Calif Edition Banner March 2010
Vol 1, Issue 45

Find Solutions & Strategies                           October 18, 2010

Name That Pill
Medications every lawyer and judge should know
In This Issue
* PANEL DECISIONS: Ex parte communications; MPNs
* BLOG ROUND UP: fraud, CCCs, Miceli, EDD statutory interest
* NEWS HEADLINES: Self-insurance plans

A Note From the Editor

Robin Kobayashi 2010
Dear WC Professionals:

Our new Medicare Secondary Payer Compliance book is selling like hotcakes, thanks to our enewsletter subscribers. Be sure to take advantage of the special discount offer while our book supply lasts. If you're an applicant's attorney, you need this book, too. See why below.

Robin E. Kobayashi, J.D.
LexisNexis Editorial & Content Development

Quick Links

50 States WC Agencies

EAMS Blogs Index (updated 9/27/2010)

featured article
Robert RasspMedications Every Lawyer and Judge Should Know, by Robert G. Rassp, Esq. The following chart lists the brand names or common and chemical names of drugs we regularly see in our cases embedded in medical-legal reports, pill stacked uptreating physician reports and subpoenaed medical records. Some physicians randomly use the brand names, and others use the chemical name, causing us mortals much frustration in determining exactly what drugs an injured worker is taking for what conditions. The information here can assist counsel in determining during a deposition of an injured worker or of a physician exactly what medication a person is taking and for what medical condition. Read more
recent panel decisions - sneak preview
Each week we report a few recent panel decisions that we're considering for the LexisNexis® services:

NOTE: This free eNewsletter reports only a handful of panel decisions each month. If you want notification of all 40 to 65 noteworthy panel decisions added each month to the Lexis database, please consider purchasing our new panel decisions reporter (see below).    

QMEs; Ex Parte Communications. WCAB denied applicant's petition for removal from WCJ's order admitting medical reports of panel QME over applicant's objection on basis that reports were inadmissible because panel QME's service of reports only on defendant constituted an ex-parte communication in violation of LC 4062.3, when WCAB found that even if panel QME's service of medical reports solely on defendant could be deemed an ex parte communication, such communication fell within the "insignificant and inconsequential" exception as set forth in Alvarez v. W.C.A.B. See Lenier panel decision.


Medical Provider Networks; Reasonable Geographic Area. WCAB affirmed WCJ's finding that applicant was not precluded from treating with MPN physician whose office was located approximately 51 miles from applicant's residence, as there is no express statutory or regulatory "reasonable geographic area" limitation for treatment by MPN physicians, and WCAB found that no such limitation could be implied based upon "reasonable geographic area" limitation for non-MPN treatment set forth in LC 4600 and Rule 9780(h), and that LC 4660.3 and Rule 9767.6(e) allow injured employees to treat with any MPN physician after the first visit without regard to where physician is located. See Menicucci panel decision.

why applicant's attorneys need to know about MEDICARE SECONDARY PAYER COMPLIANCe
> An applicant's attorney has exposure to Medicare for repayment as a "person in receipt of funds from the settlement". See recent Stricker case in which the court conferred a 6-year statute of limitations on that basis for recovery.

MSP seal> An applicant's attorney has exposure to his or her client if Medicare benefits are denied and the applicant didn't understand this at the time of settlement.

> An applicant faces off-set of SSDI payments, tax returns, or any other payment owed by the federal government to repay any medical payments owed.

> Defense counsel and claimant's attorneys share equally in the Medicare Secondary Payer burden until Medicare is made whole for any related payments rendered. (The only burden that the defense carries that is greater than the claimant's is MMSEA Section 111 reporting.)

Protect yourself from financial exposure and protect your clients. See below on how to order our MSP compliance book. Due to popular demand, the discount offer for eNewsletter subscribers has been extended through Oct. 31, 2010.
Take Control of Your Insurance Settlements With A Brand New Resource From LexisNexis!



"An excellent new book ... a one-of-a-kind resource ... [Jennifer C. Jordan's] straight-talk is much appreciated when it comes to this illusive area of the law"


- Rebecca Shafer, JD, President, Amaxx Risk Solutions, Inc.

