LexisNexis® Legal Newsroom
National and State-by-State Workers' Comp News Powered by Larson's (5/26/2015)

NCCI Symposium Reports First Responder Bills Top List of 2015 Legislation . NCCI Symposium: Dr. Victor Shares Insights on Physician Dispensing . NCCI Symposium: CWCI Shares Insights on Calif. Medical Dispute Resolution . NCCI Symposium: Moody’s Presents U.S. Macro Outlook . NCCI Symposium...

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 UR/IMR Process: Form Over Substance?

Injured worker’s IMR application denied for being 1 day late In Avila v. University of California Irvine Medical Center , 2015 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB affirmed the WCJ’s order, which denied the applicant’s appeal of the Administrative Director’s decision that...

California Workers’ Comp Case Roundup (6/10/2015)

CALIFORNIA COMPENSATION CASES Vol. 80 No. 5 May 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: 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 P.D. LEXIS --, the WCAB, in a split panel opinion, rescinded its prior decision [see Saunders v. Loma Linda Univ.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...

California: Untimely Independent Medical Review – Southard Decision

This case is very similar to the Saunders noteworthy panel decision . In Southard v. Hallmark Greeting Cards , 2015 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB, in a split panel opinion, rescinded the WCJ’s finding that an employee may appeal an independent medical review (IMR) determination pursuant...

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: 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...

Love without Borders: Delaware Law Eliminates Provider Certification Requirement for Out-of-state Treatment

Special thanks to Tara Bustard, Andy Carmine and Walt Schmittinger for bringing to my attention that House Bill 166 was signed into law on Monday. This is the long-awaited legislative remedy to the issues acknowledged by Wyatt v. Rescare and Vanvliet v. D&B Transportation (see my posts of 11/21/13...

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...

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 ,...

California Workers’ Comp Case Roundup (9/2/2015)

CALIFORNIA COMPENSATION CASES Vol. 80 No. 8 August 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...

IMR Determination Valid Even If Not Issued Within Statutory Timeframes: Cal. Comp. Cases September Advanced Postings (9/10/2015)

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. Norberto Arredondo , Petitioner...

California: Court of Appeal Upholds Constitutionality of IMR

Shortly after the second Second District Court of Appeals provided the defense community with a welcome decision in Batten v. WCAB , the First Appellate District followed up with its much anticipated decision in Stevens v. WCAB , the first constitutional challenge to IMR to be heard by an appellate court...

Five-day Timeframe for Issuing UR Decision Was Extended by UR Reviewer’s Timely Request for MRI Reports: Cal. Comp. Cases November Advanced Postings (11/10/2015)

Here’s the latest batch of advanced postings for the November 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. Cynthia Crawford , Petitioner...

California: Expenses for Housekeeping Services Deemed Recoverable as Medical Treatment

But it remains to be seen whether injured workers can actually obtain this type of medical treatment through UR/IMR In Reese v. All Saints Health Care , 2015 Cal. Wrk. Comp. P.D. LEXIS 570 [ 2015 Cal. Wrk. Comp. P.D. LEXIS 570 ], the WCAB rescinded the WCJ’s finding that the applicant licensed...

CWCI Study Examines Medical Review and Medical Dispute Resolution in California Workers’ Comp

Despite assertions that the California workers’ compensation medical review and dispute resolution process results in wholesale denial of care for injured workers, a new California Workers’ Compensation Institute (CWCI) analysis shows that about 96% of treatment services are approved and...

California Workers’ Compensation: 2015 Year in Review

By Julius Young, Esq., Richard M. Jacobsmeyer, Esq., Barry D. Bloom, Co-Editors-in-Chief, Herlick, California Workers' Compensation Handbook This 2016 edition is the 35th edition of Herlick, California Workers’ Comp Handbook (hereinafter “Herlick”). The latest Herlick Handbook...

Have Yourself a Merry Little Waiver: Referral of Medical Treatment for UR Concedes Causation in Delaware

It is very fitting to feature a case involving UPS this time of year. I stumbled upon Paul Schneider v United Parcel Service , IAB#1283119 (12/1/15) and what makes this case a bit of a “re-gifting” is that it contains what most would think is a well-known and well established proposition...

California: Top 25 Noteworthy Panel Decisions (July–December 2015)

LexisNexis has picked the top “noteworthy” panel decisions issued by the California Workers’ Compensation Appeals Board during the period July through December 2015. The list features a number of decisions addressing the assignment and reporting of panel qualified medical evaluators...

California Utilization Review: Prospective vs. Retrospective Review

A recent decision with an interesting fact pattern provides analysis of retrospective vs. prospective RFA, retro care and UR review on delayed benefits By Richard M. Jacobsmeyer, Esq. The W.C.A.B. has affirmed a Findings and Award determining a defendant failed to conduct timely retrospective UR...

California: Claim Against UR Physician Not Preempted by Workers’ Compensation Law

Noting that a utilization review physician has a doctor-patient relationship with the person whose medical records are being reviewed, a California appellate court held that in at least some circumstances an injured worker and his wife could maintain a civil action against a physician for a workers’...

California: Invalid Utilization Review Determinations in a Post-Dubon II World

When UR decision did not address issue raised by treating physician’s request for authorization, there was no timely UR In Arroyo v. Inland Concrete Enterprises, Inc. , 2016 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB granted removal and rescinded the WCJ’s finding that the defendant’s...