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There can be no doubt that most of you have already heard that beginning on July 15, 2022, the new Copy Service Fee Schedule will take effect and the general changes are as follows:

1. Flat rate raises from $180 to $230. (Thanks inflation)
2. Bills must be paid or contested within 30 days of receipt
   1. Failure to meet this deadline will result in an 25% increase as an incentive to pay bills in a timely manner since copy services companies often have to resort to asking the WCAB for help. (What do we have to do to get this kind of attention?)
3. Additional sets of records will be limited to a flat rate of $10 and that claims administrators are only liable for one additional set of records. (Ok we got some attention).

Labor Code Section 4622(a) requires that payment of any uncontested services be made by the employer or its carrier within sixty (60) days of receipt, after which time a penalty and interest accrue. It seems that with the new changes, not only do we have a 25% increase after 30 days of failure to pay or contest the bills but could also be liable for penalties and interest after 60 days. As such, it is important to immediately object or pay the undisputed invoices within 30 days.

Objections

Despite the new changes, the reasons for objecting to the copy services remains overall the same. Some of the main objections include:

CCR §9982(d) which indicates:

(1) There will be no payment for copy and related services that are: (1) Provided within 30 days of a written request … for copies of records in the employer’s, claims administrator’s, or WC insurer’s possession that are relevant to the employee’s claim,

(2) Provided by any person or entity which is not a registered professional photocopier.

CCR §9982(e) states that a claims administrator is not liable for payment of:

(1) Records previously obtained by subpoena or authorization by the same party and served from the same source, unless the subpoena or authorization is accompanied by a declaration … setting forth good cause to seek duplicate records.

(a) If there is good cause, the claims administrator is liable for payment. Good cause includes new counsel seeking duplicate records for review, and loss or destruction of records due to natural disaster

One potential issue is that CCR §9982(e)(1)(a) states that the claim administrator is liable for payment after showing of good cause, but, the new fee schedule only allows for one duplicate copy. This could cause potential conflict, if or when good cause is shown due to a “natural disaster” ie: new counsel etc. I mean new counsel or a natural disaster, etc. Would the claims administrator be liable for payment of more than one copy at the time? Depends on the good cause I guess.

However, over the past several years, and in this ever-advancing technological world, we have no need for more than one set of records, and for the average case it is less and less likely that more than one set is necessary. In any event, this is a potential scenario you should be advised of since copy services are currently obtaining several additional copies of records without good cause and still trying to obtain payment for them. 

Nonetheless, if any of objection is relevant in your case, I recommend issuing an objection to the billing within the new 30-day timeframe. Alternatively, upon receiving a bill for medical-legal expenses it is best to promptly pay any undisputed charges within 30 days in order to avoid the 25% increase, penalties and interest and issue an EOR for any disputed charges indicating the reasons for the denial.

Med-legal Expense Disputes

What if a copy services company issues a Notices of Intent to File Petition for Determination of Med-Legal Expense Dispute pursuant to 8 CCR § 10786(b)? Generally, these Petitions are based on the claim that the defendants failed to notify the Med-legal provider within 60 days pursuant to Labor Code §4622 that they object to the reasonableness or necessity of the expenses on the EOR, and that absent that information on the EOR, defendants forfeit that right to object.

However, you may recall the case of Colamonico v. Secure Transportation (2019) 84 Cal. Comp Cases 1059 (WCAB en banc), which held that defendant didn’t waive their objection based on Labor Code §4620 or §4621 because they failed to raise the objections in an explanation of review pursuant to Labor Code §4622.

Colamonico also identified that a medical-legal provider has the initial burden of proof to show the following three elements apply to their services:

1. There must be a contested claim at the time the expenses were rendered;
2. The expenses were incurred for the purpose of proving or disproving the contested claim;
3. The services were reasonable and necessary at the time they were incurred.

As such, the Medical legal provider must show the above three elements before the claims administrator has any responsibilities under Labor Code §4622. Upon receiving a Notice of Intent to File Petition for Determination of Med-Legal Expense Dispute, make sure the provider has provided the above. If the providers fail to provide adequate evidence of any of the three elements, they fail to meet their initial burden of proof and will not be able to show the WCJ they have a valid medical-legal expense. If the providers meet their burden of proof, the burden shifts to the reasonable value of invoices pursuant to Labor Code §4622. If the defendant does not show they paid the responsible amount to the provider, defendant may be found liable for penalties and interest.

The court in Colamonico also warned if the defendant’s actions are found “frivolous or solely intended to cause unnecessary delay” there is potential for sanctions and attorney fees. As such, continue to respond to ALL invoices in the form of an EOR, within 30 days of receipt, and pay any uncontested bills, in order to avoid exposure for penalties and interests.

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