There are many people who don't understand that the Centers for Medicare and Medicaid Services' approval process of a Medicare set-aside arrangement is voluntary and carries P1130 R12 coveran inherent cost. In fact, many of the decisions that need to be made in a settlement negotiation are risk management decisions rather than being truly Medicare Secondary Payer-oriented. Once you understand why CMS wants what it wants, you will realize that its preference may not be the only way to achieve MSP compliance. The Complete Guide to Medicare Secondary Payer Compliance, Jennifer C. Jordan, Editor-in-Chief, will help you take control of your insurance settlements. > Read more about the contents (1,350 pages). List Price: $179

 $145 (plus shipping & handling & applicable sales tax). Offer good through 10/31/2010.

Fraud SignWorkers' Comp  Fraud Blotter 10/14/2010 - recent arrests, charges, convictions, investigations. Read it.         


Cal Comp CasesCalifornia Compensation Cases October Advanced Postings 10/13/2010. Read it.

Shaw JacobsmeyerFinally - California Appellate Court Addresses Miceli Issue, by Richard Jacobsmeyer. Read it.

Goldman Magdalin KrikesCalifornia: Stepped-Up Enforcement of EDD Statutory Interest, by Goldman, Magdalin & Krikes. Read it.

NPD reporter banner

NEW! Designed especially for subscribers only, this monthly reporter saves you research time so that you can quickly find recent panel decisions on key topics.

Thumbs Up OCTOBER ISSUE NOW IN PRODUCTION: Guest contributors write about developing the record and range of evidence in AMA Guides cases.

We do the legwork for you: Our editorial consultants pour through hundreds of cases to find noteworthy decisions that you should know about.

What you get each month: Brief summaries of typically 40 to 65 cases, arranged by topic. Commentary articles written by guest contributors.
How you'll get it: (1) Word document (sent via email), which allows Lexis subscribers to link directly to the WCAB decisions on; and (2) Print version, which can be stored in a binder.

View sample: Click here

What it costs: Regular price - $199/yr. Special Limited Time Offer for eNewsletter subscribers - $159 for the first year's subscription. Offer expires 12/31/2010.


> CA: Workers' Comp System - "Trouble Brewing"
CA: DIR Moves To Strengthen Regulations Governing Self Insurance Plans and Increase Oversight Of Self Insured Groups
> CA: Corrosion Concerns Prompt Cal/OSHA To Inspect Refineries
> CA: Julius Young, Richard Jacobsmeyer Announce New Video Based Website
CA: CalChamber Warns Prop. 19 Marijuana Initiative Could Jeopardize Workplace Safety
CA: Governor Signs Law to Strengthen Cal/OSHA Citation Process
CA: Audit Finds L.A. City Attorney's Office Mismanaged Workers' Comp Claims
CA: DWC Announces No Change in TTD Rates for 2011
> CA:
AIA Says Escalating Medical Costs Undermining Workers' Comp Reforms
> It Pays To Keep Employees Fit
> SUNZ Insurance Company Adds Three More States To Coverage Area
> York Names Two Executives To Lead Sales For Growing Programs Division
Coventry Tackles Drug Repackaging, Reducing Prescription Drug Costs
PMA Announces White Paper on Injury Prevention in Healthcare Industry
> Dr's RTW Certificate Outweighs Employer's 'Common Sense' Concerns
> NCCI Study Shows Workers' Comp Claims Frequency Continues to Decline in 2009

P2548 CA WC HotDocs
Order the Forms
P1432 book cover
Order Today
Top 25 Blogs 2009
View the Honorees
80283 cover
Order Today
enewsletter archives
Take a deep dive into our past eNewsletters for 2010...warning - some links to articles may not any linking problems to

October 11, 2010
October 4, 2010
September 27, 2010
September 20, 2010
September 13, 2010
September 7, 2010
August 30, 2010
August 23, 2010
August 16, 2010
August 9, 2010
August 2, 2010
July 12, 2010
July 6, 2010
June 28, 2010
June 21, 2010
June 14, 2010
June 1, 2010

May 24, 2010

May 17, 2010

May 10, 2010

May 3, 2010

April 26, 2010

April 19, 2010

April 12, 2010

April 5, 2010

March 29, 2010

March 22, 2010

March 15, 2010

March 8, 2010

March 1, 2010

February 22, 2010

February 16, 2010

February 9, 2010

February 2, 2010

January 26, 2010 

LexisNexis and the Knowledge Burst logo are registered trademarks of Reed Elsevier Properties Inc., used under license. Other products or services may be trademarks or registered trademarks of their respective companies.

Privacy & Security Copyright © 2010 LexisNexis, a division of Reed Elsevier Inc. All rights reserved.