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 WCAB has jurisdiction over the lien claim except for charges on 10/10/2018 due to failure to timely request second bill review; the lien claimant is entitled to recover the lien amount subject to the Official Medical Fee Schedule and adjustments for partial payments.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
No evidence that the contract between MedRisk and Respondent controlled the amounts charged for treatment, so WCAB retains jurisdiction over the lien claim.
Favours Applicant prevailed
This fact led to the rejection of the defense's jurisdictional challenge and allowed the lien claim to proceed.
From the decision · page 6... [N]o evidence was offered by Defendant to demonstrate MedRisk contract pertains to services rendered for this Defendant, or the claims administrator Illinois Midwest Insurance Agency, to find the contract to be controlling in this matter. As such the contract is not found to deprive the WCAB of jurisdiction over this medical treatment payment dispute. (Opinion on Decision, pg. 4; Petition for Reconsideration, 4:14-18)
Favours Applicant prevailed
This fact required amendment of the award to exclude charges for treatment on 10/10/2018 less the credited amount.