The burden of proof in Workers’ Comp Appeals Board (WCAB) cases is always laid upon the lien claimants. The lien claimants must bear the burden of proof and stand in the shoes of the applicant. Lien claimants must prove the prima facie case of entitlement to the benefit that is being sought. The burden of proof is based upon a preponderance of the evidence, i.e. just enough evidence to prove that what the claimant seeks to prove is more likely than not. If the lien claimant does not have enough evidence to sustain the burden of proof, the defendant is not required to present any evidence.
Applicant Testimony
When the defendant has asserted a good faith defense that would bar the applicant’s claim in its entirety, it may then be necessary to have the applicant testify at the lien trial in order to sustain the lien claimant’s burden of proof. In purely medical disputes (in which there is no discord over what happened to the applicant) and purely legal disputes (in which the dispute only regards the application of the law to the facts), applicant testimony is not required. However, if it is the case of a factual dispute, it will require the applicant’s testimony, especially if there is a dispute to AOE/COE of a specific date of injury or other fact-based jurisdictional and threshold issues.
5 Requirements for a Medical Treatment Lien’s Validity
1. A compensable injury that affected the part of the body or condition that was treated (AOE/COE).
2. Medical control at the time the treatment occurred (MPN issue).
3. A qualified medical provider enacted the treatment.
4. The treatment was reasonably necessary to cure or relieve the effects of the injury.
5. The charges must be reasonable in value (OMFS).
It is the claimant’s burden to prove all of these five requirements. The burden of proof can be extensive and proving all the requirements will take thorough arguments and expertise. Consult a professional lien hearing representative that has the experience and knowledge needed to maneuver the burden of proof successfully.