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Cal. Comp. Cases November Advanced Postings (11/3/2011)

Featured Case of the Week: Airline Pilot's Claim for Injuries Barred by Going and Coming Rule Dann Peter Shubin, Petitioner v. Workers' Compensation Appeals Board, Southwest Airlines, PSI, administered by Cambridge Pasadena, Respondents, 2011 Cal. Wrk. Comp. LEXIS 166 Injury AOE/COE...

CWCI Study Finds Use of Physician Networks in California Workers’ Comp Is at a Record High

The use of network physicians to provide medical care to injured workers in California rose sharply in 2005 -- immediately after Medical Provider Networks (MPNs) first became available in California workers’ compensation, expanding employer medical control from 30 days to the life of the claim...

Does an Employee Have to Obtain a Comprehensive Medical-Legal Evaluation Prior to Disputing a Utilization Review Determination?

In State Compensation Insurance Fund v. Workers' Comp. Appeals Bd. (Sandhagen) (2008) 44 Cal.4th 230 [73 Cal.Comp.Cases 981] (Sandhagen), the California Supreme Court clarified that an employer did not have the option of going through either UR or the QME process in addressing a treatment request...

No Change in California Workers’ Comp Medical Mileage Rate For 2012 Travel

The mileage rate that workers’ comp claims administrators pay injured workers for travel related to medical treatment or evaluation of their injuries will remain at 55.5¢ per mile for travel on or after January 1, 2012, regardless of the date of injury. California Labor Code §4600 ...

Cal. Comp. Cases January Advanced Postings (1/6/2012)

Here’s the first batch of advanced postings for the January 2012 issue of Cal. Comp. Cases. Lexis.com subscribers can link to the complete headnotes. Roxanna Ortiz , Petitioner v. Workers' Compensation Appeals Board, One Source, PSI, adjusted by ESIS, Respondents , 2011 Cal. Wrk. Comp. LEXIS...

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...