LexisNexis® Legal Newsroom
California W.C.A.B. Affirms Prior Valdez Decision

When it rains it pours... Having just issued an en banc decision yesterday on QME panel issues, the W.C.A.B. has just issued its 3rd Reconsideration decision in Valdez v Warehouse Demo Services . The original decision issued in April 2011 holding reports obtained by an applicant outside of a validly...

California W.C.A.B. Affirms Prior Valdez Decision

When it rains it pours... Having just issued an en banc decision yesterday on QME panel issues, the W.C.A.B. has just issued its 3rd Reconsideration decision in Valdez v Warehouse Demo Services . The original decision issued in April 2011 holding reports obtained by an applicant outside of a validly...

California: Court of Appeals Publishes Valdez Reversal Opinion

The Second District Court of Appeal has ordered publication of its decision in Valdez v W.C.A.B . which reversed the W.C.A.B. en banc ruling that medical reports obtained by applicants pursuant to Labor Code § 4605 were not admissible. Thus, the Court of Appeal decision now becomes citable authority...

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: Independent Medical Review Appeals: The Shape of Things to Come

Workers’ Compensation Judges are starting to see appeals of IMR decisions where the parties are raising very interesting arguments at conferences and trials. We expect to see quite a few noteworthy panel decisions in the coming months outlining what the WCAB can and cannot do when a party challenges...

New CWCI Study Produces Benchmark Data on Physician Reporting in California Workers’ Comp

A new CWCI study finds that the average number of first-year medical reports per claim provided by California workers’ comp treating physicians to claims administrators rose by 123% in the 12 years leading up to the adoption of the new physician fee schedule, fueled in part by increases in evaluation...

California: Communication of UR Decisions to Treating Physicians Must Specify Nature or Content of Message

In Shanley v. Henry Mayo Newhall Memorial Hospital , 2014 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB panel rescinded the WCJ’s finding that the defendant’s 8/6/2013 utilization review (UR) determinations of a treating physician’s request for lumbar MRI and EMG were valid under Labor Code...

New Study on Low Back Pain Examines Costs and Benefits of State Workers’ Compensation Policy Variations

While employer control reduces medical costs, allowing employees a one-time change in physician may not be as expensive as employers fear By Thomas A. Robinson, co-author, Larson’s Workers’ Compensation Law According to a recent study published in the Journal of Occupational and Environmental...

California: Disputing an MPN Physician’s Release From Care

When an employee disputes an MPN physician’s release from care, is the employee entitled to choose to resolve the dispute with the treating physician’s diagnosis or treatment by either obtaining a second opinion within the MPN or by selecting a panel qualified medical evaluator? In...

California: The MTUS and Treating Physician Reports

Does Labor Code § 4604.5(a) specifically require the treating physician’s report to cite the applicable Medical Treatment Utilization Schedule provisions? In Sandoval v. San Diego Unified School District , 2016 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB, affirming the WCJ, held that the...