Workers' Compensation

Recent Posts

California: Opioid Medications in the Treatment of Work-Related Injuries
Posted on 1 Oct 2014 by Calif. WCAB Noteworthy Panel Decisions Reporter

According to the Department of Industrial Relations Director Christine Baker, “ opioid misuse is a national concern ”. As a result of this “misuse”, the Division of Workers’ Compensation recently posted proposed “ Guidelines... Read More

WCAB Panel Finds UR IMR Physician Need Not Be Licensed in California
Posted on 23 Jun 2016 by Brad Wixen

The recent noteworthy panel decision of Navroth v. Mervyn’s Stores , 2016 Cal. Wrk. Comp. P.D. LEXIS --, is just fascinating for so many reasons beyond the content of the finding itself. How often does a pro per applicant make important case law... Read More

California: Can a Utilization Review Determination Exceed Its Appropriate Scope?
Posted on 11 Aug 2014 by Calif. WCAB Noteworthy Panel Decisions Reporter

With respect to the increasing litigation over the UR process, is Dubon really the issue in many of these UR disputes? Utilization Review (UR) has been around for more than ten years now. UR first came into play in 2003 when Governor Gray Davis passed... Read More

Challenging the Legality of an IMR Decision: The Final Chapter in Stevens
Posted on 2 Jun 2017 by LexisNexis Workers' Comp Law Newsroom Staff

Does the WCAB’s interpretation of the Court of Appeal's language open up the possibility of successful appeals of IMR decisions in the future? In Stevens v. Outspoken Enterprises, Inc. , 2017 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB, on remittitur... Read More

California: Utilization Review and Independent Medical Review Best Practices
Posted on 4 Mar 2015 by Karen C. Yotis

Loosening the rope on the UR/IMR Gordian Knot Karen C. Yotis, Esq., Feature Resident Columnist of the LexisNexis Workers’ Compensation eNewsletter , provides insights into workplace issues and the nuts and bolts of the workers' comp world... Read More

California: When Utilization Review Determination Untimely, No Portion of UR Determination Could Be Relied on to Deny Medical Treatment
Posted on 17 Oct 2014 by Calif. WCAB Noteworthy Panel Decisions Reporter

WCAB panel issues a new post-Dubon II decision In Korn v. Entertainment Partners , 2014 Cal. Wrk. Comp. P.D. LEXIS --, a WCAB panel affirmed a WCJ’s finding that an applicant, who was employed as a craft services person, suffered an industrial... Read More

California: Untimely Independent Medical Review
Posted on 13 Jun 2015 by Calif. WCAB Noteworthy Panel Decisions Reporter

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... Read More

California: Does a Home Care Assessment Constitute “Treatment” Subject to Utilization Review?
Posted on 17 Feb 2017 by Brad Wixen

Fine Lines and a Glimpse at the Future In Rodriguez v. Simi Valley Unified School District, 2016 Cal. Wrk. Comp. P.D. LEXIS 671 , applicant, a custodian, sustained injury at her employer. The injury was sufficiently serious that her treating physician... Read More

Evidence-Based Medicine Can Be Hazardous to Your Health
Posted on 2 Dec 2013 by Robert G. Rassp, Esq.

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... Read More

California: Untimely Independent Medical Review – Southard Decision
Posted on 2 Jul 2015 by Calif. WCAB Noteworthy Panel Decisions Reporter

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... Read More

California: Finding a Forum to Decide the MTUS Presumption
Posted on 13 Jun 2015 by Calif. WCAB Noteworthy Panel Decisions Reporter

What if invalidity of the UR decision is not the issue? As part of the workers’ compensation litigation process, what if the injured worker wants to rebut the legal issue of the MTUS’ presumption of correctness? Is an expedited hearing the... Read More

CWCI Schedules Web-Based Training on New MTUS Regulations
Posted on 5 Jun 2015 by California Workers' Compensation Institute

The California Workers’ Compensation Institute (CWCI) has scheduled a web-based training seminar for Wednesday, July 15 to educate workers’ compensation claims and medical professionals, attorneys and other members of the community on revisions... 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