[As Modified on Denial of Rehearing
Cal.Rptr.3d 326] ORIGINAL PROCEEDING: Petition for writ of
review. Petition annulled. Sharyn Lynne Sala, Judge.
(W.C.A.B. Nos. ADJ10348591, ADJ10349019)
[Copyrighted Material Omitted]
& Barthel and Louis A. Larres, Fresno, for Petitioner
Meadowbrook Insurance Company.
Offices of John D. Moloney and John D. Moloney for Respondent
appearance for Respondent Workers’ Compensation Appeals
appearance for Respondents Miguel Velazquez and Servando
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.
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
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.
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, 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.
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
conclusion of trial, the workers’ compensation judge (WCJ)
issued her findings and award and order in favor of DFS. [255
Cal.Rptr.3d 327] 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.
WCAB denied the reconsideration petition. It reasoned that
the A.D. 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 ...