Got Treatment? How to Expedite Medical Treatment and Avoid Penalties in California

Lexis.com subscribers can link to the cites below. The recent panel decision of Castrillo v. Catholic Health Care West, 2012 Cal. Wrk. Comp. P.D. LEXIS 454 , presents an interesting slant on a judge’s denial of the applicant’s request for penalties. In order to expedite medical treatment...

Everybody Loves Raymond…….. and Delaware Superior Court Ruling Allows IAB to Bypass Utilization Review

Okay, this one is a big deal, folks, a procedural lollapalooza, with props to both Mike Galbraith and Dennis Menton who heralded the Superior Court appellate decision as it was released by the Court. Allow me to simply introduce Mike's comments and Dennis' summary, since they have the superior...

Everybody Loves Raymond…….. and Delaware Superior Court Ruling Allows IAB to Bypass Utilization Review

Okay, this one is a big deal, folks, a procedural lollapalooza, with props to both Mike Galbraith and Dennis Menton who heralded the Superior Court appellate decision as it was released by the Court. Allow me to simply introduce Mike's comments and Dennis' summary, since they have the superior...

CAAA 2013 Winter Convention Begins With a Focus on Medical Treatment Control, Expedited Hearings, and MPNs

By David Bryan Leonard, Esq. The 2013 California Applicant’s Attorney’s Association (CAAA) winter convention commenced January 24, 2013, in San Diego, California. This has been the first large CAAA convention since the implementation of Senate Bill 863 (SB 863). In an ongoing tradition...

CAAA 2013 Winter Convention Begins With a Focus on Medical Treatment Control, Expedited Hearings, and MPNs

By David Bryan Leonard, Esq. The 2013 California Applicant’s Attorney’s Association (CAAA) winter convention commenced January 24, 2013, in San Diego, California. This has been the first large CAAA convention since the implementation of Senate Bill 863 (SB 863). In an ongoing tradition...

Applicant Dropped Off On Skid Row Justified Penalties: Cal. Comp. Cases February Advanced Postings (1/30/2013)

Here’s the first batch of advanced postings for the February 2013 issue of Cal. Comp. Cases. Lexis.com subscribers can link to the cases to read the complete headnotes and summaries. © Copyright 2013 LexisNexis. All rights reserved. TIG Insurance Company (administered by Risk Enterprise...

Applicant Dropped Off On Skid Row Justified Penalties: Cal. Comp. Cases February Advanced Postings (1/30/2013)

Here’s the first batch of advanced postings for the February 2013 issue of Cal. Comp. Cases. Lexis.com subscribers can link to the cases to read the complete headnotes and summaries. © Copyright 2013 LexisNexis. All rights reserved. TIG Insurance Company (administered by Risk Enterprise...

California: Home Health Care Service – Now & Then

Now that SB 863 is in effect, massive changes have taken place with regard to the authorization of home health care services. Therefore, it is important to understand the history behind the concept of home health care services as medical treatment (MT) pursuant to Labor Code Section 4600 . The recent...

Missouri: Hospital Sanctioned for Boiler-Plate Denial of Treatment

An employer owes attorney’s fees as a sanction for an unreasonable defense when it sent claimant a letter denying medical treatment without any explanation and never bothered to contact claimant before denying the claim, according to a recent Commission decision, Nouraie v Mo Baptist Hospital ...

Penalty for Failure to Authorize Plasma Decompression Disc Surgery: Cal. Comp. Cases May Advanced Postings (4/30/2013)

Here’s the second batch of advanced postings for the May 2013 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2013 LexisNexis. All rights reserved. Turlock City Tow Services, Westport...

California: The AME/PQME Quagmire on Determining Medical Necessity Post SB 863

By Robert G. Rassp, Esq. © Copyright 2013 LexisNexis. All rights reserved. Excerpts of this article will appear in a future edition of Rassp & Herlick, California Workers' Compensation Law . Attention Lexis Online Subscribers: Citations link to lexis.com. Bracketed citations link...

Union Carve-Outs: Labor-Management’s Alternative to Workers’ Compensation in Minnesota

By John Stahl, Esq. Collectively bargained workers’ compensation programs, which are commonly known as carve outs, are a cousin to “opt-out” programs in that both are alternatives to traditional workers’ compensation systems. The similarities extend to both programs avoiding...

