Does Meadowbrook Apply to 5811 Costs?

The field of workers’ compensation can be difficult to understand for those who do not regularly work or practice in that area.  Even for some types of businesses which may handle workers’ compensation cases without specializing in that field, dealing with and understanding the different requirements can be difficult.    A recent published opinion, Meadowbrook Insurance Co. v. Workers’ Compensation Appeals Board and DFS Interpreting, et al. addressed the issue of payment for interpreter treatment services.  It is also important for you and your business to understand how this case may apply if your business deals in workers’ compensation.

In Meadowbrook, two different workers were both injured in separate incidents in the course and scope of their regular employment.  Both filed workers’ compensation claims and both required the services of a Spanish interpreter to facilitate their medical care.  Meadowbrook was the provider for workers’ compensation insurance for the employer, and DFS Interpreting provided the Spanish interpretation services for the workers during their case.  DFS submitted invoices for their services, as per the California Labor Code.  Meadowbrook responded by refusing payment and issuing an explanation of review.  DFS timely provided an objection to the nonpayment.  However, DFS failed to adhere to the requirements of California Labor Code 4603.2, which provides in pertinent part: “If the provider disputes the amount paid, the provider may request a second review within 90 days of service of the explanation of review”.  The statute goes on to provide in detail what must be included in this second request for review.  In Meadowbrook, the WCAB determined that DFS should be permitted to proceed with its liens for payment against Meadowbrook.  However, the California appeals court disagreed, and overturned the WCAB decision, due to DFS’s failure to adhere to subsection (e)’s requirements concerning the procedure for a request for a second review.

The Meadowbrook case spoke specifically to the treatment services provided by an interpreter.  However, interpreter services are often characterized as Labor Code 5811 Costs  t involved with providing services during a workers’ compensation case.  The next issue becomes whether the holding Meadowbrook would apply to a dispute about 5811 costs.  A large part of the holding in Meadowbrook hinged on the Second Bill Review provisions of Labor Code 4603.2.     Meadowbrook did not specifically speak to Interpreter Services which are controlled by Labor Code 5811 or WCAB Rule 9795.3(b)(1).   These services include WCAB Appearances, Depositions, and Arbitrations.   WCAB Rule 9795.3(a)(7) also contemplates “other similar settings determined by the Workers’ Compensation Appeals Board to be reasonable and necessary to determine the validity and extent of injury to an employee.”  The WCAB has found repeatedly that translation of Settlement Documents fall into this category.  Labor Code 5881(b)(2)D) has similar language, but  does not have the requirement to request a Second Bill Review.   There is an Official Medical Fee Schedule which provides specific payment structures for particular medical services in the context of workers’ compensation. Your understanding of the proper reimbursement rate is important to your business.

We have extensive experience helping our clients with interpreter collection in workers’ compensation cases.  Contact us today for a consultation.

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