LexisNexis® Legal Newsroom
California WCMSA Case: Did Clinical Need for Medical Treatment Occur Faster Than CMS Process for Approving Medicare Set-Aside?

By Jennifer C. Jordan, Esq. In California, there is a unique trend compared to the rest of the nation in that the Medicare Set-Aside process is primarily defense driven with less than full disclosure to the Applicants. While not applicable to all employers/insurers, it is problem enough that the Applicant's...

California WCMSA Case: Did Clinical Need for Medical Treatment Occur Faster Than CMS Process for Approving Medicare Set-Aside?

By Jennifer C. Jordan, Esq. In California, there is a unique trend compared to the rest of the nation in that the Medicare Set-Aside process is primarily defense driven with less than full disclosure to the Applicants. While not applicable to all employers/insurers, it is problem enough that the Applicant's...

The WCMSA Conundrum in California

By Robert G. Rassp, Esq. The following email string is true, accurate and correct. It is a typical email string between an applicant’s attorney and a defense attorney. We all have cases like this in our inventories. In this case, the Applicant was a medical laboratory technologist who sustained...

The WCMSA Conundrum in California

By Robert G. Rassp, Esq. The following email string is true, accurate and correct. It is a typical email string between an applicant’s attorney and a defense attorney. We all have cases like this in our inventories. In this case, the Applicant was a medical laboratory technologist who sustained...

Settlement Did Not Affect Right to Further Medical Treatment for Sleep Apnea: Cal. Comp. Cases July Advanced Postings (7/17/2012)

Here’s the fourth batch of advanced postings for the July 2012 issue of Cal. Comp. Cases. Lexis.com subscribers can link to the cases to read the complete headnotes and summaries. © Copyright 2012 LexisNexis. All rights reserved. City of Los Altos (Police Department), Petitioner v. Workers'...

California: Can an Attorney Fee Be Requested on a Medicare Set-Aside Trust?

Lexis.com subscribers can link to the cites below. As any participant in the workers’ compensation system over the past ten to fifteen years can tell you, if you want to discuss a Compromise and Release, you will likely also have to consider “Medicare’s interests” in evaluating...

California: Stipulated Agreements – When Can You Back Out?

Lexis.com subscribers can link to the cases, statutes, and rules cited below . Buyer’s remorse. It is not unusual for a party to agree to the terms of a settlement and then wake up the next morning with that horrible feeling in the pit of their stomach. Maybe that was not such a great deal after...

California: Stipulated Agreements – When Can You Back Out?

Lexis.com subscribers can link to the cases, statutes, and rules cited below . Buyer’s remorse. It is not unusual for a party to agree to the terms of a settlement and then wake up the next morning with that horrible feeling in the pit of their stomach. Maybe that was not such a great deal after...

Injured Worker’s Spouse Entitled to $21,600 for Retroactive Home Health Care Services: Cal. Comp. Cases October Advanced Postings (10/16/2012)

Here’s the fourth batch of advanced postings for the October 2012 issue of Cal. Comp. Cases. Lexis.com subscribers can link to the cases to read the complete headnotes and summaries . © Copyright 2012 LexisNexis. All rights reserved. Insurance Company of the State of Pennsylvania, insurer...

California WCMSA: Separate Settlements for Each Claim - The Benson Case

By Robert G. Rassp, Esq. Appellate review of California Labor Code Sections 4663 and 4664 on apportionment has mandated that physicians provide in their conclusions with reasonable medical probability approximately what percentage of permanent disability or impairment is directly caused by each industrial...

California WCMSA: Separate Settlements for Each Claim - The Benson Case

By Robert G. Rassp, Esq. Appellate review of California Labor Code Sections 4663 and 4664 on apportionment has mandated that physicians provide in their conclusions with reasonable medical probability approximately what percentage of permanent disability or impairment is directly caused by each industrial...

Defendant’s 39-Day Delay of $49K Settlement Payment Found Unreasonable: Cal. Comp. Cases February Advanced Postings (2/18/2015)

Here’s the fourth batch of advanced postings for February 2015 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the cases to read the complete headnotes and summaries. © Copyright 2015 LexisNexis. All rights reserved. Ace American Insurance Company (administered...

Employer’s Right to Credit in Third-Party Recovery Not Barred When Employer Not Aware of Hazardous Conditions: Cal. Comp. Cases October Advanced Postings (10/7/2015)

Here’s the latest batch of advanced postings for the October 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. Angel Perez-Zepeda, Petitioner...

California: Defendant Found Responsible for EDD Lien When Lien Not Resolved Prior to Approval of Compromise and Release

In Borbeck v. ACE Building Maintenance , 2015 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB affirmed the WCJ’s order requiring the defendant to pay EDD $33,921.68 in satisfaction of EDD’s lien for unemployment compensation paid to the applicant. The WCAB found that unemployment compensation payments...

Decedent Entitled to Pursue Injuries to Body Parts Not Covered in Compromise and Release: Cal. Comp. Cases February Advanced Postings (2/3/2016)

Here’s another batch of advanced postings for the February 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. Johns Mansville, self insured...

Applicant May Obtain Second Opinion Physician If Applicant Disputed Diagnosis or Treatment Prescribed by Primary Treating Physician: Cal. Comp. Cases February Advanced Postings (2/18/2016)

Here’s the latest batch of advanced postings for February 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. Edward Bautista, Petitioner v....

California Workers’ Comp Cases Roundup (6/1/2016)

CALIFORNIA COMPENSATION CASES Vol. 81 No. 5 May 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 2016 LexisNexis. All rights...

California: Compromise and Release and Medicare Set-Aside: Informed Consent and Assumption of Risk

Liability for future medical treatment for a work related condition cannot be transferred to Medicare without its permission In Alvarenga v. Scope Industries , 2016 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB panel rescinded the WCJ’s order approving the parties’ Compromise and Release, which...

Claim for Psychiatric Injury as Compensable Consequence of Chronic Hepatitis Not Precluded by Compromise and Release: Cal. Comp. Cases July Advanced Postings (6/22/2016)

Here’s the latest batch of advanced postings for the July 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. City of Los Angeles (Los Angeles...

California Workers’ Comp Case Roundup (7/7/2016)

CALIFORNIA COMPENSATION CASES Vol. 81 No. 6 June 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 2016 LexisNexis. All rights...

California: Jurisdiction Issues That Could Sabotage Your Case

Quite a few WCAB Noteworthy Panel Decisions (NPDs) have issued lately on the question of jurisdiction. In each of them, the parties had petitioned to go forward on an issue, only to discover at the hearing level, that the WCAB might not have jurisdiction to decide the matter. Practitioners should be...

California: Medicare Settlement Agreements: The Perils of Unanticipated Problems After Settlement

What exactly is the role of the WCAB, not to mention the parties to the C&R, in addressing unanticipated problems that come up with an MSA after settlement? In Muniz Villalpando v. Doherty Brothers , 2017 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB, in a split panel opinion, rescinded the WCJ’s...