Joined: Jun 2002
Monday January 10, 2005 6:05 PM
Oy Vey Ginger,
I feel your pain ----- I end up having to stand shoulder to shoulder with these types of bozos in the trenches of numerous WCABs. I agree with you 100% Ginger. Give me a professional who knows his/her stuff as an opponent, and I am a happy camper.
However, it is my usual misfortune to be stuck on the other side of the street, trying my best to educate uninformed DAs about the OMFS, and the fact that once they receive a 10608(a) demand, they have a duty to serve ALL the medicals.
Just last Friday, I had a DA opponent from a large firm that usually, I truly respect. The stage of proceedings was the second lien conference. At the first lien conference last October, the matter was continued due to the failure to serve my company any medical reports, despite six (6) previous demands, and the DA was ordered by the WCJ to serve us the medical reports.
In early November, I served a Petition for Sanctions/costs on the DA, his client, the AA, and the WCAB. The Petition for Sanctions/costs was based on me having wasted my day by having to drive to the WCAB for a hearing that was continued due to the previous failures to comply with my 10608(a) demands.
One would think that this DA, after having been ordered to serve the medicals by the WCJ, then after being reminded by having received my Petition for Sanctions/costs, this DA would have promptly served me with a copy of the entire medical file. Not a snowball's chance in Hades.
I show up at the WCAB empty handed, expecting to hear that the medicals were "in the mail." Naw, the DA ends up handing me a packet of selected medicals that he intends to enter into evidence.......not the entire medical file.
All of our services (supplies and materials) were provided in 2004. This bozo DA is attempting to get the WCJ to allow his Notice To Produce (NTP) ordered by the WCJ. This DA could not be derailed from his train of thought that he was entitled to learn how much my company pays for the supplies and materials furnished the IW.
Before we saw the WCJ, I informed this DA that the amount I paid for supplies was irrelevant, being as we were pegged to Medicare plus a 20% mark-up, effective 1/1/04 per SB 228. He kept on turning a deaf ear to me. Finally, when we did get before the WCJ, this DA continued to push for the WCJ to issue an order for me to comply with the DA's NTP.
The WCJ told the DA that the NTP was immaterial because the OMFS was controlling in regards to the amount that was considered reasonable. Then, when I inform the WCJ that I have only received the defense medicals, and I needed another continuance, and I needed the WCJ to issue an additional order to serve the entire medical file, and that I will be amending my Petition for Sanctions, the DA blows a 50 amp fuse in front of the WCJ.
My lien was only $1,317.00. My Petition for Sanctions was at $1,600.00. Now, I will be adding on additional costs for my second wasted day at the WCAB. I'm actually looking forward to setting this particular matter for trial. This matter was an accepted CTS claim, with additional body parts added that were disputed. The defense QME fully acknowledged the IW did have CTS, but found no industrial causation for the remainder. This matter settled with a Thomas for $35,000.00 ----- and the only body part for which we provided services was the CTS.
This was a 'nature and extent' case that should never have settled with a Thomas. If the DA had just offered to pay me at OMFS at the time of settlement, I would have accepted it. However, I have now had to make two additional totally unnecessary appearances, and I will be pressing for the full amount due, plus the statutory increase and interest, as well as sanctions/costs.
Ginger, give me a professional who knows his job, and does it. There are way too many bozos in the sandbox ----- on both sides of the street.
I hope getting this rant off my chest will make my evening easier tonight, but even if it does, I still have to appear before a different WCJ, at a different WCAB tomorrow, and I am appearing at a lien conference once again without having been served the medicals.
At least tomorrow I will be consoled that we only made two (2) demands for medicals that have gone unanswered. Maybe, just maybe, tomorrow's DA will offer to pay our billing at OMFS and I will not have to stroll tomorrow's DA down the same sanctions/costs street.