California: W.C.A.B. Limits Application of Messele Decision

After seeking input on its Notice of Intent to limit application of the Messele decision prospectively, and getting none, the W.C.A.B. has confirmed its decision to limit the application of its holding. The W.C.A.B. has, in a decision which issued yesterday as follows: To cases where a QME panel...

Herlick Handbook 31st Edition: Educating the California Workers’ Comp Community Since 1964

LexisNexis Announces New Editors-in-Chief: Richard Jacobsmeyer, Julius Young, Barry Bloom This 31st edition marks a transition in the history of Herlick, California Workers’ Compensation Handbook . Longtime author Stanford D. Herlick passed away in 2010, and the handbook is now co-edited by a...

Does an Employee Have to Obtain a Comprehensive Medical-Legal Evaluation Prior to Disputing a Utilization Review Determination?

In State Compensation Insurance Fund v. Workers' Comp. Appeals Bd. (Sandhagen) (2008) 44 Cal.4th 230 [73 Cal.Comp.Cases 981] (Sandhagen), the California Supreme Court clarified that an employer did not have the option of going through either UR or the QME process in addressing a treatment request...

California: Utilization Review, Interrupted

Does an Employee Have to Obtain a Comprehensive Medical-Legal Evaluation Prior to Disputing a Utilization Review Determination? In State Compensation Insurance Fund v. Workers’ Comp. Appeals Bd. (Sandhagen) (2008) 44 Cal.4th 230 [73 Cal.Comp.Cases 981] (Sandhagen), the California Supreme Court...

Lien Claimant’s PQME Reports Admitted Into Evidence: Cal. Comp. Cases February Advanced Postings (2/10/2012)

Here’s the second batch of advanced postings for the February 2012 issue of Cal. Comp. Cases. Lexis.com subscribers can link to the case to read the complete headnotes and summaries. County of Mendocino, PSI, Petitioner v. Workers' Compensation Appeals Board, City of Willits, PSI, Aaron...

California Panel QME Process: Is It Time to Admit We Are Dealing With a Monster?

A serious question needs to be asked about whether requiring the use of one Qualified Medical Evaluator (QME) in a workers’ compensation case, as opposed to the use of “battling QME’s”, has reduced litigation or has actually served to increase litigation. No question, at least...

California: Court Upholds W.C.A.B. Ruling Excluding Medical Legal TD From Labor Code § 4656 Window

The 3rd Appellate District has resolved a one of the issues that has been frequently discussed but almost never raised (at least in my experience) regarding payment of TTD during the period between 4/19/2004 and 12/31/2007 when the first payment of TD triggered a 2 year window for payment of TTD benefits...

California: When to Object to a Treating Physician’s Permanent Disability Determination

Lexis.com subscribers can link to the cases and statutes cited below. California Labor Code Section 4062 provides that if either party objects to a “medical determination” made by the treating physician concerning any medical issues not covered by Labor Code Section 4060 or 4061 and not...

California: Was That Just a Reverse Almaraz/Guzman That Flew By?

As a result of the February 3, 2009, en banc decision in Almaraz v. Environmental Recovery Services/Guzman v. Milpitas Unified School District (2009) 74 Cal. Comp. Cases 201 (Appeals Board en banc), the September 3, 2009 decision after reconsideration in Almaraz/Guzman ( Almaraz v. Environmental Recovery...

California: The Right to Select the Specialty of the Panel QME: Whose Choice Is It Anyways?

Lexis.com subscribers can link to the citations below. Prior to the passage of Senate Bill 899, both sides maintained the right to select their own QME. Inherent in the use of “battling QME’s” was also the right to decide what type of specialist a party would utilize. Where a back...

California: The Right to Select the Specialty of the Panel QME: Whose Choice Is It Anyways?

Lexis.com subscribers can link to the citations below. Prior to the passage of Senate Bill 899, both sides maintained the right to select their own QME. Inherent in the use of “battling QME’s” was also the right to decide what type of specialist a party would utilize. Where a back...

California Workers’ Compensation Reform SB 863 Analysis: Medical Treatment Provisions

***NEW! TO READ AN UPDATED ANALYSIS OF THE 8/30/2012 VERSION OF SB 863, CLICK HERE . On 8/31/2012, the Legislature passed SB 863.*** ***WARNING: The analysis below was based on the 8/24/2012 version of SB 863. Several amendments were made to the bill since that time. *** The proposed “new...

