A discussion of peripheral issues related to Copy Service Issues by Timothy W. Rose
Per Labor Code §4620 & 8 CCR §9793 a medical-legal expense is described as “…any costs and expenses incurred by or on behalf of any party, the administrative director, or the board, which expenses may include x-rays, laboratory fees, other diagnostic tests, medical reports, medical records, medical testimony, and, as needed, interpreter’s fees… for the purposes of proving or disproving a contested claim.” Per 8 CCR §9793 (b), a “contested claim” is:
(b) “Contested claim” means any of the following:
(1) Where the claims administrator has rejected liability for a claimed benefit.
(2) Where the claims administrator has failed to accept liability for a claim and the claim has become presumptively compensable under Section §5402 of the Labor Code.
(3) Where the claims administrator has failed to respond to a demand for the payment of compensation after the expiration of any time period fixed by statute for the payment of indemnity benefits, including where the claims administrator has failed to either commence the payment of temporary disability indemnity or issue a notice of delay within 14 days after knowledge of an employee’s injury and disability as provided in Section §4650 of the Labor Code.
(4) Where the claims administrator has accepted liability for a claim and a disputed medical fact exists.
In Celiflora Lopez v. Harbor View Farms (2018), the WCAB determined that there was contested claim where the claim had not been denied. As such, the alleged medical-legal service provider was not a qualified provider pursuant to Labor Code §4620. Which would exclude claims for penalties, interest and costs. However, this appears to be in conflict with some potential rights to discovery. Per Ozuna v. Kern County Superintendent of Schools (2016), the first set of records requested are to be considered medical-legal in nature. I believe the key in distinguishing these cases to build a defense is to address what the reason for the records request is actually used for, though this is subject to further interpretation and litigation. Such as, are the records ultimately reviewed and utilized? Does the location contain records that are actually relevant, or is the copy service merely scanning records and then issuing additional subpoenas based on other locations noted within the records they have obtained? This is but one area of potential litigation and argument between the parties.