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California Workers’ Compensation Reform SB 863 Analysis: Medical Treatment Provisions (9/7/2012)

The following analysis is based on the 8/30/2012 amended version of SB 863: SB863, widely lauded as the “new and improved” workers’ compensation reform package passed both the houses of the legislature on Friday, August 31 and is now on the Governor’s desk waiting to be signed...

California Workers’ Compensation Reform SB 863 Analysis: Medical Treatment Provisions (9/7/2012)

The following analysis is based on the 8/30/2012 amended version of SB 863: SB863, widely lauded as the “new and improved” workers’ compensation reform package passed both the houses of the legislature on Friday, August 31 and is now on the Governor’s desk waiting to be signed...

California DIR Officials Outline Goals and Tasks for Implementing SB 863 Workers’ Comp Reforms

By David Bryan Leonard, Esq., Special to the LexisNexis Workers’ Compensation Law Community The 2012 California Workers’ Compensation and Risk Conference opened September 19, 2012 at the St. Regis Resort, Dana Point with an update from the DIR/DWC/WCAB entitled “What’s on the...

CWCI Finds Use of Network Physicians in California Workers’ Comp Continues to Grow

Treatment by network physicians is becoming increasingly prevalent in California workers’ compensation, with new data showing that nearly 80 percent of first-year physician-based outpatient medical services for 2010 California work injuries was provided by physicians who are part of a medical network...

California: Liability for Self-Procured Treatment Outside the Medical Provider Network

A California WCAB panel recently held that while liens may be disallowed for medical treatment procured outside the defendant's Medical Provider Network, the applicant himself is not personally liable to the lien claimants pursuant to Labor Code § 4605 when he " did not intend " to...

California Medical Provider Networks: Another Aspect of SB 863 Needing Judicial Oversight

Another aspect of SB863 needing judicial oversight is the failure of the MPNs to assist patients in obtaining appointments with in-network treating psychiatrists, while denying payment to non-network psychiatrists as "self-procured". Instead of providing legally-required assistance, the Claims...

California: MPN Treatment Requests Not Subject to UR/IMR

Karen C. Yotis, Esq., a Feature Resident Columnist for the LexisNexis Workers’ Compensation eNewsletter , provides insights into workplace issues and the nuts and bolts of the workers’ comp world. Is Hogenson Du(ing) an End Run Around Dubon? Is Dubon dead? Well, maybe. Judge Craig Glass...

CWCI Schedules Online Seminar on New MPN Regs and Other Recent Regulatory Revisions

The California Workers’ Compensation Institute (CWCI) has scheduled an online seminar for Thursday, September 18 to educate workers’ compensation claims and medical professionals, attorneys and other members of the community on revised regulations governing medical provider networks (MPNs...

California: WCAB Says MPN Treatment Requests Are Subject to UR/IMR

Legislature did not demonstrate an intent to preclude employers from seeking UR of MPN physicians’ requests for authorization of medical treatment In Stock v. Camarillo State Hospital , 2014 Cal. Wrk. Comp. P.D. LEXIS --, a WCAB panel held that the defendant’s utilization review (UR) determination...

Website Provided Notice That MPN Physician Could Treat at Specified Locations Only: Cal. Comp. Cases October Advanced Postings (9/26/2014)

Here’s the first batch of advanced postings for the October 2014 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2014 LexisNexis. All rights reserved. Tynia Ayers , Petitioner v. Workers'...

California: Top 25 Noteworthy Panel Decisions (July–December 2014)

LexisNexis has picked the top “noteworthy” panel decisions issued by the California Workers’ Compensation Appeals Board during the period July through December 2014. You’ll find many helpful cases in this list, including a recent decision on reasonable attorney’s fees ,...

California: Stipulation to Treatment Outside a Medical Provider Network

In Shawl v. Steve’s Automotive , 2015 Cal. Wrk. Comp. P.D. LEXIS --, a split WCAB panel rescinded the WCJ’s decision and held that the applicant, who incurred an industrial injury to multiple body parts on 3/7/2001, was entitled to continue treatment with Jacob Rabinovich, M.D., outside the...

