What the panel ordered
Petition for Reconsideration denied.
Petition for Reconsideration filed by lien claimant Azadeh Rahimi, Ph.D., denied by the WCAB panel after review of the WCJ report and record.
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
The lien claimant was entitled to reimbursement for the initial comprehensive evaluation/treatment report at the stipulated value, but all subsequent treatment reports were disallowed due to failure to properly request authorization and failure to prove service on defendants.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Lien claimant provided only one initial comprehensive evaluation report with proof of service; over 120 subsequent single page treatment reports lacked proof of service or proper authorization.
Favours Defendant prevailed
This failure to prove service and authorization led to disallowance of reimbursement for subsequent treatment reports.
From the decision · page 4Subsequently, Dr. Rahimi generated over 120 single page treatment "reports" during the period from 12/18/09 through 7/11/16 (Lien Claimant Exhibit R2). There are no proofs of service or RFAs associated with any of those reports. Four RFAs were introduced into evidence by lien claimant at trial. Two in 2013, one in 2015, and one in 2016 (Lien Claimant Exhibits R3-R6). The RFAs are somewhat contradictory requesting treatment sessions one time a week for six months, but also requesting only "10-12 sessions". None has a proof of service, or fax confirmation, to show that they were ever sent to, or received by, defendants.
What the panel did with the medical opinions
The role the physician served, and the weight the opinion carried. Physicians are named here as the decision names them; we do not score them.
Provided initial comprehensive evaluation and over 120 single page treatment reports for applicant's psyche injury.
The initial comprehensive report was accepted for reimbursement; subsequent single page treatment reports were disallowed due to lack of proper authorization and proof of service.
From the decision · page 4Dr. Rahimi evaluated the applicant for the first time on 12/18/09. As noted above, he generated a lengthy initial report, reviewing extensive prior medicals, as well as performing psyche testing. The report is dated 1/11/10 and was addressed only to Dr. Lavi and applicant's attorney (Lien Claimant R1).
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Evid. Code, § 641
A letter correctly addressed and properly mailed is presumed to have been received in the ordinary course of mail.
The lien claimant failed to prove proper service of treatment reports and RFAs on defendants.
From the decision · page 1While "[a] letter correctly addressed and properly mailed is presumed to have been received in the ordinary course of mail" (Evid. Code, § 641), the one-page treatment reports that are included in lien claimant's Exhibit 2 are not letters that were "correctly addressed" to anyone and there's no proof of service or proof of mailing of any kind in the record. (8 Cal. Code Regs., tit. 8, § 10625, 10635.)
8 Cal. Code Regs., tit. 8, §§ 10625, 10635
Regulations require proof of service or mailing for treatment reports and RFAs.
The lien claimant did not provide proof of service or mailing for the treatment reports and RFAs, leading to disallowance of reimbursement for subsequent treatments.
From the decision · page 1While "[a] letter correctly addressed and properly mailed is presumed to have been received in the ordinary course of mail" (Evid. Code, § 641), the one-page treatment reports that are included in lien claimant's Exhibit 2 are not letters that were "correctly addressed" to anyone and there's no proof of service or proof of mailing of any kind in the record. (8 Cal. Code Regs., tit. 8, § 10625, 10635.)
What proof carried it
The evidence the panel weighed, by kind.
No proof of service or mailing for over 120 single page treatment reports and RFAs; only initial report properly served.
From the decision · page 4Subsequently, Dr. Rahimi generated over 120 single page treatment "reports" during the period from 12/18/09 through 7/11/16 (Lien Claimant Exhibit R2). There are no proofs of service or RFAs associated with any of those reports. Four RFAs were introduced into evidence by lien claimant at trial. Two in 2013, one in 2015, and one in 2016 (Lien Claimant Exhibits R3-R6). The RFAs are somewhat contradictory requesting treatment sessions one time a week for six months, but also requesting only "10-12 sessions". None has a proof of service, or fax confirmation, to show that they were ever sent to, or received by, defendants.
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About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
- The injured worker is not named here, and the case caption is not printed. Physicians appear as the decision names them, because a medical opinion is an act in a public proceeding.
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