May 22, 2023

CWCI Spotlights Low-Volume/High-Cost Dermatologicals, Opioids & Antidepressants

Oakland, CA – Part II of a California Workers’ Compensation Institute (CWCI) research series on low- volume/high-cost drugs used to treat California injured workers identifies three Dermatological drugs, three Opioids, and three Antidepressants that represent a relatively small share of the prescriptions within their therapeutic drug group, but due to high average reimbursements, have become cost drivers, consuming a...

May 16, 2023

California: When QME in One Specialty Defers to Other Specialties

Here’s a noteworthy panel decision in which the Appeals Panel ordered additional panel QMEs. Read our headnote below. CA - NOTEWORTHY PANEL DECISIONS Copyright 2023 by Matthew Bender & Company, Inc. Rochelle Boyd , Applicant v. Visser, National Interstate Richfield, Defendants W.C.A.B. No. ADJ11629744—WCAB Panel: Commissioners Dodd, Capurro, Deputy Commissioner Schmitz Workers’ Compensation...

May 15, 2023

CWCI Report Provides A Detailed Look at California WC Medical Dispute Resolution

Oakland, CA – As state lawmakers debate legislation that revisits the California workers’ compensation medical dispute resolution process, a new California Workers’ Compensation Institute (CWCI) Report to the Industry finds that the number of independent medical reviews (IMRs) used to resolve medical disputes hit a record low in 2022 as prescription drug disputes continue to decline, and that a small subset of doctors...

May 11, 2023

California: Permanent Disability Rating and Pyramiding

Here’s a noteworthy panel decision on permanent disability rating and pyramiding. Read our headnote below. CA - NOTEWORTHY PANEL DECISIONS Copyright 2023 by Matthew Bender & Company, Inc. Terri Glasgow , Applicant v. Massie Diagnostic Imaging, State Compensation Insurance Fund, Defendants W.C.A.B. Nos. ADJ1651527 (SBR 0314707)—WCAB Panel: Commissioners Dodd, Capurro, Snellings Workers’...

May 03, 2023

California: Burden of Proof in COVID-19 Injury AOE/COE Case

Here’s a noteworthy panel decision in which the WCAB rescinded the WCJ’s decision in a COVID-19 injury AOE/COE case, where the COVID-19 presumption of injury did not apply. Our case headnote is below. CA - NOTEWORTHY PANEL DECISIONS Copyright 2023 by Matthew Bender & Company, Inc. Elsa Garcia, Joffre Garcia (Deceased) , Applicant v. U.S. Bank, Old Republic, Defendants W.C.A.B. No. ADJ14627934—WCAB...

April 27, 2023

California: Dual Employment in the Context of PEO Lease-Back Situations

Here’s an interesting noteworthy panel decision that addresses the issue of dual employment in the context of PEO lease-back situations. Our headnote is set forth below. CA - NOTEWORTHY PANEL DECISIONS Copyright 2023 by Matthew Bender & Company, Inc. Jesus Ortega Gonzalez , Applicant v. Major Transportation Services, Inc., a California Corporation, Baljinder S. Gill, individually, and dba Major Express...

April 20, 2023

California Compensation Cases April 2023

CALIFORNIA COMPENSATION CASES Vol. 88, No. 4 April 2023 A Report of En Banc and Significant Panel Decisions of the WCAB and Selected Court Opinions of Related Interest, With a Digest of WCAB Decisions Denied Judicial Review CONTENTS OF THIS ISSUE LexisNexis Online Subscribers: You can link to your account on Lexis+ to read the complete headnotes and court decisions, en banc decisions, writ denied summaries, panel...

April 20, 2023

California: Progressive Insidious Diseases

Here’s a brief summary of a recent noteworthy panel decision that addresses the issue of progressive insidious diseases. CA - NOTEWORTHY PANEL DECISIONS Copyright 2023 by Matthew Bender & Company, Inc. Elizabeth Arbogast , Applicant v. California Highway Patrol, legally uninsured, administered by State Compensation Insurance Fund, Defendants W.C.A.B. No. ADJ9509417—WCAB Panel: Commissioners Capurro...

