May 29, 2024

California: Appeals Board Panel Clarifies Scope and Intent of Labor Code § 4663(d) Disclosure Requirement

Appeals Board panel revisits Hardesty By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board One of the first lessons learned by practitioners new to the field of workers’ compensation law is that proceedings before the Workers’ Compensation Appeals Board (WCAB) are governed by specific provisions of the Labor Code and the Rules...

May 29, 2024

California Compensation Cases May 2024

CALIFORNIA COMPENSATION CASES Vol. 89, No. 5 May 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 Denied Judicial Review CONTENTS OF THIS ISSUE Appellate Court Compensation Case Lexis+ Online Subscribers: You can link to your account on Lexis+ to read the complete headnotes and court decisions, en banc decisions...

May 17, 2024

California: A Look at the Distinct Roles of Evaluating Physicians

By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board The medically related intricacies of a California workers’ compensation case are varied and often confusing. Acronyms abound. They include agreed medical evaluator (AME) and qualified medical evaluator (QME), medical provider network (MPN), primary treating physician (PTP) as well...

May 08, 2024

California: Noteworthy Independent Medical Review (IMR) Decisions (May 2024)

LexisNexis has selected some recently issued noteworthy IMR decisions that illustrate the criteria that must be met to obtain authorization for a variety of different medical treatment modalities. LexisNexis Commentary for each selected IMR is provided below. Many of these IMR decisions were reprinted in California Compensation Cases , which can be accessed on Lexis+. The list discusses specific IMR opinions which explain...

May 03, 2024

California: A Guide to Complex Issues: Presumption of Permanent Total Disability, Progressive, Insidious Disease and More

By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board Appeals Board panel decisions that rescind a WCJ’s decision and return the case to the trial level for further proceedings and decision generally are not featured in this e-newsletter. The rationale is logical—the dispute may resolve on remand and/or the new decision following...

April 23, 2024

California: Procedure for Obtaining a QME Panel in a Different Specialty in a Disputed Case

Board Panel Opinion Provides a Succinct Explanation By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board The process for determining medical issues in a workers’ compensation claim sometimes seems unduly complex and confusing. Labor Code sections 4060 - 4068 establish how medical issues are determined, and the procedures vary depending...

April 18, 2024

California Compensation Cases April 2024

CALIFORNIA COMPENSATION CASES Vol. 89, No. 4 April 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 Denied Judicial Review CONTENTS OF THIS ISSUE Appellate Court Case Not Originating with Appeals Board LexisNexis Online Subscribers: You can link to your account on Lexis+ to read the complete headnotes and court...

April 18, 2024

California: Shipley Doctrine Lives, Continues to Safeguard Due Process Rights of Litigants Before the WCAB

By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board Several months ago, an article in LexisNexis Workers’ Compensation Newsletter discussed Zurich American Ins. Co. v. Workers’ Comp. Appeals Bd . (2023) 97 Cal. App. 5th 1213 , 89 Cal. Comp. Cases 1 ( Zurich ), in which the 2nd District Court of Appeal held that the 60-day time...

April 10, 2024

California: ERISA and Federal Preemption Claims vis-à-vis Workers’ Compensation State Requirements

By William Tappin, Esq., Law Offices of Tappin & Associates, Sierra Madre, CA There has been a lot of confusion with respect to whether ERISA preempts state laws regarding numerous programs, including mandatory workers’ compensation coverage by employers. By way of background, it should be noted that some brokers were selling programs as a replacement for workers’ compensation coverage. These were...

April 09, 2024

Larson’s Workers’ Compensation Law Case Spotlights (Spring 2024)

By Thomas A. Robinson, co-author, Larson’s Workers’ Compensation Law Editorial Note: All section references below are to Larson’s Workers’ Compensation Law, unless otherwise indicated. Employee Fraud. While the vast majority of workers’ compensation claimants follow the rules, speak truthfully, do not exaggerate symptoms, or otherwise unethically attempt to maneuver within “the...

April 03, 2024

California Compensation Cases March 2024

CALIFORNIA COMPENSATION CASES Vol. 89, No. 3 March 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 Denied Judicial Review © Copyright 2024 LexisNexis. All rights reserved. CONTENTS OF THIS ISSUE LexisNexis Online Subscribers: You can link to your account on Lexis+ to read the complete headnotes and court...

April 01, 2024

California: A Successful Flight with Kite Ain’t What it Used to Be

By Hon. Colleen Casey, Former Commissioner, California Workers’ Compensation Appeals Board It has been over a decade since the 2nd DCA (District Court of Appeal) denied writ in the case of Athens Administrators v. W.C.A.B. (Kite) (2013) 78 Cal. Comp. Cases 213 (writ den.). Yet, during that entire ten-year span, not one District Court of Appeal has weighed in on the Kite issue. In fact, Kite was the only “Addition...

