Acknowledging that the statutory presumption of correctness afforded the opinion of an independent medical evaluator who had been selected from Tennessee's Medical Impairment Registry ("MIR") could be rebutted by clear and convincing evidence... Read More
Data on California workers’ compensation independent medical review (IMR) decisions issued in the first quarter of this year shows that the medical dispute resolution process established as part of the 2012 workers’ comp reforms continues... Read More
Recent noteworthy panel decisions show that the applicant would be wise to present all relevant medical reports and records, and citations to the MTUS, ACOEM, ODG, or other nationally accepted medical standards to the IMR reviewer, and that when a material... Read More
Defendants can submit every prescription request to UR, but is this cost effective and does it fulfill their obligation to provide appropriate medical treatment to cure or relieve injured workers from the effects of their industrial injuries? In Cordova... Read More
CALIFORNIA COMPENSATION CASES Vol. 79 No. 5 May 2014 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... Read More
According to a study recently released by Workers’ Compensation Research Institute (WCRI), California enjoyed a five percent decrease in medical payments per workers’ compensation claim in 2013 on a year-over-year basis, likely reflecting... Read More
A report from the California Workers’ Compensation & Risk Conference, Sept. 10-12, 2014, Dana Point, CA By David Bryan Leonard, Esq. Without pause, Christine Baker, Director of the California Department of Industrial Relations, took the... Read More
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... Read More
The Workers’ Compensation Appeals Board (WCAB) has rung in the New Year with new rules, new regulations and new responsibilities for all participants in the workers’ compensation community. It is important to be cognizant of all the changes... Read More
In Loynachan v. County of Los Angeles , ADJ7144283, the WCJ held that the applicant, who was permanently totally disabled as a result of a 10/1/2009 industrial injury, was entitled to continue receiving 24 sessions of behavioral psychotherapy each year... Read More
At a recent workers’ comp conference in Southern California, WCAB Commissioner Kathy Zalewski noted that the WCAB commissioners had been doing a bit of “crocodile wrestling” over Dubon . I’ve seen crocodile wrestling in Thailand... Read More
By Rob McCarthy Maurice Abarr wants to set the record straight about what happened leading up to the Dubon II en banc decision earlier this month. He got the chance Saturday at a Van Nuys panel discussion, hosted by Lawworm.com Inc. Maurice is the... Read More
The California WCAB has applied Dubon in two recent noteworthy panel decisions finding material procedural defects in the UR process when the defendants did not provide medical records reasonably needed for the UR physicians to make a valid determination... Read More
Beware of UR and IMR physicians who use MTUS, ACOEM, and ODG guidelines to deny treatment when, in fact, other MTUS, ACOEM, or ODG guidelines do support an RFA from a treating physician In Gonzalez-Ornelas v. County of Riverside , 2016 Cal. Wrk. Comp... Read More
The primary purpose of the newly created Independent Medical Review (IMR) process is to review medical treatment (MT) disputes and issue determinations. SB863 added LC §4610.6 (i) to the Labor Code, which states in pertinent part, “In no event... Read More