April 12, 2023

California: Sleep Disorder and the AMA Guides

Here are our headnotes for a recent noteworthy panel decision on sleep disorder and the AMA Guides. CA - NOTEWORTHY PANEL DECISIONS Copyright 2023 by Matthew Bender & Company, Inc. Karen Miller , Applicant v. State of California, Ventura Youth Correctional Facility, legally uninsured, adjusted by, State Compensation Insurance Fund/State Contract Services, Defendants W.C.A.B. Nos. ADJ8181938, ADJ8702275—WCJ...

April 05, 2023

California: Claim Not Barred by Going and Coming Rule; Premises Line Rule Applied

In a recent noteworthy panel decision, the applicant’s injury was not barred by the “going and coming rule” because her claim fell within the premises line rule. Here’s our headnote and the PDF for the decision. Ricarda Duran, aka Sonia Tineo Toledo, Applicant v. Priority Workforce, Inc. dba MVP Payroll Financing LLC, LCF Priority Business Services Inc., United Wisconsin Insurance Company administered...

March 27, 2023

The Current Status of the Law on Medical Marijuana Reimbursement in Workers’ Compensation

By Albert B. Randall, Jr. & Samantha L. Schilling, Franklin & Prokopik, P.C., Baltimore, MD Although marijuana remains illegal under federal law as it is classified as a Schedule I drug in the Controlled Substances Act (“CSA”), as of January 2023, 37 states, as well as the District of Columbia, have enacted state legislation allowing for the medical use of cannabis (hereinafter referenced as “medical marijuana...

March 27, 2023

California Compensation Cases March 2022

CALIFORNIA COMPENSATION CASES Vol. 88, No. 3 March 2023 A Report of En Banc and Significant Panel Decisions of the WCAB and Selected Court Opinions of Related Interest, With a Digest of WCAB Decisions Denied Judicial Review CONTENTS OF THIS ISSUE LexisNexis Online Subscribers: You can link to your account on Lexis+ to read the complete headnotes and court decisions, en banc decisions, writ denied summaries, panel...

March 26, 2023

Castellanos: Rethinking the California Legislature’s Plenary Power Vis-à-vis Workers’ Compensation

By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board Article XIV section 4, California Constitution: The Legislature is hereby expressly vested with plenary power, unlimited by any provision of this Constitution, to create, and enforce a complete system of workers’ compensation, by appropriate legislation, and in that behalf to create and enforce...

March 20, 2023

CWCI Documents Recent California Workers’ Comp Professional Medical Service Treatment Patterns

Oakland, CA – A new study finds treatment patterns for California workers’ comp professional medical services have stabilized in recent years, with only minor changes in the utilization rates and volume of services rendered to injured workers within the first two years for indemnity claims with 2014 through 2019 initial treatment dates, and within the first six months for indemnity claims with 2018 through 2021 initial...

March 13, 2023

California: Does an Employer Have a Right to Remain as a Party Defendant?

When a worker sustains an industrial injury, the normal procedure is for that employee to file a claim. Next, the employer conducts proper administrative tasks and promptly alerts their insurer. The insurance company then takes the necessary steps to insert themselves into the litigation process in place of the employer and proceeds to defend the claim. Pursuant to Labor Code § 3755 , this “action” by the insurer releases...

March 07, 2023

California Jurisdiction over Industrial Injury Claims of Professional Athletes: The Saga Continues

By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, Workers’ Compensation Appeals Board The primacy of the Workers’ Compensation Appeals Board (“Appeals Board) over extra-territorial industrial injuries sustained by California residents is sacrosanct. In no uncertain terms, Labor Code § 5305 confirms the Appeals Board’s jurisdiction over all controversies over injuries sustained outside of...

