• News Icon Published October 5, 2017

    Eight Medical Providers Suspended for Fraud by Division of Workers’ Compensation

    The California DIR’s Department of Workers’ Compensation (DWC) has suspended an additional 8 medical providers who were found guilty of fraud. Orders of Suspension from California’s workers’ compensation system were filed against the following medical providers: Abraham Khorshad – This Beverly Hills investor in Aspen Medical Resources was also a co-conspirator with providers Jeffrey Campau and … Continued

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  • News Icon Published September 27, 2017

    400 QMEs File Lawsuit Claiming License Terminated by DIR Without Hearings

    Three former qualified medical evaluators (QMEs) who were denied re-appointment are suing the Department of Industrial Relations (DIR) and its director Christine Baker for using “underground regulations” to deny them re-appointment.

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  • News Icon Published September 20, 2017

    Medicaid Systems Able to Pursue Full Settlement Amounts on Oct. 1

    As the result of a federal law effective October 1, state Medicaid systems will likely intensify their efforts to collect money they’re owed from workers’ compensation settlements. 

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  • News Icon Published August 29, 2017

    California DWC Posts Searchable Database of Liens Dismissed by Operation of Law

    The California DIR’s Department of Workers’ Compensation (DWC) has posted a searchable database of liens dismissed by operation of law.

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  • News Icon Published June 5, 2017

    10 Attorneys and 6 Cappers Charged in Massive Workers’ Compensation Insurance Referral Scheme

    Charges have been filed against 10 attorneys and six cappers in a multi-million dollar workers’ compensation insurance referral scheme in Orange County.

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  • News Icon Published May 2, 2017

    Apportionment and Genetic Factors of Disability

    The Court of Appeal, Third Appellate District, in City of Jackson v. WCAB (Rice) (4/26/17), has issued a decision that will provide substantial assistance in achieving the Legislature’s directive in Labor Code Section 4663 with respect to apportionment.

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  • News Icon Published April 20, 2017

    State Charges 26 in $40 Million SoCal Kickback Scheme

    Orange County prosecutors recently charged 26 business owners, pharmacists, and doctors in a $40 million kickback scheme in Southern California.

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  • News Icon Published February 10, 2017

    Aguilera v. Collins Chiropractic Group

    In a recent decision, the Workers’ Comp Appeals Board affirmed its prior decision in Aguilera v. Collins Chiropractic Group which said that a plaintiff’s industrial injury caused only 88% permanent disability rather than the 100% determined by the Workers’ Comp Judge.

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  • News Icon Published February 8, 2017

    Gilpin v Porterville USD 2017 Cal. Wrk. Comp. P.D. LEXIS 4

    Gilpin filed two actions against two separate employers. One of the defendants filed a Petition for Consolidation.

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  • News Icon Published January 27, 2017

    Maxham v California Department of Corrections Clarifies Agreed Medical Examiner (AME) Distinction

    When is a communication not information? Is there a distinction between the two or are there consequences from a failure to correctly categorize? The Workers’ Compensation Appeals Board, in its January 23, 2017 En Banc Decision in Maxham v California Department of Corrections, has provided the answers.

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  • News Icon Published January 20, 2017

    DIR Stays 200,000 Liens with Claimed Value of $1 Billion

    The Department of Industrial Relations (DIR) announced on January 18, 2017 that it stayed 200,000 liens worth more than $1 billion in an effort to prevent ongoing workers’ compensation fraud.

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  • News Icon Published December 15, 2016

    Billing Fraud

    As reported by workcompcentral, The Division of Workers’ posted proposed emergency regulations to implement the legislative mandate to suspend doctors convicted of billing fraud or harming patients.

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  • News Icon Published November 23, 2016

    Your MPN May Still Be Valid, Despite a Lack of Multiple Physicians

    Maria Soto v. Sambrailo Packaging, Zenith Insurance Company, 2016 Cal. Wrk. Comp. P.D. LEXIS 26, a panel decision, reaffirms the WCAB’s recent trend of finding valid MPN access standards where there are no physicians available within applicant’s preferred specialty.

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  • News Icon Published November 16, 2016

    Petitions for Dismissal for Failure to Appear

    In Nunez v Petrochem Insulation, Inc, 2016 Cal. Wrk. Comp P.D. LEXIS, the Court was presented with a scenario which did not result in the achievement of the objective of the California Constitution, Article 16, that cases be resolved expeditiously, inexpensively and without encumbrance of any character.

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  • News Icon Published November 11, 2016

    UR IMR versus MPN IMR

    On October 13, 2016, applicant attorney filed a Petition for Writ of Review to the 4th DCA in Parrent v. Workers’ Compensation Appeals Board/Pacific Bell Telephone Co. SBC, Case Number D071162, with the defendant filing an Answer on November 7, 2016.

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  • News Icon Published October 31, 2016

    What Is A Good Faith Personnel Action

    A WCAB panel clarified that not all actions taken by an employee are considered “personnel actions” under LC3208.3(h) in Ferrell v. County of Riverside 2016 Cal. Wrk. Comp PD Lexis.

