Workers’ Compensation · Primary-source case analysis

Colamonico: The Medical-Legal Provider Bears the Initial Burden of Proof

By Aneeta Mishra and Timothy Chan

Published April 17, 2026

Colamonico allocates the proof burdens in a medical-legal lien dispute and separates payment-review requirements from the provider's threshold entitlement to reimbursement.

Copy-service lien after a claimed injury

Ashley Colamonico claimed industrial injury to her spine and internal organs while working as a driver. A copy-service provider issued subpoenas and invoices for records requested in the claim. Years later, the defendant issued explanations of review, and the dispute proceeded to a lien trial over necessity, value, penalty, and interest.

The provider's two-part initial showing

The Board held that the provider must first prove that a contested claim existed when the expense was incurred and that the expense was incurred to prove or disprove that contested claim under section 4620. It must also prove the services were reasonably, actually, and necessarily incurred under section 4621(a).

An EOR omission does not waive threshold objections

The defendant did not waive sections 4620 and 4621 objections merely by failing to state them in an explanation of review under section 4622. The Board rejected prior authority to the extent it treated those threshold entitlement objections as forfeited by the EOR omission.

Disposition

Because the trial ruling did not apply the burden framework announced in the en banc decision, the WCAB rescinded the findings and orders and returned the matter for further proceedings. The ruling preserved an unchallenged penalty-and-interest determination for specified invoices.

Key takeaways

• A provider must prove a contested claim existed when services were incurred.
• The services must help prove or disprove that claim.
• Reasonable, actual, and necessary incurrence is a separate element.
• Not every omitted EOR objection is waived.