ADJ16229232 — California WCAB decision

What the panel ordered

Petition for Reconsideration granted; final decision after reconsideration deferred pending further review of the merits and the entire record.

Lien claimant seeks reconsideration of the Findings & Orders issued on May 13, 2025, which denied lien claimant's request to recover medical-legal expenses for services provided on November 21, 2022, due to lack of a proper request for medical-legal examination at that time.

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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.

LiensDefendant prevailed

The WCJ found no valid request for medical-legal examination at the time of service on November 21, 2022, because the Cal. Lab. Code 4600 letter was mailed the same day and not yet received by lien claimant, so lien claimant did not meet burden to prove entitlement.

From the decision · page 3In attempting to support entitlement to lien recovery, Lien Claimant primarily relied upon the Cal. Labor Code § 4600 letter from Applicant's Attorney dated November 21, 2022, (Joint X-1) and the medical report of Lien Claimant dated November 21, 2022 (LC's 3). In review of the presented evidence, the undersigned found that the Lien Claimant did not meet their burden to prove their sole date of service of November 21, 2022, was a medical-legal expense.

The facts that decided it

What proof carried it

The evidence the panel weighed, by kind.

Documentary evidencefavours Defendant prevailed

Cal. Labor Code 4600 letter mailed same day as lien claimant's date of service, not yet received by lien claimant

From the decision · page 3The evidence supported that at the time the date of service was conducted, the Lien Claimant did not have a Cal. Labor Code § 4600 letter from the Applicant's Attorney as the letter was mailed the same day as the Lien Claimant's date of service. The letter specifically requested a medical-legal when the Applicant had reached maximum medical improvement. (Joint X-1, p.2). In the medical report dated November 21, 2022, Lien Claimant did not find the Applicant to have reached maximum medical improvement (LC's 3, p.16 § 17), and thus the condition precedent of Applicant's Attorney's request for a medical-legal had not been met. Given the foregoing, Lien Claimant did not meet its burden to

Documentary evidencefavours Defendant prevailed

Lien claimant failed to produce evidence that Applicant or Applicant's Attorney requested medical-legal examination at time of service

From the decision · page 5In their report, Lien Claimant found the Applicant to not be permanent and stationary and requiring further treatment, and notes that issues of apportionment will be addressed "... in a permanent and stationary report." (LC's 3, p.17-18). As the doctor did not find the Applicant permanent and stationary, the condition precedent in place by the Applicant's Attorney had not been met. The evidence supports the conclusion that (1) Applicant's Attorney's 4600 letter was not in the possession of the Lien Claimant at the time the service was conducted, and (2) that the condition precedent of which the Applicant's Attorney would have requested a medical-legal examination had not been met. Therefore, there was no request for a medical-legal from the Applicant's Attorney according to the evidence provided at the time the date of service was conducted. Equally, the Lien Claimant failed to produce any evidence supporting the Applicant requested a medical-legal, which was Lien Claimant's burden to provide.

ADJ16229232 · August 25, 2025

What the panel ordered

What was disputed, and how it came out

The facts that decided it

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The rules the panel named

What proof carried it

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