Workers' Compensation

Recent Posts

California: Diagnostic Testing: Is it Medical Treatment or Medical-Legal Expense?
Posted on 1 May 2015 by Calif. WCAB Noteworthy Panel Decisions Reporter

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... Read More

California Utilization Review: Prospective vs. Retrospective Review
Posted on 15 Jan 2016 by Richard M. Jacobsmeyer

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... Read More

Dubon’s Petition for Writ of Review Denied as Moot: Cal. Comp. Cases February Advanced Postings (2/20/2015)
Posted on 21 Feb 2015 by California Compensation Cases Staff

Here’s the fifth 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 headnote and summary. © Copyright 2015 LexisNexis. All rights reserved... Read More

California: Challenging Utilization Review at an Expedited Heading: Becerra and Corona Panel Decisions
Posted on 11 Mar 2013 by Mark Kahn

By Mark L. Kahn (Associate Chief Judge-Ret.), Arbitrator/Mediator/Attorney - Altman Lunche and Blitstein LexisNexis Online Subscribers: Citations below link to Lexis Advance. Bracketed citations link to lexis.com. Applicant can challenge whether... Read More

California: Workers' Comp Case Roundup (2/14/2018)
Posted on 14 Feb 2018 by California Compensation Cases Staff

CALIFORNIA COMPENSATION CASES Vol. 83 No. 1 January 2018 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... Read More

CWCI Study on Independent Medical Review Outcomes in California: Smoke and Mirrors
Posted on 26 Apr 2015 by Robert G. Rassp, Esq.

There are five kinds of lies—fibs, excuses, lies, damn lies, and statistics. The CWCI "study"from a political standpoint has to say that the UR/IMR process is a "success." A great deal of energy was put into the political... Read More

California: WCAB Affirms Medical Treatment in the Form of Sleep Number i8 Bed
Posted on 14 Mar 2015 by Calif. WCAB Noteworthy Panel Decisions Reporter

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... Read More

McCool
Posted on 22 Nov 2014 by Julius Young

Can an insurer submit medication prescription requests to utilization review (UR) even where those medications have been repeatedly authorized before? That question has been hotly debated in California workers’ comp circles after a recent WCAB... Read More

California: 2004 Stipulation Regarding Future Medical Treatment Disputes Being Referred to AME Could Not Circumvent UR Procedures
Posted on 8 Aug 2014 by Calif. WCAB Noteworthy Panel Decisions Reporter

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... Read More

King v. CompPartners, Inc., et al.: Do Utilization Review Physicians Owe a Duty of Care to Applicants and What Is the Nature and Scope of the Duty of Care
Posted on 9 Feb 2016 by Raymond F. Correio

By Raymond F. Correio, Esq. A recent decision from the Fourth District Court of Appeal, King v. CompPartners, Inc., et al. 243 Cal.App.4th 685, 80 Cal. Comp. Cases 10 , certified for publication, raises a number of provocative issues which will no... Read More

California: A Hint of Things to Come in WCAB's Re-Review of Dubon?
Posted on 23 Jun 2014 by Robert G. Rassp, Esq.

In Garcia-Picen v. Tight Quarters, Inc., the Appeals Board, in a split panel opinion, held that the WCJ incorrectly determined that the defendant’s UR of a treating physician’s request for authorization to provide viscosupplementation injections... Read More

CWCI, CalChamber and CCWC File Amicus Brief in Stevens v. WCAB
Posted on 23 Jun 2017 by California Workers' Compensation Institute

Oakland – The California Workers’ Compensation Institute (CWCI), the California Chamber of Commerce and the California Coalition of Workers’ Compensation (CCWC) have filed a joint amicus brief in Stevens v. WCAB , the long-running court... Read More

Arredondo: Is the Timeliness of the Independent Medical Review Decision Irrelevant?
Posted on 14 May 2015 by Calif. WCAB Noteworthy Panel Decisions Reporter

Has the pendulum swung so far that the emphasis now is completely on the process itself and not the purpose of the process? In Arredondo v. Tri-Modal Distribution Services, Inc. , 2015 Cal. Wrk. Comp. P.D. LEXIS --, the California WCAB, in a split... Read More

California: WCAB Imposes Difficult Standards for Overturning a UR Decision
Posted on 1 Aug 2014 by Calif. WCAB Noteworthy Panel Decisions Reporter

The WCAB, in two recent noteworthy panel decisions, has imposed a difficult standard for applicants seeking to overturn a utilization review (UR) decision. Do these decisions signal a policy decision on the part of the Board to limit reversals of UR decisions... Read More