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National and State-by-State Workers' Comp News Powered by Larson's (7/6/2015)

NCCI Posts Latest Economic Outlook and Impact on Workers Comp . Fitch Ratings Announces Top Workers Comp Insurance Writers for 2014 . OSHA Issues Inspection Guidance for Health Care Industry . Columnist: New Worker Category Should Be Created to Cover Gig Workers . Some On-Demand Service Companies...

CWCI Reviews California Workers’ Comp Q1 2015 Independent Medical Review Outcomes

A new analysis of 2015 independent medical review (IMR) outcomes shows there was no significant reduction in IMR volume in the first quarter of this year, even though the independent medical reviewers continue to concur with the utilization review (UR) physician’s denial or modification of treatment...

California: When to Hold Them and When to Fold Them? Apportionment In Ortho, Psyche, And Internal Cases

This article is a favor to the WCAB commissioners and is a call out to parties and trial judges to develop the record before a case gets to the appellate level. How many times have you been confronted with an “ortho, psyche, and internal” case in which either the psychiatrist or internist...

National and State-by-State Workers' Comp News Powered by Larson's (7/13/2015)

John F. Burton, Jr. Examines Impact of Race to the Bottom for Workers Comp Costs (p. 6) . Prof. Spieler Attacks AMA Guides for Absence of Evidence-Based Medicine . A.M. Best: U.S .State Workers Comp Funds’ Net Premiums Increased 11.5% in 2014 . Insurance Companies Cautiously Providing...

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 On July 3, 2015, the WCAB panel rescinded its prior decision in which...

Applicant’s Perception of Job Stress Supported Compensable Industrial Injury in Form of Stroke: Cal. Comp. Cases July Advanced Postings (7/14/2015)

Here are the third and fourth batches 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. Acorn Engineering Company, Pacific...

National and State-by-State Workers' Comp News Powered by Larson's (7/20/2015)

ProPublica Releases Complication Rates for 17,000 Surgeons . GOP Backs Uber and On-Demand Economy . US DOL Issues Additional Guidance on Employee Misclassification . US DOL to Hold Presentation July 21 on Next 25 Years of ADA . 13% of Small Businesses Concerned About WC Fraud by Employees...

No Due Process Violation in Deferring Third-Party Credit Issue Until After Case-in-Chief Resolved: Cal. Comp. Cases July Advanced Postings (7/22/2015)

Here’s the fifth 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. Ace American Insurance Company (administered...

California QME Selection Process: Timing and Documentation Requirements

The WCAB has recently issued two noteworthy panel decisions on the QME selection process. In Murray v. County of Monterey , 2015 Cal. Wrk. Comp. P.D. LEXIS 304 (lexis.com), 2015 Cal. Wrk. Comp. P.D. LEXIS 304 (Lexis Advance), the WCAB provided guidance on the contentious QME selection process by interpreting...

Supplemental Job Displacement Benefits: Two Vouchers for Separate But Overlapping Injuries Is Not Double Recovery

In Silva v LSG Sky Chiefs and Liberty Mutual Insurance Company , 2015 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB provided guidance on supplemental job displacement benefits by interpreting the Labor Code and related Administrative Rule to entitle qualifying applicants to one voucher at the applicable value...

California: Timely Utilization Review: WCAB Strictly Applies Bodam Rule

In Gutierrez v. Bigge Crane & Rigging Company , 2015 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB affirmed the WCJ’s finding that the defendant’s utilization review of a request for authorization submitted by the applicant’s treating physician, Douglas Abeles, M.D., for prescription...

National and State-by-State Workers' Comp News Powered by Larson's (8/3/2015)

RIMS/Advisen: Stable Insurance Market Shows Decline in Workers Comp Costs . Payroll Fraud Prevention Act of 2015 Introduced in Congress . Luxe Valet On Demand Service Converts Contractors to Employees . Lawmakers Seek to Investigate DOJ’s Prosecution of Medical Marijuana Patients, Providers...

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 Workers’ Comp Case Roundup (8/6/2015)

CALIFORNIA COMPENSATION CASES Vol. 80 No. 7 July 2015 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 © Copyright 2015 LexisNexis. All rights...

California: WCAB Finds Section 132a Trumps a Collective Bargaining Agreement

How the WCAB resurrected 132a in a sick leave case In Rivera v. County of Alameda , 2015 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB affirmed the WCJ’s finding that the employer, the County of Alameda, violated Labor Code § 132a [ LC 132a ] by precluding the applicant, a juvenile institutional...

National and State-by-State Workers' Comp News Powered by Larson's (8/10/2015)

GAO Blasts SSA for Inability to Detect Concurrent FECA Payments . Private Investigators Say Drones Useful in Uncovering Workers Comp Fraud . Federal Judge to Rule in Coming Weeks on Uber Class Action Certification . Opioid Use Linked to Poor Outcomes in WC Patients Having Discogenic Fusion ...

Vocational Expert Evidence Found Unnecessary to Support PTD Award: Cal. Comp. Cases August Advanced Postings (8/11/2015)

Here’s the latest batch of advanced postings for 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. G4S Secure Solutions, Inc., National...

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: Exceptions to the Going and Coming Rule

The “going and coming” rule is a deceptively simple one. There is no reference to the “going and coming” rule concept in the Labor Code. However, the rule has developed over time by case law, essentially holding that the employer is not liable for injuries which occur during an...

National and State-by-State Workers' Comp News Powered by Larson's (8/17/2015)

NASI: WC Benefits for Injured Workers Decline While Employer Costs Rise . NAIC Releases Study on Workers Comp Large Deductible . Third Circuit Dismisses Suit Against Cephalon Re Off-Label Marketing of Two Painkillers . Study: On-Demand Economy Will Include 7.6M People by Year 2020 . AK: WCB...

When Specific Injury and Cumulative Injury Cases Consolidated, All Evidence in Both Cases Properly Admitted: Cal. Comp. Cases August Advanced Postings (8/19/2015)

Here’s the latest batch of advanced postings for 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. Cahill Contractors, Arch Insurance...

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...

National and State-by-State Workers' Comp News Powered by Larson's (8/24/2015)

Shareholders Allege TriNet Group Failed to Disclose Claims Trends, Including WC . OSHA Establishes New Procedures for Early Resolution Process in ADR Program . Uber Allegedly Failed to Uncover Criminal Records of 25 Drivers in Two Calif. Cities . AZ: ICA Revises Notice of Claim Status Form ...

CWCI Examines California Workers’ Comp Medical and Indemnity Payment Trends

The average amounts paid for medical expenses and indemnity benefits on California workers’ comp lost-time claims climbed sharply after accident year (AY) 2005 – the first year after the 2004 reforms – but a new CWCI study shows average medical and indemnity payments during the initial...

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 ,...