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Are you talking about attorneys approving their clients treatment under a lien?
They’re not really approving the treatment, the doctor already did that. they’re approving the cost of the treatment to the contractual lien.
It’s done so that doctors don’t rack up huge bills that are beyond what’s recoverable.
I don’t have a real answer to your second question but imagine it would be pretty funny to ask the lawyer why they approved the cost of treatment.