LexisNexis® Legal Newsroom
California Workers’ Comp Medical Mileage Rate to Increase for 2015 Travel

The Internal Revenue Service has announced that the standard mileage rate for business miles will increase 1.5 cents per mile to 57.5 cents per mile as of January 1, 2015. The California Workers’ Compensation Institute notes that this means the mileage rate that California workers’ compensation...

Physician Self-Referral Statute Doesn’t Apply to Inpatient Surgical Procedures (12/12/2014)

Here’s the third batch of advanced postings for December 2014 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the cases to read the complete headnotes and summaries. © Copyright 2014 LexisNexis. All rights reserved. Warner Bros. Studio Facilities, Inc...

California: Top 25 Noteworthy Panel Decisions (July–December 2014)

LexisNexis has picked the top “noteworthy” panel decisions issued by the California Workers’ Compensation Appeals Board during the period July through December 2014. You’ll find many helpful cases in this list, including a recent decision on reasonable attorney’s fees ,...

California: Arbitrary UR Cycles of Denials and Authorizations for Prescription Medications

Defendants can submit every prescription request to UR, but is this cost effective and does it fulfill their obligation to provide appropriate medical treatment to cure or relieve injured workers from the effects of their industrial injuries? In Cordova v. Garaventa Enterprises , 2015 Cal. Wrk. Comp...

New Mexico: Court Approves Injured Worker’s Use of Medical Marijuana

Where an injured worker who had sustained work-related back injuries unsuccessfully sought “conventional” treatment for pain and discomfort and subsequently turned to the use of medical marijuana, the employer and insurer could be required to pay the cost of such “treatment” as...

A Tale Of Two Rudins: A Juxtaposition Of Outcomes On Surgery In Delaware

God couldn’t be everywhere…….so he created Dr. Rudin. And today’s commentary features two cases on the issue of surgery and causation in which Dr. Rudin takes center stage. First from defense attorney Frank Nardo, Gloria Edwards v. State of Delaware , IAB#1164832 (11/14/14...

California: No Penalty for Nearly Seven-Month Delay in Providing Dental Services Approved by Utilization Review

In Murphy v. Petsmart, Inc., 2015 Cal. Wrk. Comp. P.D. LEXIS --, a split panel WCAB rescinded the WCJ’s order awarding a maximum 25 percent penalty under Labor Code § 5814 for the defendant’s delay in providing dental treatment to an applicant cashier who suffered an industrial injury...

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...