Workers' Compensation

Recent Posts

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: Claim Against UR Physician Not Preempted by Workers’ Compensation Law
Posted on 15 Jan 2016 by Larson's Spotlight

Noting that a utilization review physician has a doctor-patient relationship with the person whose medical records are being reviewed, a California appellate court held that in at least some circumstances an injured worker and his wife could maintain... Read More

California: Independent Medical Review – Which One Applies To What?
Posted on 26 Jul 2013 by Robert G. Rassp, Esq.

There is much confusion over the two Independent Medical Reviews in the California workers’ compensation system: MPN-IMR and UR-IMR. Attorneys should beware of mixing apples and oranges when it comes to these two separate and distinct processes... Read More

California: The AME/PQME Quagmire on Determining Medical Necessity Post SB 863
Posted on 21 May 2013 by Robert G. Rassp, Esq.

By Robert G. Rassp, Esq. © Copyright 2013 LexisNexis. All rights reserved. Excerpts of this article will appear in a future edition of Rassp & Herlick, California Workers' Compensation Law . Attention Lexis Online Subscribers: Citations... 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

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 P.D. LEXIS --, the WCAB, in a split panel opinion, rescinded its prior decision [see Saunders v. Loma Linda...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: WCAB Panel Finds Request for Authorization Submitted by Secondary Treating Physician Triggered Utilization Review Process
Posted on 23 May 2016 by Calif. WCAB Noteworthy Panel Decisions Reporter

Statutory scheme regarding the role of the primary treating physician is less than perfectly clear In Lopez v. City and County of San Francisco , 2016 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB panel affirmed the WCJ’s award of medical treatment... Read More

Florida: Court Affirms JCC’s Refusal to Refer Injured Employee to Spanish-Speaking Psychologist
Posted on 6 Jun 2014 by Larson's Spotlight

A divided Florida appellate court affirmed a JCC’s rejection of an injured employee’s request for referral to a Spanish-speaking psychologist as recommended by the employee’s treating physician. Agreeing that the referral to a Spanish... Read More

Review of 2011 Texas Legislature 82R House Bills and Senate Bills
Posted on 8 Jun 2011 by Stuart D. Colburn

By Stuart D. Colburn, Shareholder, Downs Stanford The 2011 Legislature considered 46 bills directly affecting and 12 (depending on how you count) bills indirectly affecting workers’ compensation. The following is a review of the 12 bills sent... Read More

Informal Draft of Pharmacy Closed Formulary Rules Posted by Texas Department of Insurance
Posted on 3 Mar 2010 by Stuart D. Colburn

The Division drafted its latest version of the proposed Closed Pharmacy Formulary Rules and asked for informal comments by March 5, 2010. The Division has been working on the closed formulary for several years. Significant issues regarding Division resources... Read More