Hamilton v. Lockheed Corporation (2001) 66 Cal.Comp.Cases 473
All decisions must be based on admitted evidence in the record; WCJ must make findings on all facts and state reasons for determination (Lab. Code, 5313; Hamilton v. Lockheed Corporation (2001) 66 Cal.Comp.Cases 473)
Applied to require clear issue framing and evidence-based findings for lien reimbursement
From the decision · page 3All decisions of the Appeals Board "must be based on admitted evidence in the record."
(Hamilton v. Lockheed Corporation (Hamilton) (2001) 66 Cal.Comp.Cases 473, 476 [2001 Cal.
Wrk. Comp. LEXIS 4947] (Appeals Board en banc).) A WCJ is required to "make and file findings
upon all facts involved in the controversy and an award, order, or decision stating the determination
as to the rights of the parties. Together with the findings, decision, order or award there shall be
served upon all the parties to the proceedings a summary of the evidence received and relied upon
and the reasons or grounds upon which the determination was made." (Lab. Code, § 5313; see also
Blackledge v. Bank of America, ACE American Insurance Company (Blackledge) (2010) 75
Cal.Comp.Cases 613, 621-22.) As required by Labor Code section 5313 and explained in
Hamilton, "the WCJ is charged with the responsibility of referring to the evidence in the opinion
on decision, and of clearly designating the evidence that forms the basis of the decision."
(Hamilton, supra, at p. 475.)
Labor Code section 4621
Lien claimant must prove expenses were reasonably, actually, and necessarily incurred (Lab. Code, 4621(a))
Applied to require proof of necessity and reasonableness of lien services
From the decision · page 3For example, the WCJ issued a finding that CIS provided services that "were reasonably
necessary medical legal services" (Finding of Fact 7) without describing the services or citing to
the record to support his conclusion. Without knowing what issues the WCJ was attempting to
determine, the phrase "reasonably necessary medical-legal services" is ambiguous. Defendant is
required to reimburse expenses "reasonably, actually, and necessarily incurred." (Lab. Code,
§ 4621(a).) Given the deviation from the language in the statute and the lack of clarity regarding
the issues in dispute, the finding could address necessity (but not reasonableness) or it could be a
broader statement that lien claimant met its burden under Labor Code section 4621. Accordingly,
we will defer the issue of the lien of CIS to allow the parties to properly frame issues and to allow
the WCJ to issue a decision in accordance with the requirements of the Labor Code.