Defendant denied right to cross-examine applicant is denied “due process of law”
- Posted By: Harvey Brown
- February 1, 2015
This is a published appellate court case
This is a very significant case for workers’ compensation principles.
The applicant had an admitted injury to the right ankle, right hand and back. These injuries were admitted. The applicant also alleged a psychiatric injury that was denied. There were multiple hearings before the Workers’ Compensation Judge (WCJ).
At the first hearing on whether the applicant was temporarily disabled the applicant admitted to working from time to time. The defendant’s cross-examination was terminated over the defendant’s objection. The defendant filed for reconsideration and the Workers’ Compensation Appeals Board (WCAB) denied reconsideration.
There were three more hearings and the applicant was eventually found permanently and totally disabled. The applicant refused to testify at all three of the hearings. The WCJ did not allow the defendant to cross- examine the applicant at each hearing. The defendant filed for reconsideration after each hearing indicating that it was “denied due process”. Each time the WCAB agreed with the WCJ.
The appellate court indicated that cross-examination is an element of a fair trial. The lack of cross-examination was prejudicial. Therefore, the WCAB decision was annulled.
- Posted In: Disability, Medical Treatment, Technicalities, Work Injury
Court reviews SB 863 and rules on whether WCAB can hear a case that is subject to Independent Bill Review
- Posted By: Harvey Brown
- January 1, 2015
This is a published appellate court case
This is a very significant case for workers’ compensation principles.
A billing dispute related to outpatient services for arthroscopic knee procedures, arthroscopic shoulder procedures, and epidural injections provided prior to 2004 resulted in a consolidation of liens.
It went to trial and resulted in a 17 day trial with a decision by the Workers” Compensation Judge (WCJ) in February 2013. Prior to the WCJ decision SB 863 went into effect in January 2013.
The defendant appealed the decision contending the Workers’ Compensation Appeals Board (WCAB) did not have jurisdiction.
The appellate court indicated that SB 863 was ambiguous to whether the Independent Bill Review (IBR) service was intended to apply to pending billing disputes. If the IBR applied to the pending action it would leave the parties without a viable way to resolve the dispute.
Therefore, they ruled SB 863 only applied to billing disputes that arise after the legislation went into effect.
An outpatient surgery center has the affirmative burden of proving that its lien is reasonable. The court then discusses how to determine reasonable. They discuss in this case a “reasonable facility fee.” They indicated that the WCJ did this correctly and may accept the evidence of one expert or choose a figure in the middle based on all the evidence.
- Posted In: Liens