LexisNexis® Legal Newsroom
Idaho: Continued Pain Does Not Contradict Finding That Worker Reached Maximum Medical Improvement

An injured worker’s contention that she still suffered significant pain was not sufficient to contradict the Commission’s finding that the worker had nevertheless reached a point of maximum medical improvement, held an Idaho court. In fact, the worker’s evidence that she was not improving...

Connecticut: Employer Need Not Pay for Palliative Medical Care

A Connecticut court affirmed the finding of the commissioner that various medications prescribed by the plaintiff’s treating physician for a head injury that occurred some 18 years earlier were palliative rather than curative, and thus were not reasonable and necessary medical treatment after the...

California: WCAB Affirms Medical Treatment in the Form of Sleep Number i8 Bed

In Carnes v. Auto Zone, Inc., 2015 Cal. Wrk. Comp. P.D. LEXIS --, a split panel WCAB affirmed the WCJ’s order that the defendant authorize medical treatment in the form of a Sleep Number i8 bed based on the reporting of the applicant’s treating physician, Eldan Eichbaum, M.D. The parties...

Delaware IAB Denies Surgery to Pinocchio

Today’s post comes to us from Wade Adams of Liberty Mutual. He is our guest blogger and I will leave it to him to tell the tale: "This is a case where Dr. Rudin performed a lumbar fusion on a claimant who had a negative MRI, but positive discogram on an accepted low back sprain. When Dr...

Like a Virgin: Delaware IAB Denies Surgery and What a Difference a Year Makes!

Today’s post comes to us from my dear colleague Jessica Leigh Julian of Marshall Dennehy. And it seems to me that there have been a flurry of proud defense lawyers standing up against the call of the scalpel. Jess joins Wade Adams this week in a successful challenge to a DACD Petition for surgery...

Florida: Claimant Must Establish Medical Need for Ongoing Palliative Treatment

A Florida court has affirmed a JCC’s decision denying a follow-up appointment with a claimant’s authorized neurologist on the ground that the comp carrier met the burden of proving that the compensable injuries were not the major contributing cause (MCC) of the claimant’s need for the...

Vermont Workers’ Compensation Update: January to March 2015

This list of recent noteworthy cases was compiled by Keith J. Kasper of McCormick, Fitzpatrick, Kasper & Buchard, PC. Julie Mercier of Williamstown, VT, has joined the staff at the Department as a Workers’ Compensation Specialist II. Ms. Mercier has an Associates of Science as a...

California: Self-Procured Medical Marijuana

Are applicants entitled to reimbursement for self-procured medical marijuana both pre- and post-SB 863? In Cockrell v. Farmers Insurance , 2015 Cal. Wrk. Comp. P.D. LEXIS --, a WCAB panel has once again rescinded the WCJ’s finding that the applicant was entitled to reimbursement (as opposed...

New York: To Support Apportionment, Prior Condition Must Be Disabling, Not Just Symptomatic

A New York appellate court held it was error to apportion an injured worker’s permanent disability based on medical testimony that 10 percent of the impairment was due to a 2009 work-related injury and that the rest was due to a 1981 work-related injury where the worker returned to work after the...

Compound Medications Not Found Reasonable and Necessary Under ACOEM Guidelines, MTUS: Cal. Comp. Cases April Advanced Postings (4/15/2015)

Here’s the fourth batch of advanced postings for April 2015 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the cases to read the complete headnotes and summaries. © Copyright 2015 LexisNexis. All rights reserved. Frontline Medical Associates, Inc.,...

Applicant’s Impairments Added Rather Than Using Combined Values Chart: Cal. Comp. Cases May Advanced Postings (4/28/2015)

Here’s the second batch of advanced postings for the May 2015 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the cases to read the complete headnotes and summaries. © Copyright 2015 LexisNexis. All rights reserved. Los Angeles County Metropolitan Transportation...

California: Diagnostic Testing: Is it Medical Treatment or Medical-Legal Expense?

An interesting question arises in whether diagnostic testing constitutes “medical treatment” or a valid “medical-legal” expense. If it’s deemed medical treatment, then it is subject to UR/IMR. Two recent panel decisions illustrate the complexities of this issue. (Publisher’s...