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  • News Icon Published October 31, 2016

    A Penalty Under LC5814 Is Possible For Unreasonable Delay of SJDB Vouchers But Only On the Amount Actually Delayed

    The WCAB has issued several cases recently in which they essentially state that LC § 5814 does apply to the unreasonable delay/denial of supplemental job displacement benefits, but the penalty of up to 25% is only on the amount actually used by the applicant, not the entire amount.

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  • News Icon Published October 31, 2016

    Three Physicians In Any Specialty Are All That Is Needed For A Valid MPN

    In a split panel decision of Luna v. The Home Depot, the WCAB stated that the defendant’s MPN is valid even though it did not have three orthopedists within the applicable geographic radius to act as primary treating physician (PTP).

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  • News Icon Published October 23, 2016

    Independent Medical Review (IMR)

    One of the hallmark provisions of the most recent statutory amendments to the Labor Code, Independent Medical Review (IMR) has generated much litigation and even more speculation as to its ramifications and ultimate constitutionality.

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  • News Icon Published October 23, 2016

    SCIF v. WCAB (Margaris) 2016 Cal. App. LEXIS 491 (DCA opinion on 6/22/16)

    As noted above and in previous Quarterly Reviews, SB 863 continues to generate controversy, the California workers’ compensation community is still trying to make sense of UR/IMR and learn how to incorporate the basic process into their practice.

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  • News Icon Published June 14, 2016

    A Look at “Predominant Cause” for Psychiatric Injuries”

    In State of California/Department of Corrections & Rehabilitation v. WCAB (Van Dyk) (2016) 81 Cal. Comp. Cases 458, Applicant had a specific injury to the lumbar spine, which settled. A CT claim was subsequently filed, alleging injury to his back and psyche.

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  • News Icon Published June 14, 2016

    Doctors Cannot Circumvent the AMA Guides

    Moten v. City of Los Angeles 2015 Cal. Wrk. Comp. P.D. LEXIS 566: In this unanimous panel decision, the applicant was evaluated by an AME who diagnosed multiple ailments. On cross-examination, the AME changed his impairment rating for the lumbar spine from 2% WPI to 20% WPI apparently taking into account the applicant’s loss of function and utilizing Almaraz/Guzman.

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  • News Icon Published June 10, 2016

    A “Violent Act” Is Not Limited to Criminal or Quasi-Criminal Activity

    Larsen v. Securitas Services 2016 Cal.Wrk.Comp. PD Lexis – (Appeals Board Noteworthy Panel Decision): The WCJ found that Applicant’s psychological permanent disability resulted from a “violent act” in accordance with Labor Code §4660.1(c)(1) and was compensable.

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  • News Icon Published March 21, 2016

    Movie Extra Gets Lost and Dies – Industrial Causation found

    New CAPPS LLC v. WCAB, Daniel Harris (Dec’d), Victoria Harris (Widow), 2016 Cal.Wrk. Comp: Decedent, who was employed as a movie extra by a production company, was found dead in his car on 10/1/12 almost 14 hours after leaving the movie set and approximately one-half mile from the road to the movie production base-camp where he was working.

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  • News Icon Published March 21, 2016

    An Alcoholic Death – Industrial Causation Found

    City of Stockton v. WCAB, Andrew Prouty (Dec’d), Theresa Prouty (Widow), 2016 Cal. Wkr. Comp.: Decedent, while employed as a firefighter, sustained and admitted injury to his low back on 9/12/2006.

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  • News Icon Published March 21, 2016

    C&R Settlement Language

    Johns Mansville v. WCAB (Cooper) 2016 Cal.Wrk.Comp LEXIS 2 (W/D): After settling an asbestos related case involving lungs and respiratory system by way of CNR, applicant died and his widow was allowed to bring another claim against same defendant.

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  • News Icon Published March 21, 2016

    No Penalties Due To “colorable Basis” For Denial

    In ARS Construction, et al v. Worker’s Compensation Appeals Board, Wayne Davis, Respondents, the Board, in a split decision, found defendant’s delay in providing workers compensation benefits, arguing the panel QME report did not constitute substantial medical evidence, did not warrant the imposition of penalties after an ultimate AOE/COE finding following trial.

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  • News Icon Published March 21, 2016

    Scheduling a PQME Re-evaluation in 60 days

    Lopez v. Hemington Landscape discusses the 60 day requirement as it relates to PQME re-evaluations.

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  • News Icon Published February 10, 2016

    Codefendant obtaining its own PQME

    In Chanchavac v. LB Industries, Inc., the WCAB held that a codefendant was entitled to obtain its own PQME evaluation in a continuous trauma injury for which they both had coverage even though the other codefendant had already secured such an evaluation when there was no election against either defendant.

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  • News Icon Published February 10, 2016

    Proper Deferral of Utilization REVIEW

    Millette v. 81 Grand holdings, Inc. (writ denied) is a good overview of what is necessary for a proper deferral of utilization review.

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