WCAB
Cal. Ins. Guarantee Assn. v. WCAB
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…