Calif Edition Banner March 2010
Vol 1, Issue 12

Find Solutions & Strategies                                 April 12, 2010

Medical Provider Network Litigation
 Employer allowed to litigate transfer of applicant to MPN after failing to properly notice applicant of requirement to treat within MPN
In This Issue
* PANEL DECISIONS: MPN, offer of work. social security, autopsy
* FEATURED ARTICLE: donut hole
* BLOG ROUND UP: fraud, CCC's, techshow, migraines
* NEWS HEADLINES: football, health care reform, social security backlog, OSHA
* LARSON'S: 50% Off Sale

A Note From the Editor

Robin Kobayashi
Dear WC Professionals:
For the last two weeks, some of you have had problems accessing the panel decisions. I've included new links for these cases in today's enewsletter (see box immediately below). Also, if you have any problems accessing your account on the new web center, please email me and we will fix it for you. Thanks for your patience as we work out the kinks in the migration to our new site.
Robin E. Kobayashi, J.D.
LexisNexis Editorial & Content Development

New Links for Panel Decisions

Here are new links for the panel decisions reported in the last two issues of the eNewsletter:


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recent panel decisions - sneak preview
Check out these recent panel decisions that we're considering for the LexisNexis® services:
NOTE:  If you have any problem accessing cases, please email me at
Medical Provider Networks; Transfer of Care; Notice Requirements. Defendant was not barred by doctrine of res judicata from litigating issue of whether it properly transferred applicant's medical care for into its MPN pursuant to Rules 9767(g), 9767.9 and 9767.10, notwithstanding prior finding by WCJ that applicant could self-procure treatment outside MPN because defendant did not provide proper notice of MPN under Rule 9767.12, when first trial involved issue of notice and subsequent trial involved transfer of care, which applicant did not dispute. See Anderson panel decision.
Permanent Disability; Offers of Regular, Modified, or Alternative Work. Defendant was not entitled to 15% decrease under LC 4658(d)(3)(A) in permanent disability indemnity awarded to applicant because defendant's offer of modified work was not made on form prescribed by Rule 10133.53 and did not substantially comply with LC 4658(d)(3)(A), as offer did not specify that work would last at least 12 months, was not executed under penalty of perjury, and was not made within 60 days of applicant becoming permanent and stationary. See Mansfield panel decision.
Credit; Temporary Disability Indemnity; Social Security. Applicant with injury to both knees, low back and in form of hearing loss did not take himself out of labor market by applying for social security benefits and SCIF was not entitled to offset liability for temporary disability indemnity owed to applicant against his social security benefits. See Alexander panel decision.

Discovery; Petition to Compel Autopsy. WCAB denied defendant's petition to compel autopsy of decedent who died following surgery necessitated by industrial left arm injury, when defendant failed to make an adequate showing of need for an autopsy. See Brunk panel decision.
featured article: THE donut hole

Teddy SnyderWhat You Need to Do Now About the Medicare Set-Asides in Your Files. Teddy Snyder at Ringler Associates discusses the effect of the Affordable Health Care For America Act on Part D MSA Allocations, and how MSAs should be fixed now to account for the closure of the Medicare Part D prescription coverage gap aka the "donut hole". Read it.

Fraud Sign
Workers' Comp Fraud Blotter 4/8/2010 recent arrests, charges, convictions, investigations. Former insurance broker sentenced to 10 years in prison. Cigarette shop owners plead innocent to workers' comp, weapons, and drug charges. 
Cal Comp Cases
Cal. Comp. Cases March Issue. The March 2010 issue is now on Barba, Chavez, City of Laguna Beach v .CIGA, Coito, Interstate Fire and more.
Cal Comp Cases
Cal. Comp. Cases April Advanced Postings 4/6/2010. Permanent disability, Penalties, Statute of limitations.
Howard Stevens
Getting a Panel on a Denied Case in California. Howard Stevens at McDermott & Clawson LLP, examines the confusion over the effect of Rule 30 on denied cases.
Robin Kobayashi
What They Saw at the ABA TechShow 2010 - 40 of the Best Commentaries and Resources. Robin E. Kobayashi of LexisNexis has rounded up 40 of the best blogs, podcasts, documents, and videocasts that summarize the lessons, experiences, and takeaways from this year's TechShow. 
Rebecca ShaferIncluding Migraines in Wellness Programs May Reduce Workplace Injuries. Reprinted from Workers' Comp Kit Blog, this article examines common misconceptions about migraines and how to diagnose them. 
news headlines
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