March 21, 2024

California: Incompetency and Proceedings Before the WCAB

By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board Among the varied duties of the Workers’ Compensation Appeals Board (WCAB) is the determination of the competency of an injured employee or dependent. (Lab. Code, § 5408). Upon a finding of incompetency, the WCAB may appoint a guardian-ad-litem or conservator, and until such appointment...

March 13, 2024

Analyzing the Pandemic’s Big Shift in Working from Home: Productivity, Innovation, Working Arrangements, Pay

By Christopher Mahon, LexisNexis Insights Contributing Author In 1965, less than 0.5% of American workers worked from home. Due to technological innovation in the late twentieth century, that 0.5% rose to 7% by 2019. By June of 2023, 28% of full working days were being worked from home. This big shift, made possible by technology, was catalyzed by the pandemic. Researchers are now analyzing how the big shift has changed...

March 13, 2024

California: Defendant’s Liability for Post-Award Compensable Consequence Injuries

By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board Even carefully crafted stipulations that purport to limit an employer’s liability for medical treatment to conditions or body parts not specifically listed in the stipulations will not insulate the employer from liability for future medical treatment even more than five years after...

March 04, 2024

California: Is the Good Faith Personnel Action Defense to a Claim of Psychiatric Injury Illusory?

By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board Claims of work-related psychiatric injuries have a fraught history. In 1989 as part of the Margolin-Bill Greene Workers’ Compensation Reform Act, Lab. Code § 3208.3 was adopted with the intent of reducing the proliferation of claims of psychiatric injury by raising the compensability...

March 01, 2024

CWCI Study Examines Cumulative Trauma and Litigated Claims in California Workers’ Comp

Oakland - A new California Workers’ Compensation Institute (CWCI) study shows that almost half of all litigated claims in the LA Basin are cumulative trauma (CT) claims that involve physical or mental injuries that arise over time from repetitive stress, motion, or exposures, rather than from a specific event or accident. The CWCI study, based on a sample of 1.4 million California work injury claims with 2010...

February 26, 2024

California: Noteworthy Independent Medical Review (IMR) Decisions (February 2024)

LexisNexis has selected some recently issued noteworthy IMR decisions that illustrate the criteria that must be met to obtain authorization for a variety of different medical treatment modalities. LexisNexis Commentary for each selected IMR is provided below. Many of these IMR decisions were reprinted in California Compensation Cases , which can be accessed on Lexis+. Lexis+ subscribers can access those particular decisions...

February 21, 2024

California Compensation Cases February 2024

CALIFORNIA COMPENSATION CASES Vol. 89, No. 2 February 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 Denied Judicial Review CONTENTS OF THIS ISSUE LexisNexis Online Subscribers: You can link to your account on Lexis+ to read the complete headnotes and court decisions, en banc decisions, writ denied summaries...

February 15, 2024

California: Is Shipley on Life Support? The Implications of Zurich

By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board In the 1785 poem, To a Mouse , Robert Burns observed that the best laid plans of mice and men often go awry. Burns’ observation is relevant in the case of some petitions for reconsideration filed before the Workers’ Compensation Appeals Board (Appeals Board). As in all judicial...

February 05, 2024

California: WCAB Practices Are Evolving: Are Their Templates Evolving as Well?

By Hon. Colleen Casey, Former Commissioner, California Workers’ Compensation Appeals Board The struggle is real. How and when should Workers’ Compensation Judges (WCJs) apply the statute of limitations to bar compensation claims of injured workers? This process is especially challenging when dealing with industrial cumulative traumas (CT) and their end date pursuant to Lab. Code § 5412. As discussed...

January 31, 2024

CWCI Analyzes California Workers’ Comp Inpatient Care

Oakland, CA - The number of inpatient hospitalizations in the California workers’ compensation system declined 51.1% between 2012 and 2022, spurred by declining claim volume, technological advances and changes in Medicare rules that allow more outpatient procedures, the elimination of redundant payments for spinal surgery hardware, and the expansion of evidence-based guidelines for spinal fusions and other surgeries...

January 29, 2024

Working From Home May Have Negative Health Consequences

By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board Employees who work from their homes instead of an office or other location is not a new phenomenon. In the 1980’s and 1990’s some industries began to employ workers who worked exclusively from home. No doubt you first received a telemarketing or sales call several decades ago...

January 23, 2024

California Compensation Cases January 2024

CALIFORNIA COMPENSATION CASES Vol. 89, No. 1 January 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 Denied Judicial Review CONTENTS OF THIS ISSUE LexisNexis Online Subscribers: You can link to your account on Lexis+ to read the complete headnotes and court decisions, en banc decisions, writ denied summaries,...

January 16, 2024

California: Litigation Tool Box: How to Avoid the “Gotchas”

By Hon. Colleen Casey, Former Commissioner, California Workers’ Compensation Appeals Board No wonder it’s a jungle out there. No one is following the rules. Do the Labor Code rules still exist? We were all distracted by COVID. Were changes made while we weren’t looking? Did a mind sweep function somehow delete our collective memory? Inquiring minds want to know. Recent WCAB decisions provide some curious...