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Current Law on Utilization Review in California

The Courts are rigorously enforcing the process of determining medical necessity and medical causation to ensure that the Insurance Companies and Medical Providers follow the processes set forth in SB 899 and SB 228 regarding utilization review (medical necessity), and the medical legal process (causation...

California Workers' Compensation Cases Roundup 10/7/2010

CALIFORNIA COMPENSATION CASES Vol. 75, No. 9 September 2010 A Report of En Banc and Significant Panel Decisions of the WCAB and Selected Court Opinions of Related Interest, With a Digest of WCAB Decisions Denied Judicial Review CONTENTS OF THIS ISSUE Appellate Court Compensation Case ...

CA: Mileage Rate For Medical Travel Expenses Will Increase

Oakland, CA (CompNewsNetwork) - The mileage rate for medical and medical-legal travel expenses will be increased and effective on Jan. 1, 2011. This rate must be paid for travel on or after Jan. 1, 2011 regardless of the date of injury. Labor Code section 4600, in conjunction with Government Code...

Jump in California Average Weekly Wage to Push 2012 Workers’ Comp Benefits to Over $1,000/Week

New U.S. Department of Labor data shows California's State Average Weekly Wage (SAWW) rose more than 2.4% from $979.90 to $1003.55 in the 12 months ending March 31, 2011, which the California Workers' Compensation Institute (CWCI) reports will push up minimum and maximum temporary total disability...

California: Did You Know? There’s More to the Ogilvie Case Than You Think!

On July 29, 2011, the California Court of Appeal, First Appellate District, issued its long awaited decision in Ogilvie v. Workers' Comp. Appeals Bd., which reversed the WCAB en banc decision and remanded the matter back to the WCAB to determine whether Ogilvie effectively rebutted the application...

Severance Agreement Waiving Workers’ Comp Benefits Not Valid: Cal. Comp. Cases November Advanced Postings (11/10/2011)

Featured Case of the Week: Severance Agreement Waiving Workers' Comp Benefits Not Valid Sompo Japan Insurance Company of America (formerly known as Yasuda Fire & Marine Insurance Company, c/o Broadspire, a Crawford Co.), insurer for Canon Business Solutions, Inc., Petitioner v. Workers'...

AMA Guides Tip: Understanding the DRE Gap

By Robert G. Rassp, Esq. There is significant confusion in the California workers' comp community about whether a spinal injury should fall into a DRE category I, II, or III. Carefully read the instructions in the AMA Guides Fifth Edition, Ch. 15, Sec. 15.3, p.383, where the authors distinguish...

AMA Guides Tip: Understanding the DRE Gap

By Robert G. Rassp, Esq. There is significant confusion in the California workers' comp community about whether a spinal injury should fall into a DRE category I, II, or III. Carefully read the instructions in the AMA Guides Fifth Edition, Ch. 15, Sec. 15.3, p.383, where the authors distinguish...