WCAB

Cal. Ins. Guarantee Assn. v. WCAB

Good Law
Court of Appeal of CaliforniaDecember 16, 2014D065072California11,052 words

Opinion

Opinion

Aaron, J.

I.

INTRODUCTION

We issued a writ of review on the petition filed by the petitioners in this matter to

address the two questions raised in the petition: (1) Does the Workers' Compensation

Appeals Board (the Board) retain jurisdiction over a medical billing dispute pertaining to

more than 300 consolidated claims, after the Legislature passed significant workers'

compensation reform legislation that created a new administrative independent review

process for the resolution of billing disputes?; and (2) if the Board does retain jurisdiction

over this dispute, is there substantial evidence to support the workers' compensation

judge's (WCJ) findings of fact regarding his determination of the "reasonable fee" to be

paid for arthroscopic knee procedures, arthroscopic shoulder procedures, and epidural

injection procedures performed at three commonly managed ambulatory surgical center

(ASC) facilities in San Diego County?

We conclude that although the text of the relevant legislation and resulting statutes

is ambiguous, the most reasonable interpretation of the legislation is that it does not

2 divest the Board of jurisdiction to decide the dispute at…

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