Background of Cal Lab Code § 4903.5
Cal Lab Code § 4903.5 state as follows
(a) No lien claim for expenses as provided in subdivision (b) of Section 4903 may be filed after six months from the date on which the
appeals board or a workers' compensation administrative law judge issues a final decision, findings, order, including an order approving
compromise and release, or award, on the merits of the claim, after five years from the date of the injury for which the services were
provided, or after one year from the date the services were provided, whichever is later.
To simply state it as applied to a medical provider who treats or provides services to an injured worker. To file a lien to initiate the litigation
process to protect the payment of the medical bill, the provider must file within specific time limits or loss the right to collect any monies
due for treatment the injured worker.
1. 5 years from the date the injury and or industrial accident happened
2. 1 year from the date of service (usually means last date of service if multiple)
3. or 6 months from the case between the injured worker is adjudicated, settled, or dismissed by the follow:
• Compromise and Release
• Findings & Award (F&A):
• Findings & Order (F&O):
• Stipulation with Request for Award (Stip):
• Or any other Courts documents resolving the case between the injured worker and employer / insurance carrier.
• Which ever is longer
The law was created to put some closure to cases that had been resolved between the injured worker and the employer / insurer. The law
was enacted in conformity of what Judges had determined in Laches as a reasonable time set a time limit for the filing of liens
What happened next was that a question arose, how would the medical provider know when the case between the injured worker and
employer / insurance carrier resolved so that the medical provider knew he or she had only six months left to file a lien. The reason why a
medical provider may wait till a case was resolved before filing a lien is one they would hope that the medical bill would be resolved by that
time and on a disputed medical bill the employer / insurance company will not resolve the medical bill until the case between the injured
worker and employer / insurance company is resolved.
The Workers Compensation Appeals Board agreed with this assertion that a medical provider would not know when the case had been
resolved if the settlement documents had not been served on the medical provider, therefore stopping the running of the six month to file a
lien when the case is resolved until the medical provider was served with those documents.
CCR § 10886. Service on Lien Claimants
“ Where a lien claim is on file with the Workers’ Compensation Appeals Board or where a party has been served with a lien, and a
compromise and release agreement or stipulations with request for award or order is filed, a copy of the compromise and release agreement
or stipulations shall be served on the lien claimant.”
“No lien claim shall be disallowed or reduced unless the lien claimant has been given notice and an opportunity to be heard.”
As shown the courts have given wide interpretation to the defense being served with a lien claim to include knowledge of the medical
providers medical bill, which cause the responsibility of the defense to serve the settlement documents.
Kaiser Foundation Hospitals v. Workers' Comp. Appeals Bd., 155 Cal. App. 3d 917, 202 Cal. Rptr. 520, 1984 Cal. App. LEXIS 2043, 49
Cal. Comp. Cas. (MB) 365 ( Cal. App. 1st Dist. 1984
“…when an employer fails to perform its statutory duty to notify an injured employee of his workers' compensation rights, and the injured
employee is unaware of those rights from the date of injury through the date of the employer's breach, then the statute of limitations will be
tolled until the employee receives actual knowledge that he may be entitled to benefits under the workers' compensation system. “
Loc Tran, Applicant v. Viet Nguyen Trucking Company, American All Risk Loss Administrators, Defendants W.C.A.B. No. AHM
0080703—WCAB Workers' Compensation Appeals Board (Panel Decision) 2007 Cal. Wrk. Comp. P.D. LEXIS 42 Opinion Filed July 30,
2007:
“To the extent that the WCJ finds that the notice described in Labor Code § 4904(a) was given to the defendant, we find that the defendant
was required to comply with WCAB Rules 10886, 10888, and 10890. Pursuant to Labor Code § 4904(a), When a defendant has been given
written notice ''setting forth the nature and extent of any claim that is allowable as a lien,'' a lien is created in favor of the claimant. WCAB
Rule 10886 explicitly requires a defendant to serve a lien claimant with a compromise and release when a lien has been served on the
defendant regardless of whether the lien claim has been filed with the WCAB. We also note that Rules 10888 and 10890 are not limited in
their application to lien claimants who have filed their liens with the WCAB.
