCJ) issued her findings and award and order in favor of DFS. The WCJ found that DFS's liens were not barred by its failure to request a second review because the administrative director (AD) had not adopted a fee schedule pursuant to section 4600, subdivision (g).

         Meadowbrook filed a petition for reconsideration. It argued that the WCAB lacked jurisdiction to resolve the billing dispute because there was indeed a valid fee schedule in existence as required by the definition of “amount of payment” in Title 8, section 9792.5.4.

         The WCAB denied the reconsideration petition. It reasoned that the AD had not specifically adopted a fee schedule for interpreters after the Legislature enacted Senate Bill No. 863 (2011-2012 Reg. Sess.), chaptered as Statutes 2012, chapter 363 (Sen. Bill No. 863). Thus, there was not an applicable fee schedule and DFS was not required to submit a request for second review under section 4603.2, subdivision (e) or Title 8, section 9792.5.5.

         Meadowbrook filed a petition for writ of review, which we issued.

         DISCUSSION

         I

         Standard ...


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