California Workers’ Compensation Reform SB 863 Analysis: Medical Treatment Provisions

***NEW! TO READ AN UPDATED ANALYSIS OF THE 8/30/2012 VERSION OF SB 863, CLICK HERE . On 8/31/2012, the Legislature passed SB 863.*** ***WARNING: The analysis below was based on the 8/24/2012 version of SB 863. Several amendments were made to the bill since that time. *** The proposed “new...

California Workers’ Compensation Reform SB 863 Analysis: Medical Treatment Provisions (9/7/2012)

The following analysis is based on the 8/30/2012 amended version of SB 863: SB863, widely lauded as the “new and improved” workers’ compensation reform package passed both the houses of the legislature on Friday, August 31 and is now on the Governor’s desk waiting to be signed...

California Workers’ Compensation Reform SB 863 Analysis: Medical Treatment Provisions (9/7/2012)

The following analysis is based on the 8/30/2012 amended version of SB 863: SB863, widely lauded as the “new and improved” workers’ compensation reform package passed both the houses of the legislature on Friday, August 31 and is now on the Governor’s desk waiting to be signed...

California: Notes From CHSWC

The California Commission of Health, Safety and Workers' Compensation held its first 2013 meeting this past Thursday. Here's a thumbnail sketch of some of the more interesting tidbits discussed: Christine Baker, Director of the California Department of Industrial Relations, stated that the...

California: What to Consider Before Filing a Request for a Panel QME

By David Bryan Leonard, Esq. Speaking at the California Workers’ Compensation Defense Attorneys’ Association 2013 Winter Conference, counsel for the Division of Workers’ Compensation James A. Fisher and defense attorney Yvonne E. Lang detailed the process for obtaining a panel QME...

CWCI Schedules Seminars on New Workers’ Comp Regulations

The California Workers’ Compensation Institute has scheduled a one-day seminar in March in San Francisco and Long Beach to introduce industry professionals to new regulations that implement key provisions of SB 863, the 2012 workers’ compensation reform bill. The program, designed to help...

California: W.C.A.B. Affirms Prior En Banc Decision Re: ADR 35.5(e) as Invalid

The W.C.A.B. has issued its follow-up decision in the previously issued en banc decision in Navarro v. City of Montebello . In its original decision the W.C.A.B. had issued a notice of intent to rule that Administrative Directive Rule 35.5(e) is an invalid interpretation of the provisions of Labor Code...

No Entitlement to Replacement QME When QME Allegedly Failed to Issue Timely Supplemental Report: Cal. Comp. Cases May Advanced Postings (5/13/2014)

Here’s the fourth batch of advanced postings for the May 2014 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2014 LexisNexis. All rights reserved. Illinois Midwest Insurance Agency,...

Sanctions for Skeletal and Frivolous Petitions: Cal. Comp. Cases July Advanced Postings (7/3/2014)

Here’s the second batch of advanced postings for July 2014 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2014 LexisNexis. All rights reserved. Martin Reiner, Petitioner v. Workers'...

California: Should a Suspended QME Be Able to Write Admissible Medical-Legal Reports?

Recently, the Workers’ Compensation Appeals Board issued a decision in Gary McKinney v. United Parcel Service ADJ6679833 and ADJ8786254, 2014 Cal. Wrk. Comp. P.D. LEXIS --. McKinney was a driver/dockworker for United Parcel Service (UPS). He alleged an injury on August 8, 2008 to his psyche as...

California: WCAB Imposes Difficult Standards for Overturning a UR Decision

The WCAB, in two recent noteworthy panel decisions, has imposed a difficult standard for applicants seeking to overturn a utilization review (UR) decision. Do these decisions signal a policy decision on the part of the Board to limit reversals of UR decisions? In the first panel decision, the WCAB, in...

California: Can a Utilization Review Determination Exceed Its Appropriate Scope?

With respect to the increasing litigation over the UR process, is Dubon really the issue in many of these UR disputes? Utilization Review (UR) has been around for more than ten years now. UR first came into play in 2003 when Governor Gray Davis passed Senate Bill 228 . The following year, on April...

QME Reports Not Inadmissible During Suspension, Probation of QME License by Medical Unit: Cal. Comp. Cases November Advanced Postings (10/31/2014)

Here’s the second batch of advanced postings for the November 2014 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2014 LexisNexis. All rights reserved. Gary McKinney , Petitioner v....