Cal Lab Code § 4903.5 state as follows
(a) No lien claim for expenses as provided in subdivision (b) of Section 4903 may be filed after six months from the date on which the
appeals board or a workers' compensation administrative law judge issues a final decision, findings, order, including an order approving
compromise and release, or award, on the merits of the claim, after five years from the date of the injury for which the services were
provided, or after one year from the date the services were provided, whichever is later.
To simply state it as applied to a medical provider who treats or provides services to an injured worker. To file a lien to initiate the litigation
process to protect the payment of the medical bill, the provider must file within specific time limits or loss the right to collect any monies
due for treatment the injured worker.
1. 5 years from the date the injury and or industrial accident happened
2. 1 year from the date of service (usually means last date of service if multiple)
3. or 6 months from the case between the injured worker is adjudicated, settled, or dismissed by the follow:
• Compromise and Release
• Findings & Award (F&A):
• Findings & Order (F&O):
• Stipulation with Request for Award (Stip):
• Or any other Courts documents resolving the case between the injured worker and employer / insurance carrier.
• Which ever is longer
The law was created to put some closure to cases that had been resolved between the injured worker and the employer / insurer. The law
was enacted in conformity of what Judges had determined in Laches as a reasonable time set a time limit for the filing of liens
What happened next was that a question arose, how would the medical provider know when the case between the injured worker and
employer / insurance carrier resolved so that the medical provider knew he or she had only six months left to file a lien. The reason why a
medical provider may wait till a case was resolved before filing a lien is one they would hope that the medical bill would be resolved by that
time and on a disputed medical bill the employer / insurance company will not resolve the medical bill until the case between the injured
worker and employer / insurance company is resolved.
The Workers Compensation Appeals Board agreed with this assertion that a medical provider would not know when the case had been
resolved if the settlement documents had not been served on the medical provider, therefore stopping the running of the six month to file a
lien when the case is resolved until the medical provider was served with those documents.
CCR § 10886. Service on Lien Claimants
“ Where a lien claim is on file with the Workers’ Compensation Appeals Board or where a party has been served with a lien, and a
compromise and release agreement or stipulations with request for award or order is filed, a copy of the compromise and release agreement
or stipulations shall be served on the lien claimant.”
“No lien claim shall be disallowed or reduced unless the lien claimant has been given notice and an opportunity to be heard.”
As shown the courts have given wide interpretation to the defense being served with a lien claim to include knowledge of the medical
providers medical bill, which cause the responsibility of the defense to serve the settlement documents.
Kaiser Foundation Hospitals v. Workers' Comp. Appeals Bd., 155 Cal. App. 3d 917, 202 Cal. Rptr. 520, 1984 Cal. App. LEXIS 2043, 49
Cal. Comp. Cas. (MB) 365 ( Cal. App. 1st Dist. 1984
“…when an employer fails to perform its statutory duty to notify an injured employee of his workers' compensation rights, and the injured
employee is unaware of those rights from the date of injury through the date of the employer's breach, then the statute of limitations will be
tolled until the employee receives actual knowledge that he may be entitled to benefits under the workers' compensation system. “
Loc Tran, Applicant v. Viet Nguyen Trucking Company, American All Risk Loss Administrators, Defendants W.C.A.B. No. AHM
0080703—WCAB Workers' Compensation Appeals Board (Panel Decision) 2007 Cal. Wrk. Comp. P.D. LEXIS 42 Opinion Filed July 30,
2007:
“To the extent that the WCJ finds that the notice described in Labor Code § 4904(a) was given to the defendant, we find that the defendant
was required to comply with WCAB Rules 10886, 10888, and 10890. Pursuant to Labor Code § 4904(a), When a defendant has been given
written notice ''setting forth the nature and extent of any claim that is allowable as a lien,'' a lien is created in favor of the claimant. WCAB
Rule 10886 explicitly requires a defendant to serve a lien claimant with a compromise and release when a lien has been served on the
defendant regardless of whether the lien claim has been filed with the WCAB. We also note that Rules 10888 and 10890 are not limited in
their application to lien claimants who have filed their liens with the WCAB.
 |  |  |  |