Drugstore Cowboy: DE Supreme Court Upholds Carrier's Right to Supply Medication Through a Preferred Vendor

I just love it when I get the scoop first. Came back from lunch to the message below from my dear one Walt Schmittinger. Not only is Walt the progeny of the late great dean of workers' comp, Jay Schmittinger, he is also always at the cutting edge of the law. For the back story on this issue, refer...

Be Our Guest: DE Providers Host Medical School for Lawyers Dinner Seminar

I like to think I am a social creature. I like to eat (can’t ya tell?) and I LOVE to talk shop. So as you might imagine, I was in my glory last night at the Columbus Inn attending the Medical School for Lawyers Dinner Seminar . Add to that a panel of esteemed docs as our faculty and an audience...

Colorado: Hotel and Restaurant Expenses for Out-of-Town Medical Treatment Need Not Be Advanced

Hotels and restaurants patronized by a workers’ compensation claimant during authorized travel out-of-town to obtain treatment by a specialist are not “medical providers” as that term is defined by § 8–42–101(4), C.R.S. (2012), held a Colorado appellate court recently...

Missouri: Court Ponders Whether Insurer Can Direct Care When Missouri Employer Closes Its Business

Do insurers gain the right to select a medical provider when the employer is no longer in business? In Lyman v Missouri Employer's Mutual Insurance Company , 2013 Mo. App. Lexis 970 (August 23, 2013) [ version available to lexis.com subscribers ], the court of appeals reversed a summary judgment...

Missouri: Young Woman Who Won’t Quit Smoking Awarded Permanent Total

Attention Lexis Online Subscribers: Case citations link to lexis.com. Bracketed case citations link to Lexis Advance. A 33 year old woman in Marion County hurt her back lifting a box of books, had back surgery and asserts she was unable to work due to nonunion and intractable back pain. The issue...

DE Supreme Court Clarifies Emergency Treatment Exception to Section 2322B(8)(b)

A big shout out to Linda L. Wilson of Marshall Dennehy who sent me her case, decided only yesterday by our Supremes. It is very timely as we are coming off the glow of last week’s Randy J. Holland Inn of Court Inaugural that Justice Holland authored the decision under scrutiny- Amanda Wyatt...

Evidence-Based Medicine Can Be Hazardous to Your Health

By Robert G. Rassp, Esq. The current trend across the country is to require evidence-based medicine for treatment of employees who are injured on the job. Statutory and regulatory mandates are emerging on a state-by-state basis. Stakeholders within the workers’ compensation community are not...

California Workers' Comp Case Roundup (1/4/2014)

CALIFORNIA COMPENSATION CASES Vol. 78 No. 12 December 2013 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 2013 LexisNexis. All rights...

Missouri: Court Finds Denial of Treatment While Carrier Investigates Comp Claim

An employer has an obligation to provide medical treatment for a work-related injury when it received a request for care even if the employer has not finished its investigation, according to the recent court of appeals case, Downing v. McDonald's Sirloin Stockade, 2014 Mo App. Lexis 37 (lexis.com...

California: A New Year With New Rules and New Responsibilities

The Workers’ Compensation Appeals Board (WCAB) has rung in the New Year with new rules, new regulations and new responsibilities for all participants in the workers’ compensation community. It is important to be cognizant of all the changes and to realize that they spring from a variety of...

Grasshopper Cheesecake and an Extension of the Wyatt Doctrine in Delaware

It’s been busy, busy, busy in my little kitchen that could. I won the Chili Cook-Off last weekend and was up to my elbows in crème de menthe and crème de cacao, as I made a Grasshopper Cheesecake for a St. Paddy’s Day Potluck. Thankfully, a guest blogger came forward to allow...

California: Unreasonable Denial of Medical Treatment by Abruptly Withdrawing Authorization for Injured Worker’s Opioid Pain Medication

Both utilization review physician and MTUS expressly recommended slow tapering of opioid pain medications The WCAB, in a split panel opinion, rescinded a WCJ’s order denying the applicant’s petition for penalty under Labor Code § 5814 , and held that a penalty was justified as the...

California: Whose Burden Is It, Anyway?

With all of the changes in the law the last few years, practitioners are finding it more difficult to determine which side has the burden of proof. Once determined, they have a difficult time finding the appropriate evidence needed to meet this burden. Set forth below is a summary of recent Noteworthy...