CALIFORNIA COMPENSATION CASES Vol. 82 No. 4 Apr 2017 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 © Copyright...
The 3rd District Court of Appeals has issued its decision in Ramirez v W.C.A.B ., again upholding the constitutionality of the IMR process for review UR determinations and providing, perhaps, some addition nuggets for potential challenges on the W.C.A.B. decision...
Oakland – An analysis of the California workers’ comp independent medical review (IMR) process used to resolve medical disputes finds that in 2016, IMR physicians once again upheld about 90% of utilization review (UR) physician’s modifications...
In a 5–2 decision, the Supreme Court of Pennsylvania, reversing an earlier decision by the Commonwealth Court, held that a physician performing an Impairment Rating Evaluation (IRE) under § 306(a.2)(1) of the state’s Workers’ Compensation...
The Alaska Workers’ Compensation Board appropriately awarded an injured worker attorney’s fees pursuant to Alaska Stat. § 23.30.145(b), where a school bus driver underwent two spinal surgeries following a work-related accident and, about the same time that the...
In McKinney v. Enterprise Rent-A-Car of San Francisco , 2016 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB reversed the WCJ’s finding that the defendant was liable for sanctions under Labor Code § 5813 for bad faith handling of requests for authorization ...
By LexisNexis California WCAB Noteworthy Panel Decisions Reporter Staff In De Leon v. Safeway, Inc., 2016 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB, reversing the WCJ, held that the request for authorization to provide medical treatment by the applicant’s...
The Supreme Court of Idaho held substantial and competent evidence supported the Commission’s finding that the need for the claimant’s cervical spine surgery was not caused by a prior work-related accident where the Commission relied upon an IME’s opinion that...
CALIFORNIA COMPENSATION CASES Vol. 81 No. 7 July 2016 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 © Copyright...
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 despite the...
The 2nd Appellate District has issued the first of what should prove to be several appellate decisions on the timeliness of IMR decisions and the assertion by a W.C.A.B. panel decision that IMR timelines were mandatory and late IMR vested jurisdiction with the...
A new analysis of California workers’ compensation independent medical review (IMR) decisions issued in the first quarter of 2016 shows that the medical dispute resolution process mandated by the 2012 workers’ comp reform bill is yielding consistent...
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. P.D. LEXIS...
Can it be inferred that a communication of a determination 30 minutes after the deadline means the actual decision was made within that 30 minute time frame? Does the same 5 day time frame for making a UR determination also include the time to communicate the decision...
If one was trying to track hot topics and trends in California workers’ comp, a good place to start would have been a recent March conference in Oakland attended by many prominent stakeholder representatives. Oakland’s Marriott Hotel was the site...