Defendant Improperly Terminated Home Health Care Provided Since 2007: Cal. Comp. Cases May Advanced Postings (5/6/2015)

Here’s the third batch of advanced postings for May 2015 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2015 LexisNexis. All rights reserved. Lions Raisins, aka Lions Raisins Packing...

California: New Medical Provider Network Regulations: It's a New Medical Treatment Paradigm

The 2004 workers’ compensation reform package of SB 899 brought about many changes as to how employers were required to provide medical treatment to injured workers. (Publisher’s Note: Citations link to lexis.com; bracketed citations link to Lexis Advance.) The newly created Labor Code...

Injured Worker Deported From U.S. Could Testify Via Skype: Cal. Comp. Cases May/June Advanced Postings (5/27/2015)

Here are the fifth batch of advanced postings for the May 2015 issue and the first batch of advanced postings for the June 2015 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2015 LexisNexis...

California: Untimely Independent Medical Review

Split WCAB panel finds untimely IMR, like untimely UR, is invalid In Saunders v. Loma Linda University Medical Group , 2015 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB, in a split panel opinion, rescinded its prior decision [see Saunders v. Loma Linda Univ. Med. Group , 2014 Cal. Wrk. Comp. P.D. LEXIS...

California: Top 25 Noteworthy Panel Decisions (January-June 2015)

LexisNexis has picked the top “noteworthy” panel decisions issued by the California Workers’ Compensation Appeals Board during the period January through June 2015. The list features a number of split-panel decisions, including bonus cases addressing the validity of untimely independent...

Utilization Review Untimely When Defendant Didn’t Subject Treating Physician’s Requests for Authorization to UR: Cal. Comp. Cases July Advanced Postings (6/26/2015)

Here’s the first batch of advanced postings for July 2015 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2015 LexisNexis. All rights reserved. Deluxe Laboratories, ESIS, Inc., Petitioners...

California: Diagnostic Testing: Medical Treatment or Medical-Legal Expense? (Part 2)

In the May 4, 2015 issue of the LexisNexis Workers’ Compensation eNewsletter California Edition we reported the noteworthy panel decision of Hubbard v. United Parcel Service , 2015 Cal. Wrk. Comp. P.D. LEXIS 223 (April 21, 2015). On July 3, 2015, the WCAB panel rescinded its prior decision in which...

Love without Borders: Delaware Law Eliminates Provider Certification Requirement for Out-of-state Treatment

Special thanks to Tara Bustard, Andy Carmine and Walt Schmittinger for bringing to my attention that House Bill 166 was signed into law on Monday. This is the long-awaited legislative remedy to the issues acknowledged by Wyatt v. Rescare and Vanvliet v. D&B Transportation (see my posts of 11/21/13...

District of Columbia: Remand Required Where Review Board Fails to Determine Medical Issues on their Merits

The District of Columbia Court of Appeals reversed a significant portion of an order by the Compensation Review Board (CRB) that found an injured worker was not entitled to compensation for proposed medical treatments on the basis that they were not reasonable and necessary. The worker, a former bus...

Defendant Can’t Unilaterally Terminate Home Health Care Services Without Evidence of Change in Applicant’s Condition or Circumstances: Cal. Comp. Cases August Advanced Postings (8/5/2015)

Here are the first and second batches of advanced postings for the August 2015 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2015 LexisNexis. All rights reserved. Warner Brothers, Time...

California: WCAB Panel Takes Strict, Literal Approach to IMR Appeals

No material mistake of fact exists when IMR reviewer fails to list the actual reports and records reviewed by the IMR physician In Hacker v. County of San Bernardino-Public Health Department , 2015 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB, in a split panel opinion, held that the WCJ’s findings...

California: Defendant’s Affirmative Obligation to Provide Medical Treatment

Defendant ordered to comply with earlier award of medical treatment in the form of assisted living services In White v. Department of Social Services , 2015 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB panel affirmed the WCJ’s order instructing the defendant to comply with an earlier award of medical...

Utilization Review Addresses Medical Necessity, Not Manner of Payment: Cal. Comp. Cases September Advanced Postings (8/26/2015)

Here’s the latest batch of advanced postings for the September 2015 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2015 LexisNexis. All rights reserved. Murphy v. WCAB , lexis.com ,...