CALIFORNIA COMPENSATION CASES Vol. 89, No. 7 July 2024 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...
Havanis v. Calif. Dept. of Transportation (Board Panel Decision) By Hon. Colleen Casey, Former Commissioner, California Workers’ Compensation Appeals Board I. Medical apportionment is not the...
By Robert G. Rassp, author of The Lawyer’s Guide to the AMA Guides and California Workers’ Compensation (LexisNexis) Disclaimer: The material and any opinions contained in this treatise are...
Oakland, CA – Private self-insured claim volume in the California workers' compensation system fell 9.5% in 2023, producing the biggest year-to-year decline in private self-insured claim frequency...
By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board No matter the source of your media consumption, it seems that the topic...
In a recent panel decision, the WCAB, denying reconsideration, affirmed the WCJ’s decision that the Applicant, who was previously awarded 100% permanent disability with the need for further medical treatment, was entitled to further medical treatment in the form of continued interdisciplinary post-acute rehabilitation at an assisted living facility absent any change in circumstances. In this case, the Defendant had been providing ongoing authorization for the Applicant to reside at an assisted living facility since January 23, 2020, but had denied a request for his continued stay on October 1, 2020. The WCAB, relying on Patterson v. The Oaks Farm (2014) 79 Cal. Comp. Cases 910 (Appeals Board significant panel decision), held the Applicant was not required to provide ongoing requests for authorization and that the Defendant could not force the Applicant to be discharged from the facility by obtaining a denial by utilization review absent any change of circumstances. Ultimately, ensuring the Applicant’s continued stay, absent any change in circumstances and without the Defendant’s constant demands for ongoing requests for authorization, ensures the Applicant’s safety and maintains continuity in his living situation and medical care. See the Rivota panel decision.
Reminder: Board panel decisions are not binding precedent.
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