LexisNexis® Legal Newsroom
California: Independent Medical Review – Which One Applies To What?

There is much confusion over the two Independent Medical Reviews in the California workers’ compensation system: MPN-IMR and UR-IMR. Attorneys should beware of mixing apples and oranges when it comes to these two separate and distinct processes. This article hopefully will clarify the issues and...

California: Can a Utilization Review Determination Exceed Its Appropriate Scope?

With respect to the increasing litigation over the UR process, is Dubon really the issue in many of these UR disputes? Utilization Review (UR) has been around for more than ten years now. UR first came into play in 2003 when Governor Gray Davis passed Senate Bill 228 . The following year, on April...

California Fringe Medical Benefits: A Question of Evidence

In Logudice v. Mimi’s Café , 2015 Cal. Wrk. Comp. P.D. LEXIS --, a WCAB panel affirmed the WCJ’s finding that the defendant was liable for residential relocation, moving costs, rent differential, and housekeeping services as reasonable and necessary medical treatment to cure or relieve...

California: Untimely Independent Medical Review

Split WCAB panel finds untimely IMR, like untimely UR, is invalid In Saunders v. Loma Linda University Medical Group , 2015 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB, in a split panel opinion, rescinded its prior decision [see Saunders v. Loma Linda Univ. Med. Group , 2014 Cal. Wrk. Comp. P.D. LEXIS...

California: Claim Against UR Physician Not Preempted by Workers’ Compensation Law

Noting that a utilization review physician has a doctor-patient relationship with the person whose medical records are being reviewed, a California appellate court held that in at least some circumstances an injured worker and his wife could maintain a civil action against a physician for a workers’...

King v. CompPartners, Inc., et al.: Do Utilization Review Physicians Owe a Duty of Care to Applicants and What Is the Nature and Scope of the Duty of Care

By Raymond F. Correio, Esq. A recent decision from the Fourth District Court of Appeal, King v. CompPartners, Inc., et al. 243 Cal.App.4th 685, 80 Cal. Comp. Cases 10 , certified for publication, raises a number of provocative issues which will no doubt impact on the ongoing contentious battle between...

California: WCAB Panel Finds Request for Authorization Submitted by Secondary Treating Physician Triggered Utilization Review Process

Statutory scheme regarding the role of the primary treating physician is less than perfectly clear In Lopez v. City and County of San Francisco , 2016 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB panel affirmed the WCJ’s award of medical treatment recommended by the secondary treating physician Clement...