Workers' Compensation

Request for Additional Information Extended Time to Issue Utilization Review Determination: Cal. Comp. Cases June Advanced Postings (6/15/2016)

Here’s the latest batch of advanced postings for the June 2016 issue of Cal. Comp. Cases.

Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries.

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Rachel Wells, Petitioner v. Workers' Compensation Appeals Board, Seltzer, Fontaine, Beckwith, et al., Respondents, lexis.com, Lexis Advance

Medical Treatment—Utilization Review—Time Deadlines—WCAB rescinded WCJ’s finding that 4/2/2015 request for additional information sent by defendant’s utilization review organization to applicant’s treating physician was invalid because it was not signed by physician, thereby rendering 4/7/2015 utilization review decision conditionally denying prescription medications untimely, and giving WCAB jurisdiction to decide medical necessity, when WCAB found that, contrary to WCJ’s analysis…

Beutler Corporation, Arch Insurance Company, Petitioners v. Workers' Compensation Appeals Board, Martin Ornelas, Respondents, lexis.com, Lexis Advance

Credit—Third-Party Recovery—Amounts Paid Under Uninsured Motorist Liability Policy—WCAB affirmed WCJ’s finding that Arch Insurance Co. (Arch), employer’s workers’ compensation carrier, was not entitled to take credit/offset pursuant to Labor Code § 3861 against its workers’ compensation liability for applicant’s recovery from uninsured motorist liability policy purchased by employer from Arch, based on rationale and principles in Fireman’s Fund Indem. Co. v. Industrial Acci.Com. (Turci) (1964) 226 Cal. App. 2d 676, 38 Cal. Rptr. 336, when WCAB reasoned…

County of Riverside, PSI, Petitioner v. Workers' Compensation Appeals Board, Kevin C. Couch, Respondents, lexis.com, Lexis Advance

Presumption of Industrial Causation—Cancer Presumption—Peace Officers—WCAB, reversing WCJ, found that applicant deputy sheriff suffered injury AOE/COE in form of chronic lymphocytic leukemia (CLL) based on presumption of compensability in Labor Code § 3212.1, when WCAB concluded that defendant did not rebut presumption as required under Faust v. City of San Diego (2003) 68 Cal. Comp. Cases 1822 (Appeals Board en banc opinion) by proving with reasonable medical probability that there was no reasonable link between applicant’s workplace exposure and development of CLL, because…

Bruce White, Petitioner v. Workers' Compensation Appeals Board, Montecito County Club (MCC BB Property, LLC), Liberty Mutual Insurance Company, Respondents, lexis.com, Lexis Advance

Permanent Disability—Rating—WCAB awarded applicant 52 percent permanent disability and further medical treatment for low back injury that occurred from 1/1/1995 through 2/7/2010 while working for defendant as golf cart mechanic, based on opinions from panel qualified medical evaluator, formal rating from Disability Evaluation Unit, and 2005 Permanent Disability Rating Schedule, when WCAB found that...