CA: DWC Posts Revised Draft Physician Fee Schedule

OAKLAND , CA - The Division of Workers' Compensation (DWC) has modified its draft physician fee schedule and has posted an online forum for members of the public to review and comment on the revised draft. The forum can be found at http://www.dir.ca.gov/dwc/DWCWCABForum/dwc_PhysicianFeeSchedule...

CA: CWCI Reports on Medical Development Trends for AY 2002-2009

OAKLAND, CA - A new report by the California Workers' Compensation Institute analyzes claims experience from AY 2002 through June 2009 and takes an updated look at the development of California workers' compensation paid medical costs. View the report (posted May 25, 2010) Source: CWCI

CA: DWC Adjusts DMEPOS Section of Official Medical Fee Schedule

OAKLAND, CA - The Division of Workers' Compensation has posted an order adjusting the durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) section of the Official Medical Fee Schedule to conform to changes in the Medicare payment system as required by Labor Code section 5307.1...

CA: Calif. Workers' Comp Premium Volume Declines for Fifth Year in a Row

OAKLAND, CA - According to the California Workers' Compensation Institute, California’s workers’ compensation premium volume declined last year for the fifth year in a row to a nine-year low of $6.9 billion. Source: Sacramento Business Journal

CA: Workers' Comp Insurer Had No Duty to Notify Bank That Issued Check Was Genuine

LOS ANGELES, CA - A California Court of Appeal has held that a man who suffered a seizure while in jail after a mix up over his attempt to cash a workers' compensation check at a bank could not sue the workers' compensation insurance company that issued the check for failing to contact the bank...

CA: Worker's Suicide Resulted From Chronic Pain After Industrial Injury

Bajro Sisic (Dec), Ramiza Sisic (Wid) v. Vasona Management, Inc. Injury AOE/COE--Suicide--Irresistible Impulse--WCAB, affirming WCJ's finding, held that decedent/general maintenance worker who suffered an admitted industrial injury to his back/hernia on 7/21/2003, died as a result of an irresistible...

CA: Order to Compel Medical Exam Rescinded Due to Lack of Notice to Injured Worker

Maximo Amaya v. Faustino Limon’s Chair Factory WCAB Procedure—Walk-Through Documents--WCAB granted applicant/wood finisher's petition for removal and rescinded WCJ's Order compelling applicant to attend re-evaluation with panel QME regarding injuries to his cervical spine, shoulders...

CA: Medical Board Reinstated 66 Convicted Felons During Past 10 Years

California - The Orange County Register reports that the California Medical Board has reinstated the medical licenses of 66 convicted felons during the past 10 years, including a Beverly Hills psychiatrist who was arrested and charged with hiring "cappers" to recruit thousands of laid off workers...

CA: New Lien Procedures for L.A. District Office Lien Unit

OAKLAND, CA & LOS ANGELES, CA – The California Division of Workers’ Compensation has announced new lien procedures for the Los Angeles District Lien Unit. The new procedures contain the following specifics: 1. Parties to a lien dispute are expected to have completed discovery and exhausted...

CA: Cincinnati Bengals Unsuccessful in Denying WCAB of Jurisdiction in Injured Football Player's Case

Wesley Carroll v. New Orleans Saints Jurisdiction--Subject Matter Jurisdiction--Out-of-State Employment--WCAB, rescinding WCJ's finding, held that there was insufficient evidence in record to determine whether requirements in Labor Code § 3600.5(b) were satisfied so as to deprive State of...

CA: Order Approving C&R Settlement Constituted Prior Award for Purposes of Apportionment

Juan Antonio Perez Garcia (Juan Antonio Perez) v. Tapia Brothers Permanent Disability--Apportionment--Compromise and Release Agreement as Prior Award--WCAB rescinded WCJ's finding that applicant's 5/3/2004 injuries to neck, left shoulder and left knee resulted in 46 percent permanent disability...

CA: Adjudication of LC 132a Entitlement to Back Wages as Prerequisite to Determining DFEC

Bruce Mitchell v. City and County of San Francisco, PSI Discrimination--Labor Code § 132a--Diminished Future Earning Capacity--WCAB held that WCJ did not abuse his discretion in deferring issues regarding applicant/police cadet's loss of earnings until after resolution of his Labor Code §...

CA: Loss of Grip Strength Properly Ratable Under Strict Reading of AMA Guides, Almaraz Doctrine

Joel Medina v. Salinas Valley Memorial Hospital, Acclamation Insurance Management Service Permanent Disability—Rating—AMA Guides —WCAB upheld WCJ ' s finding that AME's report constituted substantial evidence to support inclusion of applicant's grip loss as an impairment...

