What Is California Labor Code §4903.05: Lien Filing Fee and Form?

Every lien claimant shall file its lien with the appeals board in writing upon a form approved by the appeals board. The lien shall be accompanied by a full statement or itemized voucher supporting the lien and justifying the right to reimbursement and proof of service upon the injured worker or, if deceased, upon the worker’s dependents, the employer, the insurer, and the respective attorneys or other agents of record.

What Does California Labor Code 4903.05 Require?

Labor Code 4903.05 sets the paperwork every lien claimant must file, and adds a fee and a sworn statement for medical expense liens.

A lien is a request for payment out of your workers' compensation case. A doctor, a hospital, an interpreter, or another provider can file one to ask the Workers' Compensation Appeals Board (WCAB) to order payment of a bill tied to your claim. Labor Code 4903 decides which costs can become a lien in the first place. Labor Code 4903.05 is the rulebook for how a lien claimant must file one.

These filing duties fall on the lien claimant, not on you. Even so, a lien can sit between you and your settlement until it is resolved. It helps to know what the law requires before a lien gets paid, reduced, or thrown out.

How Do You File a Lien Under Labor Code 4903.05?

You file the lien in writing, on the board's own form, and prove you served it on everyone in the case.

Subdivision (a) sets the basic filing rule that applies no matter what the lien is for. The lien claimant must file the lien with the appeals board in writing, on a form the board approves. The filing must come with a full statement or an itemized voucher that supports the amount and explains the right to be paid back.

The lien claimant must also prove it served a copy. That proof of service must go to the injured worker, or to the worker's dependents if the worker died, plus the employer, the insurer, and each side's attorney or other agent of record. For a lien filed on or after January 1, 2017, the claimant must also attach an original bill along with the statement or voucher. Medical records only need to be filed when they are relevant to the issues the lien raises.

Which Liens Need the $150 Fee and Electronic Filing?

A lien that falls under subdivision (b) must be filed electronically and usually needs a $150 fee paid first.

Labor Code 4903.05 adds extra steps for one kind of claim: a lien for the medical and medical-legal expenses described in subdivision (b) of Labor Code 4903, or for a claim of costs. The table below compares the baseline filing rule against the added steps for that kind of claim.

The $150 fee is paid to the Division of Workers' Compensation before the lien is filed, through an electronic payment system. If the division uses an outside processor for that payment, it absorbs the processing cost instead of passing it to the filer. Skipping the fee on this kind of claim makes the lien invalid, even if the appeals board accepts it for filing, and an invalid lien does not preserve or extend the filing deadline. The claims of two or more providers also cannot be merged into one filing.

A short list of filers does not owe the fee: a licensed health care service plan, a group disability insurer, a qualifying self-insured employee welfare benefit plan, a Taft-Hartley health and welfare fund, and a publicly funded program that pays medical benefits on a nonindustrial basis.

What Must the Required Declaration Say?

The filer must swear that the dispute skips bill and medical review, and that it fits one of several listed reasons.

A subdivision (b) lien that owes the filing fee must also come with a signed declaration, made under penalty of perjury. The declaration states that the dispute does not go through independent bill review under Labor Code 4603.6 or independent medical review under Labor Code 4610.5. It must also show that the filer fits one of these reasons:

• Is the injured worker's treating physician inside the employer's medical provider network.
• Is the agreed medical evaluator or the qualified medical evaluator (QME).
• Provided treatment the employer or claims administrator authorized through utilization review under Labor Code 4610.
• Made a diligent search and found that the employer has no medical provider network in place.
• Has proof that medical treatment was neglected or unreasonably refused, as Labor Code 4600 describes.
• Billed for care given during a medical emergency, as state law defines that term.
• Is a certified interpreter at a medical-legal exam, a copy service, or another cost the administrative director allows as a lien by rule.

Skipping this paperwork is not a small gap. The law dismisses a covered lien with prejudice, by operation of law, if the filer never submits a signed declaration. A false declaration is grounds for dismissal with prejudice too, after notice. A lien already on file before January 1, 2017 got a one-time window, open through July 1, 2017, to add this declaration; that earlier window has long since closed.

How Does Labor Code 4903.05 Connect to Other Lien Rules?

This section works alongside Labor Code 4903, 4903.5, 4603.2, 4610, 4610.5, and 4600.

Labor Code 4903 decides which costs, such as a reasonable attorney's fee or a medical bill, can become a lien at all. Labor Code 4903.05 only covers how to file one. The filing deadline is its own separate rule: Labor Code 4903.5 generally gives a filer 18 months from the date of service for care provided on or after July 1, 2013, or 3 years for earlier care.

Subdivision (b) also says that filing this way does not change the service rules in Labor Code 4603.2, which governs how a medical bill gets reviewed and paid. The declaration's listed reasons connect to Labor Code 4610, which covers utilization review, and Labor Code 4610.5, which covers independent medical review. One reason also points back to Labor Code 4600, your right to medical treatment, when a provider shows that care was neglected or refused.

What Should You Do If a Lien Is Filed Against Your Claim?

Keep every notice you get, and check whether the filing followed the form and service rules.

Save any lien notice or proof of service you receive, along with the envelope or email and the date. Check that the paperwork names your claim correctly. A filing that skips the required form, the fee, or the declaration for a medical expense claim can be challenged on that basis alone. A lien being filed does not change your own right to medical care or to your disability payments; it is a separate dispute over who gets paid and how much.

If you are not sure whether a lien against your case was filed correctly, or what it could mean for your settlement, a licensed attorney can review the paperwork and the dates with you.

A lien filed against your workers' compensation case can raise questions that have nothing to do with your own claim for benefits. Yazdchi Law P.C. can look at the filing, the service, and the timing with you. The firm reviews each matter on its own facts. Call (661) 273-1780 or use the contact form for a free initial consultation.