Lien vs. Second Review — pick the right track
If the dispute is about the AMOUNT paid against the fee schedule, use Second Review / IBR — never a lien (it will be dismissed). File a lien only when the dispute falls OUTSIDE that process: the employer disputes liability for the claim or body part, or the expense isn't fee-schedule-covered. The generator at /wizard/lien-declaration produces the LC §4903.05(c)(2) declaration under penalty of perjury, stating the statutory basis.
Fee and deadline
A $150 filing fee applies (LC §4903.05(c)(1)). The lien must be timely under LC §4903.5: 18 months from date of service for DOS on or after July 1, 2013; 3 years for earlier dates. The declaration affirms the dispute is not subject to the §4603.2/§4622 second-review/IBR process.