LexisNexis® Legal Newsroom
California: W.C.A.B. Provides Guidance on AME/QME Request Process Timing Issues

If there was ever a question the medical legal process in workers’ compensation has become concerned with tactical minutia rather than dealing with substantive issues in the day to day comp practice, the W.C.A.B.’s en banc opinion in Tsegay Messele v. Pitco Foods, Inc.; California Insurance...

California: W.C.A.B. Provides Guidance on AME/QME Request Process Timing Issues

If there was ever a question the medical legal process in workers’ compensation has become concerned with tactical minutia rather than dealing with substantive issues in the day to day comp practice, the W.C.A.B.’s en banc opinion in Tsegay Messele v. Pitco Foods, Inc.; California Insurance...

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...

California EAMS: Winning the Race to the Medical Unit

[ Note: This article was updated on January 11, 2012, to provide the reader with more information about handling civil matters. ] Workers’ compensation practitioners enjoy a rule that is unique to the world of EAMS litigation. 8 CCR 10507 provides in part as follows: (a) If a document is...

California EAMS: Winning the Race to the Medical Unit

[ Note: This article was updated on January 11, 2012, to provide the reader with more information about handling civil matters. ] Workers’ compensation practitioners enjoy a rule that is unique to the world of EAMS litigation. 8 CCR 10507 provides in part as follows: (a) If a document is served...

No Permanent Total Disability Found Based on AME and VR Expert Opinions: Cal. Comp. Cases April Advanced Postings (3/29/2012)

Here’s the first batch of advanced postings for the April 2012 issue of Cal. Comp. Cases. Lexis.com subscribers can link to the cases to read the complete headnotes and summaries. © Copyright 2012 LexisNexis. All rights reserved. Beverly Binstock, Petitioner v. Workers' Compensation...

SB 863: Changes Impacting the Use of Treating Physicians, Agreed Medical Examiners and Qualified Medical Examiners in California

By David Bryan Leonard, Esq., Special to the LexisNexis Workers’ Compensation Law Community Day two of the 2012 California Workers’ Compensation and Risk Conference included a panel by James Fisher, Esq., counsel for the Department of Industrial Relations, currently assigned to the DWC...

SB 863: Changes Impacting the Use of Treating Physicians, Agreed Medical Examiners and Qualified Medical Examiners in California

By David Bryan Leonard, Esq., Special to the LexisNexis Workers’ Compensation Law Community Day two of the 2012 California Workers’ Compensation and Risk Conference included a panel by James Fisher, Esq., counsel for the Department of Industrial Relations, currently assigned to the DWC...

California: SB 863 Checklist and Reference Guide

SB 863 CHECKLIST & REFERENCE GUIDE By Robert G. Rassp, Esq. © Copyright 2012 LexisNexis. All rights reserved. This SB 863 Checklist & Reference Guide is excerpted from The Lawyer’s Guide to the AMA Guides and California Workers’ Compensation , 2013 Edition (available...

California: SB 863 Checklist and Reference Guide

SB 863 CHECKLIST & REFERENCE GUIDE By Robert G. Rassp, Esq. © Copyright 2012 LexisNexis. All rights reserved. This SB 863 Checklist & Reference Guide is excerpted from The Lawyer’s Guide to the AMA Guides and California Workers’ Compensation , 2013 Edition (available February...

AME’s Opinion Failed to Support Apportionment: Cal. Comp. Cases December Advanced Postings (12/5/2012)

Here’s the second batch of advanced postings for the December 2012 issue of Cal. Comp. Cases. Lexis.com subscribers can link to the cases to read the complete headnotes and summaries. © Copyright 2012 LexisNexis. All rights reserved. Best Buy Company, Inc., Ace American Insurance Company...

California: The Element of Surprise as an Ex Parte Communication

Attorneys cannot surprise the other side and show “information” (films or vocational reports) to the AME at cross-examination as it is an ex-parte communication in violation of Labor Code section 4062.3 because the parties must agree on what “information” is to be provided to...

California: 2004 Stipulation Regarding Future Medical Treatment Disputes Being Referred to AME Could Not Circumvent UR Procedures

But parties not required to follow new IMR process created by SB 863 as change in law does not supersede parties’ prior stipulation In Bertrand v. County of Orange , 2014 Cal. Wrk. Comp. P.D. LEXIS --, a WCAB panel, granting removal and amending the WCJ’s order, determined that the...

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...

New Period of Cumulative Trauma Resulted in 100 Percent Permanent Disability: Cal. Comp. Cases February Advanced Postings (1/27/2015)

Here’s the first batch of advanced postings for February 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. Travelers Indemnity Company, insurer...

California: Quirky Regs and Rules Related to the Medical Legal Evaluation Process

Trial calendars have been inundated lately with expedited hearings dealing with Qualified Medical Evaluator (QME) and Agreed Medical Evaluator (AME) issues. As a result of the Post-SB 863 onslaught of new regs, rules and procedures, the legal community is having a difficult time keeping up with many...

California Fringe Medical Benefits: A Question of Evidence

In Logudice v. Mimi’s Café , 2015 Cal. Wrk. Comp. P.D. LEXIS --, a WCAB panel affirmed the WCJ’s finding that the defendant was liable for residential relocation, moving costs, rent differential, and housekeeping services as reasonable and necessary medical treatment to cure or relieve...