Workers' Compensation

    • 17 Dec 2013

    Oklahoma Workers' Compensation Law Upheld By State Supreme Court

    The Oklahoma Supreme Court has upheld Senate Bill 1062, which replaced the state's Workers' Compensation Code with the Administrative Workers' Compensation Act, and which allows some employers to opt out of the state workers' compensation system under the Oklahoma Employee Injury Benefit Act. Download a copy of the decision here , and read more about the decicion in The Oklahoman .
    • 15 Apr 2013

    California: WCAB Provides Further Guidance on Lien Activation Fees

    By David Bryan Leonard, Esq. Three new panel decisions illustrate how the WCAB is interpreting the new lien activation fees. These decisions should be of great interest to the workers’ comp community and are summarized below. Note: The three panel decisions can be accessed for free for a limited time. Note to Lexis Online Subscribers: Citations link to lexis.com. Bracketed citations link to Lexis Advance...
    • 8 Apr 2013

    Baseline Provided for Evaluating California SB 863 Reforms

    WCRI Analyzes Pre-Reform Data and Expected Impact of Reforms By John Stahl, Esq. WCRI’s 13th Medical Benchmarks study based on data through the first quarter of 2011 is intended to provide a baseline from which the impact of SB 863’s reforms of California’s workers’ compensation system can be evaluated. Comparison of reform findings and trends in workers’ compensation medical costs...
    • 1 Apr 2013

    California: SB 863 and Benson

    By Robert G. Rassp, Esq. Attention Lexis Online Subscribers: Citations link to lexis.com. Bracketed citations link to Lexis Advance. Call me weird, obsessed, bored, or deeply disturbed but recently while I was on my almost daily four-mile hike in the hills of Porter Ranch, I was thinking about how Benson ( Benson vs. WCAB (2009) 170 Cal. App.4th 1535, 74 Cal. Comp. Cases 113 [ 74. Cal. Comp. Cases 113 ]) would apply...
    • 4 Mar 2013

    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 panel decision of Williams v. Claire’s Stores Inc., Travelers Ins Co., 2012 Cal. Wrk. Comp. P.D. LEXIS 497 , discusses...
    • 25 Feb 2013

    California: Keys to Proving Apportionment: The Bullet Proof List

    The apportionment statutes were massively revised by the 2004 workers’ compensation reform package. However, apportionment was one of the only areas of the workers’ compensation law that did not get hit by the most recent reform legislation of SB 863. Nevertheless, over the past year, the WCAB has fine tuned some of the defining principles of apportionment per Labor Code section 4663 , as illustrated in several...
    • 19 Feb 2013

    California: Medical Emergencies Post SB 863

    The recent reform act of SB 863 will bring in a whole host of changes to our workers compensation medical treatment (MT) delivery system. As we pour over the new and revised statutes and the new and revised regulations, it is helpful to consider what aspects of the law have changed, and what aspects remain the same. For instance, in the recent panel decision of Moser v. Valli Construction , 2012 Cal. Wrk. Comp. P.D...
    • 22 Jan 2013

    California: It’s Here--Independent Bill Review (Part 1)

    By David Bryan Leonard, Esq. © Copyright 2013 LexisNexis. All rights reserved. 2013 has started off with a whirlwind of new regulations and administrative processes. We have several new sets of regulations that cover topics such as Independent Bill Review (IBR), Independent Medical Review (IMR), Utilization Review (UR) and Lien Activation Fees. While the majority of new processes contain the letter “R”...
    • 22 Jan 2013

    California: It’s Here--Independent Bill Review (Part 2)

    By David Bryan Leonard, Esq. © Copyright 2013 LexisNexis. All rights reserved. This is Part 2 of a two-part article. Read Part 1 here . Processing of IBR Request by the Administrative Director After the secondary review, and after the provider submits the proper request and fees for IBR, § 9792.5.9 details how the IBR request must be processed. Once the IBR is received, the Administrative Director (“AD”...
    • 16 Jan 2013

    Notice of Correction: Workers' Compensation Laws of California, 2013 Edition

    Publisher's Note: It has been brought to our attention that there are errors in Table 14, Maximum/Minimum Indemnity and Earnings, and Table 17A, Permanent Disability Indemnity for Injuries in 2013-2014, published in the 2013 Edition of Workers' Compensation Laws of California . Click here for a copy of the corrected tables: Table 14 . Table 17A . Note that the new Table 17A covers injuries for 2013 only...
    • 14 Jan 2013

    Opting Out is the New “In” Thing: Study Discusses Alternatives to Workers’ Compensation

    By John Stahl, Esq. The astronomical benefits-related costs, protracted dispute resolution process, and numerous other ills associated with workers’ compensation that have prompted reforms have also increased support for the “opt-out” movement. Opting out initially requires that a state enact a law that allows employers that would otherwise have to provide workers’ compensation coverage to offer...
    • 7 Jan 2013

    California SB 863 Reforms: Adjusters Should Adjust - The Blowback From UR and IMR

    By Robert G. Rassp, Esq. So, 2013 is just around the corner and we are gearing up to learn the new law and regulations so that we can apply them in our cases. We have an interim period between now and July 1, 2013 when disputes over medical necessity under utilization review denials, modifications or delays for injuries occurring prior to 1/1/13 are to be determined by an AME, PQME, or a WCJ. Disputes over physical...
    • 5 Dec 2012

    California: Proposed IMR Regs

    The DWC has published proposed Independent Medical Review regulations (a link to them is noted at the bottom of this post). The proposed regs are on a DWC forum page, with the forum for comments slated to close December 7. Because there is not time for regular rulemaking for these rules required by SB 863, the DWC will have to submit them to the Office of Administrative Law as emergency regulations: http://www.oal.ca...
    • 3 Dec 2012