March 01, 2023

Effect of Behavioral Health Issues on Injured Workers Returning to Work: Chronic Pain, PTSD, COVID-19 & More

By Joseph D. Dougherty, J.D. One of the primary goals of the workers’ compensation system is to return the injured worker to a productive life. And yet, this objective is sometimes lost with many state legislatures focused on reducing workers’ compensation costs. Addressing behavioral health care needs of workers is now more important than ever, given the surge in the most commonly occurring mental health problems for...

March 01, 2023

California Compensation Cases February 2023

CALIFORNIA COMPENSATION CASES Vol. 88, No. 2 February 2023 A Report of En Banc and Significant Panel Decisions of the WCAB and Selected Court Opinions of Related Interest, With a Digest of WCAB Decisions Denied Judicial Review CONTENTS OF THIS ISSUE © Copyright 2023 LexisNexis. All rights reserved. LexisNexis Online Subscribers: You can link to your account on Lexis+ to read the complete headnotes and court...

February 28, 2023

CWCI Research Series Highlights Low-Volume/High-Cost Meds in California Workers’ Comp

Oakland, CA – Part I of a new California Workers’ Compensation Institute (CWCI) research series on low-volume/high-cost drugs used to treat injured workers in California spotlights a handful of Anti-Inflammatory and Anticonvulsant medications that account for a relatively small share of the prescriptions within their therapeutic drug groups, but that have become significant cost drivers by consuming a disproportionately...

February 28, 2023

California: Employment Status of Inmate Workers: How They Are Protected and How They Are Not

In December 2022, the Workers’ Compensation Appeals Board (WCAB) issued four panel decisions that defined the parameters for analysis of the employment status of inmate workers for the purposes of determining whether these inmate workers are entitled to the protections of workers’ compensation and other labor laws. ( Garcia, Castaneda, Chaparro v. County of Fresno (December 30, 2022) [ 2022 Cal. Wrk. Comp. P.D. LEXIS...

February 24, 2023

California: Treatment Outside the Medical Provider Network

A New Twist to a Perplexing Problem By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, Workers’ Compensation Appeals Board Ever since Labor Code section 4600 was amended authorizing employers to satisfy their obligation to provide medical care to their industrially injured employees through an established medical provider network (“MPN,” see Lab. Code §§ 4600 (c), 4616 ), there have been...

January 30, 2023

Long COVID Prevalence Among Workers: Impacts on Workers’ Compensation

By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board Three years ago we were just becoming acquainted with SARS-CoV-2, the virus that causes COVID-19. We hadn’t yet heard the terms, “long COVID,” “long-haulers syndrome,” or “post-acute COVID.” Today, we know that some patients infected with COVID-19 develop recurring or new symptoms weeks or months...

January 30, 2023

California Compensation Cases January 2023

CALIFORNIA COMPENSATION CASES Vol. 88, No. 1 January 2023 A Report of En Banc and Significant Panel Decisions of the WCAB and Selected Court Opinions of Related Interest, With a Digest of WCAB Decisions Denied Judicial Review CONTENTS OF THIS ISSUE © Copyright 2023 LexisNexis. All rights reserved. LexisNexis Online Subscribers: You can link to your account on Lexis+ to read the complete headnotes and court decisions...

January 11, 2023

CWCI Study Tracks Trends in the Utilization of Inpatient Care in California Workers’ Comp

A new California Workers’ Compensation Institute (CWCI) study finds that after across-the-board declines in California inpatient hospitalizations during the COVID-19 heath crisis of 2020, the number of inpatient stays paid under Medicare, Medi-Cal, and private coverage all began to rebound in 2021, but the number of workers’ compensation hospitalizations fell an additional 5.7%. The latest results come from a CWCI study...

January 11, 2023

The Top 10 Bizarre Workers’ Comp Cases for 2022

© Copyright 2023 by Thomas A. Robinson, workcompwriter.com . All rights reserved. Reprinted with permission. As I have noted early each January for many, many years now, prior to the death of my mentor and friend, Dr. Arthur Larson, the original author of the oft-cited Larson treatises in workers’ compensation law (and in employment discrimination law, as well), Arthur and I began a quirky—though humorous—New Year’s...