California: New Medical Provider Network Regulations: It's a New Medical Treatment Paradigm

The 2004 workers’ compensation reform package of SB 899 brought about many changes as to how employers were required to provide medical treatment to injured workers. (Publisher’s Note: Citations link to lexis.com; bracketed citations link to Lexis Advance.) The newly created Labor Code...

A “Sea Change” in California: Regulatory Implementation of the SB 863 Reforms

AD says IMR gets 30 days to issue a decision after receipt of records, but doesn’t address Arredondo noteworthy panel decision Roger Rabb, J.D., Special Correspondent for the LexisNexis Workers’ Compensation eNewsletter In 2012, California passed into law Senate Bill 863 implementing...

CWCI Tracks Use of Network Physicians in California Workers’ Comp and Associated Savings

Use of network physicians to manage California injured workers’ medical care rose from just over half of all claims prior to the introduction of medical provider networks (MPNs) to nearly 80 percent of all claims after MPNs were fully implemented according to a new CWCI study that tracks network...

California: A Medical Provider Network Conundrum: The Second Opinion Process

In Bautista v. Arlon Graphics , 2015 Cal. Wrk. Comp. P.D. LEXIS --, a split panel WCAB affirmed the WCJ’s finding that the applicant machine operator with a 4/6/2014 admitted industrial injury to his ribs, pulmonary system, lumbar spine, and right ankle and alleged consequential injury his psyche...

California Workers’ Compensation: 2015 Year in Review

By Julius Young, Esq., Richard M. Jacobsmeyer, Esq., Barry D. Bloom, Co-Editors-in-Chief, Herlick, California Workers' Compensation Handbook This 2016 edition is the 35th edition of Herlick, California Workers’ Comp Handbook (hereinafter “Herlick”). The latest Herlick Handbook...

Defendant Hired Applicant in His Capacity as Homeowner and Not as Part of His Rental Property Business: Cal. Comp. Cases January Advanced Postings (12/29/2015)

Here are the latest advanced postings for the January 2016 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2016 LexisNexis. All rights reserved. Abel Reyes-Garcia, Petitioner v. Workers'...

California: Medical Provider Network Access Standards: Three Physicians Required?

In Soto v. Sambrailo Packaging , 2016 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB held that the WCJ erred in finding that the applicant who suffered an industrial injury to her neck, back and right shoulder was entitled to treat outside the defendant’s MPN because the defendant failed to meet the statutory...

Why California Workers’ Comp Is So Hard to Manage: A Snapshot of the 52nd Annual CWCI Conference

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 of the recent 52nd annual meeting of members...

California: What Constitutes a Diminishment in a Benefit When It Comes to an ADR?

In Ramirez Farias v. Able Building Maintenance , 2016 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB, in a split panel opinion, found that the applicant, who suffered an industrial injury to her neck, back, right wrist, and right shoulder from 2/28/2005 through 1/22/2014, and was treating outside of an alternative...

California: MPN Treatment Resolution: Separate and Distinct vs. Part and Parcel

Did the Legislature intend for there to be two separate methodologies for resolving treatment disputes? By Brad Wixen, Esq. The essential question in Parrent v. SBC-Pacific Bell Telephone Company , 2016 Cal. Wrk. Comp. P.D. LEXIS --, is whether the Medical Provider Network (MPN) method of resolving...

California: Two Separate Medical Review Processes Available to an MPN Treatment Recommendation

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 MPN treating physician was subject to...

California: Do All Physicians Within the MPN Need to Be Specifically Designated?

How and when to make an argument By Brad Wixen, Esq. In Rivas v. North American Trailer , 2016 Cal. Wrk. Comp. P.D LEXIS 572 , Applicant sustained a clearly significant injury when a chain and hook struck him in the head, causing a loss of consciousness, skull fracture, five days of hospitalization...

California: Top 25 Noteworthy Panel Decisions (July through December 2016)

LexisNexis has selected some of the top “noteworthy” panel decisions issued by the California Workers’ Compensation Appeals Board during the period July through December 2016. The list features a number of decisions addressing medical-legal issues such as assignment, selection and reporting...