    California SB 863: Commentary on Proposed Independent Medical Review Regulations

    On November 27, 2012, the DWC posted on the DIR website proposed “emergency” regulations for implementation of the Independent Medical Review (IMR) Process pursuant to the reform language of SB863: http://www.dir.ca.gov/dwc/DWCWCABForum/1.asp DWC welcomes comments from the general public on these proposed regulations through this Friday, December 7, 2012. To join in the discussion of these rules, click...
    • 26 Nov 2012

    Employers and Labor Debate Impact of 2007 New York Reforms: Employers Advocate New Initiatives While Workers Claim Success

    By John Stahl, Esq. Two analyses regarding the effectiveness of the 2007 Workers’ Compensation Reform Law (Reforms) in New York State provide a textbook example of how identical statistics can support totally conflicting results. One undisputed conclusion is that the voices of New York employers were adequately loud regarding workers’ compensation costs to enact the Reforms. The answer of the Public Policy...
    • 12 Nov 2012

    Up in Smoke: Should Medical Marijuana Be Allowed in California’s Workers’ Compensation System?

    The use of medically prescribed marijuana has been a controversial issue in California for many years. It is interesting that the issue does not come up more often in the workers’ compensation context. It may not come up more because marijuana is still fundamentally an illegal drug. It is hard to imagine a Workers’ Compensation Administrative Law Judge (WCJ) ordering a defendant to pay a marijuana co-operative...
    • 19 Oct 2012

    California: SB 863 Checklist and Reference Guide

    SB 863 CHECKLIST & REFERENCE GUIDE By Robert G. Rassp, Esq. © Copyright 2012 LexisNexis. All rights reserved. This SB 863 Checklist & Reference Guide is excerpted from The Lawyer’s Guide to the AMA Guides and California Workers’ Compensation , 2013 Edition (available February 2013). □ 1997 PDRS Based on work restrictions Applies to DOI prior to 1/1/05 if IW is P&S...
    • 21 Sep 2012

    SB 863: Changes Impacting the Use of Treating Physicians, Agreed Medical Examiners and Qualified Medical Examiners in California

    By David Bryan Leonard, Esq., Special to the LexisNexis Workers’ Compensation Law Community Day two of the 2012 California Workers’ Compensation and Risk Conference included a panel by James Fisher, Esq., counsel for the Department of Industrial Relations, currently assigned to the DWC Medical Unit, and Suzanne Honor-Vangerov, Esq. retired Manager of the DWC Medical Unit and current attorney with the law...
    • 20 Sep 2012

    California DIR Officials Outline Goals and Tasks for Implementing SB 863 Workers’ Comp Reforms

    By David Bryan Leonard, Esq., Special to the LexisNexis Workers’ Compensation Law Community The 2012 California Workers’ Compensation and Risk Conference opened September 19, 2012 at the St. Regis Resort, Dana Point with an update from the DIR/DWC/WCAB entitled “What’s on the horizon for 2013?” Presented by WCAB Chairwoman Ronnie Caplane and Katherine Zalewski, Chief Counsel for the Department...
    • 15 Sep 2012

    CWCI Schedules Workers’ Comp Reform (SB 863) Seminars

    The California Workers’ Compensation Institute will hold a 1-day seminar in mid-October in San Francisco and Long Beach to educate industry professionals on the provisions and practical implementation issues related to SB 863, the workers’ comp reform passed by state lawmakers at the end of the 2012 legislative session. The reform bill, hammered out in closed door sessions between representatives of labor...
    • 8 Sep 2012

    California Workers’ Compensation Reform SB 863 Analysis: Medical Treatment Provisions (9/7/2012)

    The following analysis is based on the 8/30/2012 amended version of SB 863: SB863, widely lauded as the “new and improved” workers’ compensation reform package passed both the houses of the legislature on Friday, August 31 and is now on the Governor’s desk waiting to be signed. The package contains a plethora of revisions to current law intended to improve delivery of benefits to injured workers...
    • 8 Sep 2012

    California: Utilization Review and IMR in SB 863

    Medical Treatment Changes Some of the most extensive changes to the Labor Code in SB 863 are intended to tighten up medical control in both Labor Code § 4600 as well as in the Medical Provider Networks. One of the principle methodologies for controlling medical costs in this legislation appears to be the removal of the review of decision-making processes involving medical treatment from the Workers' Compensation...
    • 7 Sep 2012

    California SB 823 and Home Health Care: Details, Details, Details . . .

    It looks likely that Governor Brown is going to sign Senate Bill 863 into law. There has been a lot of discussion concerning some of the more significant aspects of this legislation. The discussion thus far has seemed to focus on the Independent Medical Review (IMR) process, the elimination of the psyche, sleep disorder and sexual dysfunction add-ons and the increase in the PD rates. There is a lot more to the new law...
    • 4 Sep 2012

    California: Legislature Passes SB 863

    The State Legislature passed and forwarded to Governor Brown a historic workers’ compensation benefit increase and reform package on Friday, August 31, 2012 Presumably signing by the Governor is a certainty as the Governor’s office was reportedly closely following SB 863, strongly supported same at the Legislature and provided encouragement to the legislative leadership to complete the package this legislative...
    • 4 Sep 2012

    SB 863 and Permanent Disability: A Practitioner's Survival Guide to California Workers' Compensation Reform

    HOT OFF THE PRESS! A new LexisNexis Emerging Issues Analysis article… Robert G. Rassp on SB 863 and Permanent Disability: A Practitioner's Survival Guide to California Workers' Compensation Reform, 2012 Emerging Issues 6614. Mr. Rassp, known for his incisive analysis and thought-provoking commentary, tells us what hasn't changed and what has changed under SB 863 with respect to the law on permanent...