CA: Home Improvement Self-Insured Group to Expand Membership to Other Types of Retailers

SACRAMENTO, CA - The Home Improvement Self-Insured Group has gained state approval to open its membership to other types of retailers, including drug stores, gift shops, and stores selling sporting goods, hobby and crafts, electronics, beauty supplies and art supplies. Source: Sacramento Business...

CA: CMTA and CompWest Form Partnership to Provide Workers' Comp Insurance for Manufacturing Sector

Effective July 1, 2010, the partnership of California Manufacturers and Technology Association (CMTA) and CompWest Insurance Company will provide a group workers' compensation insurance program for California's manufacturing sector. Source: Insurance Journal

CA: State Collects $529M in Reinsurance Contract Dispute Between U.S. Life and Superior National

SAN FRANCISCO, CA - The Conservation & Liquidation Office, which serves the California Insurance Commissioner, announced the receipt of $529 million from U.S. Life Insurance Company, an American International Group (A.I.G.) subsidiary, in partial satisfaction of a judgment affirming the Final Arbitration...

CA: Insurance Commissioner Announces $30M in Grants to Fight Workers’ Comp Insurance Fraud

SACRAMENTO CA - Insurance Commissioner Steve Poizner announced today nearly $30 million in grants to local district attorneys to be used to find and prosecute workers’ compensation insurance fraud. "Workers’ compensation insurance fraud creates costs that are a burden on our economy...

CA: WCAB Finds Utilization Report Raised No Question of Causation of Need for Requested Surgery

Martha Zamora v. Culinary Specialties, Inc., Pennsylvania Manufacturers' Association Insurance Company Medical Treatment--Utilization Review--WCAB affirmed WCJ's award of medical treatment in form of right shoulder surgery to applicant/mixer with 7/13/2007 right shoulder injury, and held that...

CA: WCAB Further Refines Utilization Review Spinal Surgery Procedures

Jacob Vervalin v. Mission Uniform & Linen, Travelers Insurance Medical-Legal Procedure--Spinal Surgery--WCAB rescinded WCJ's finding that applicant/sales representative with 4/20/2007 spinal injury was entitled to spinal surgery based upon AME's report, when WCAB found that it was improper...

CA: WCIRB Spotlight Series Focuses on Experience Rating Eligibility

SAN FRANCISCO, CA - The Spotlight section of the WCIRB website contains timely workers' compensation information written for insurers, agents and brokers and policyholders. Throughout 2010, the WCIRB will publish a series of Spotlight articles focusing on California's experience rating system...

CA: Data Reporting Errors Plague California Workers’ Comp System

The Workers’ Compensation Insurance Rating Bureau (WCIRB), for the past four years, has been testing a program to hold carriers accountable for hundreds of millions of dollars of payroll misclassified on some of the largest workers’ comp policies in California. Large policies have been and...

CA: CalChamber Says Utilization Review Bill Increases Workers' Comp Costs

SACRAMENTO, CA - The California Chamber of Commerce says it is opposing AB 933, which the Senate Labor and Industrial Relations Committee passed by a vote of 4-1 on June 23, 2010. According to CalChamber, the bill would increase the cost of performing utilization review on medical treatment requests...

CA: Insurer Denied Reimbursement for Paying Excessive Treatment Beyond 24 Chiropractic Visit Limit

Silvia Mora v. Steelcase, Inc. Medical Treatment--Chiropractic--WCAB, rescinding WJC's finding, held that defendant was not entitled to reimbursement by lien claimant/chiropractor for treatment provided to applicant/painter/assembler with injury to her right shoulder and upper extremity during...

CA: Dependent of Deceased Worker Not Entitled to Annual Increases in Death Benefits

Christopher Peckham (Dec'd), Lisa Falvo-Peckham (Widow) v. Resolution Law Corp and Republic Indemnity Co. of America Death Benefits--Cost of Living Adjustments--WCAB upheld WCJ's finding that dependent daughter of decedent who died on 6/21/2008 was not entitled to annual increases in death...

CA: New Committee Members Elected at WCIRB Annual Meeting

San Francisco, CA - The WCIRB yesterday held its ninety-fifth Annual Meeting for the purpose of electing new insurers to the Governing Committee and Classification and Rating Committee and to consider the WCIRB’s 2010 Annual Report. The Annual Report can be found on the WCIRB website in the About...