Ameri-Medical Corp. v. Workers' Compensation Appeals Board

In this workers’ compensation proceeding, we granted petitioner Ameri-Medical Corporation’s (Ameri-Med or the medical clinic) petitions for writs of review, and consolidated these two cases for hearing and decision because they involve the question of the application and constitutionality of Labor Code section 4628, subdivision (d).

Subdivision (d) of section 4628 provides that “[n]o amount may be charged in excess of the direct charges for the physician’s professional services and the reasonable costs of laboratory examinations, diagnostic studies, and other medical tests, and reasonable costs of clerical expense necessary to producing the report. Direct charges for the physician’s professional services shall include reasonable overhead expense.”

We hold that the purpose of section 4628 must govern the interpretation of subdivision (d). The Legislature enacted section 4628, an anti-ghostwriting statute, to ensure the reliability of the medical evaluation by controlling the quality of the medical-legal report. The statute enumerates the responsibilities of the physician signing the report. Subdivision (d) does not operate to limit or regulate the amount of legitimate…