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.
The WCJ found lien claimant engaged in improper conduct circumventing defendant's internal processes, resulting in unjust enrichment; the WCAB agreed and affirmed restitution was warranted.
From the decision · page 6unjust enrichment, where it circumvented defendant's typical processes for handling disputed lien claims. Specifically, the WCJ found that lien claimant intentionally bypassed defendant's internal procedures by demanding payment from its medical review department, rather than its claims department, and that lien claimant knew or should have known that the resulting payment in full was made in error, particularly where the bill amount was still being litigated.
The WCJ found lien claimant willfully failed to comply with court orders and engaged in bad faith tactics causing delays; the WCAB affirmed sanctions and costs were justified.
From the decision · page 10Here, the WCJ found that sanctions should issue as a result of lien claimant's willful failure to comply with the court's May 6, 2015 Findings and Order requiring it to forward all documentation showing the value of its services for IBR for roughly three years.