LexisNexis® Legal Newsroom
California: The Good Faith Personnel Action Defense

Recent cases remind us that there’s a multi-level process as enunciated in Rolda [66 CCC 241] to determine whether a psychiatric claim is barred by the good faith personnel action defense under LC 3208.3(h). The defendant, using expert medical evidence, must show that a personnel action (or actions...

California: WCAB Clarifies It Hasn’t Endorsed Use of AMA Guides Sixth Edition

The California WCAB, on its own motion, rescinded its prior order in Frazier v. State of California [ 2013 Cal. Wrk. Comp. P.D. LEXIS 365 (lexis.com), 2013 Cal. Wrk. Comp. P.D. LEXIS 365 (Lexis Advance)] affirming the WCJ’s findings and award, and returned the matter to the WCJ for new decision...

California: Navarro En Banc, Which Applied to QMEs, Also Applies Equally to AMEs

The California WCAB, in a recent noteworthy panel decision, noted that the holding in Navarro , which applied to QMEs, also applies equally to AMEs. In this case, the WCAB affirmed the WCJ’s ruling that the applicant was not required to return to the prior agreed medical examiner for an evaluation...

California: W.C.A.B. Rules on Gap Between TD Ending and PTD Commencing

The W.C.A.B. has issued an en banc decision addressing one of the consequential issues to the two-year limitation on payment of temporary total disability benefits contained in Labor Code § 4656(c). In Brower v. David Jones Construction , the W.C.A.B. has addressed the issue of when permanent total...

California: Appellate Court Broadly Interprets Labor Code Section 5803

In a brief and to the point decision, the 2nd Appellate District has reversed a W.C.A.B. decision that had rescinded an award of increased benefits based upon a Petition to Reopen. The case, Benavides v W.C.A.B ., is one of the briefest opinions on a workers’ compensation issue that this commentator...

California: WCAB Imposes Difficult Standards for Overturning a UR Decision

The WCAB, in two recent noteworthy panel decisions, has imposed a difficult standard for applicants seeking to overturn a utilization review (UR) decision. Do these decisions signal a policy decision on the part of the Board to limit reversals of UR decisions? In the first panel decision, the WCAB, in...

Strict AMA Guides WPI of Zero Percent Rebutted in Ortho/Psyche Case: Cal. Comp. Cases August Advanced Postings (8/20/2014)

Here are the second and third batch of advanced postings for the August 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. Bank of America, PSI, adjusted...

California: Tips for Stips & More

What if Defendant “#1” and applicant agree to use an AME in a case, but Defendant “#2” does not. Will Defendant “#2” be bound by the findings of the AME it never agreed to use? These questions and more were answered in the recent Noteworthy Panel Decision (NPD) of...

Sole Reliance on Applicant’s Lay Testimony on Medical Issue Was Erroneous: Cal. Comp. Cases April Advanced Postings (4/2/2015)

Here are the first and second batches of advanced postings for the April 2015 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2015 LexisNexis. All rights reserved. Lynda Myers , Petitioner...

California: Self-Procured Medical Marijuana

Are applicants entitled to reimbursement for self-procured medical marijuana both pre- and post-SB 863? In Cockrell v. Farmers Insurance , 2015 Cal. Wrk. Comp. P.D. LEXIS --, a WCAB panel has once again rescinded the WCJ’s finding that the applicant was entitled to reimbursement (as opposed...

California: Medical Records for Independent Medical Review

Defendant, not applicant, has mandatory obligation to forward all relevant medical records to IMR In Garibay-Jimenez v. Santa Barbara Medical Foundation Clinic , 2015 Cal. Wrk. Comp. P.D. LEXIS --, a WCAB panel rescinded the WCJ’s order denying the applicant’s appeal from an independent...

California: Firefighter Presumption Extension Given Retroactive Effect

The 2nd District Court of Appeals has reversed a W.C.A.B. decision which had refused to apply the presumption of causation for cancer to a firefighter based on the amendment to Labor Code § 3212.1 which became effective after diagnosis but before trial. In Lozano v W.C.A.B ., the dependents of...