jonbrissman@verizon.net Senior Member
Posts: 377
Joined: Oct 2003
|
Wednesday September 10, 2008 8:13 PM
|
|
The OMFS is immaterial, look at the Medical-Legal Fee Schedule (8 CCR Sect. 9795). Each subdivision, ML101 through ML106, has criteria or elements to be met. If you billed consistently with the criteria, it seems like the only way to reduce the fee would be to attack one of the elements as lacking or insufficient. Medical-legal charges tend to be straightforward.
I recall a case where a defendant challenged a QME's brief statement that there was no basis for apportionment as insufficient to count as a complexity factor under ML103. Defendant wanted to downcode the charge to ML102. A WCJ agreed, but a WCAB panel ruled that the single sentence was adequate and awarded compensation at the ML103 level.
You know the drill -- file a lien, argue with adjuster, bill review service, or defense attorney, and file a Declaration of Readiness to Proceed if you can't settle.
JCB
|
|