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WCAB En Banc Decision Rules Medical Reports From Non-MPN Physicians Are Inadmissible

WCAB EN BANC DECISION[1] RULES MEDICAL REPORTS FROM NON-MPN PHYSICIANS ARE INADMISSIBLE AND MAY NOT BE RELIED UPON TO AWARD COMPENSATION In a decision which can only be characterized as “stunning,” the WCAB has filed an En Banc Decision after Reconsideration in the case of Elayne Valdez v. Warehouse Demo Services, declaring that the medical […]

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What are the implications of the 15% “UP and Down” Lab C 4658(d)(2)?

How Confusing Can This Be? There are perhaps few other provisions of the SB 899 reforms, which have caused a wider level of confusion and misunderstanding, than the so-called 15% PD “bump up/bump down” provisions of the PD statute, which were grafted onto to Labor Code 4658, under the 2004 era reforms. For starters, we […]

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Welcome to 2012!

A BRIEF SUMMARY OF NEW LAWS TAKING EFFECT, SOME CASE DECISIONS OF 2011, AND SOME PRACTICE SUGGESTIONS By Corey A. Ingber Copyright © 2012 Corey A. Ingber. All Rights Reserved. New laws that take effect 1-1-12i AB 228 – SCIF MAY INSURE TEMPORARY OUT-OF-STATE EMPLOYEES: Amends the California Insurance Code to authorize the State Compensation […]

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What actions, if any, should be taken when we are still getting medical reports from out-of-network physicians?

WHAT ACTIONS, IF ANY, SHOULD BE TAKEN WHEN WE ARE STILL GETTING MEDICAL REPORTS FROM OUT-OF-NETWORK PHYSICIANS? HOW DO WE DETERMINE WHETHER WE HAVE A DEFENSE? Please recall the WCAB En Banc decision in Valdez v. Warehouse Demo Services/Zurich [ADJ7048296] where on 4/20/11, the WCAB Commissioners, with two partially dissenting opinions, held that where unauthorized […]

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The WCAB has issued a Panel Decision in the case of Laury v. SCIF

March 28, 2010 WCAB PANEL DECISION UPHOLDS THE USE OF SECTION 15.13 OF THE GUIDES [Figure 15-19] TO SUPPORT AN ALMARAZ/GUZMAN II DETERMINATION (Using Apples to Make Banana Pie and then calling it Red Velvet Cake) The WCAB has issued a Panel Decision in the case of Laury v. SCIF (ADJ3400378).  While Panel Decisions are […]

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Reasonably Required Interpreting Services Permitted During Medical Treatment

Subject to Proof—Interpreting Services are Now Deemed an Essential Adjunctive to the Provision of MedicalTreatment under Lab C 4600 and are therefore Potentially Recoverable as an Element of Treatment The WCAB has issued an En Banc decision in the case of Jose Guitron v. State Compensation Insurance Fund.i Please note that en banc decisions are […]

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New DWC Regulations go into effect 10-08-10

This is inform that there are new DWC Regulations which have revised the written information employers are required to provide its employees with respect to their Medical Provider Networks (MPNs) and access to same in case of a work-related injury. These new regulations would therefore apply only to dates of injury occurring on or after […]

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What about that Regulation No. 30?

On February 17, 2009, new regulations governing the QME process became effective, though without much fanfare, let alone controversy Imbedded within these 97 pages of revised regulations is the so-called “Regulation No. 30,” which has been the subject of mounting concerns and growing frustration as claims professionals cope with yet a new set of oversight […]

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Chronic Pain Treatment Guidelines Take Effect

Date: June 26, 2009, Volume: 09-5, Number: 02 On July 18, 2009, the new Chronic Pain Treatment Guidelines will take effect as part of the Medical Treatment Utilization Schedule (“MTUS”) under Labor Code 5307.27. The regulations governing these new treatment guidelines are 34 pages long. However, the actual guidelines span some 127 pages with an […]

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Supreme Court Rules on Smith/Amar

Date: May 11, 2009, Volume: 09-5, Issue: 01 Today, the California Supreme Court issued its decision in the Smith/Amar cases. Please recall these cases involved the issue of whether after a stipulated award for future medical care, if an employer applies utilization review and therefore raises the reasonableness issue of specific care, is that action […]

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