Calif Edition Banner March 2010
Vol 1, Issue 48

Find Solutions & Strategies                           November 8, 2010

California State flagGovernor-elect Jerry Brown 
Back to the future for workers' comp?
In This Issue
* PANEL DECISIONS: Penalties, Liens
* BLOG ROUND UP: fraud, CCCs, Lien hearing, Legislation, Prescription drugs
* NEWS HEADLINES: New Insurance Commissioner
* JOB POSTING: Defense attorney

A Note From the Editor

Robin Kobayashi 2010
Dear WC Professionals:

Viva Las Vegas! Hope to see you at the National Workers' Compensation & Disability Conference this week. Visit the MEDVAL Booth #924 to enter the raffle to win a free copy of The Complete Guide to Medicare Secondary Payer Compliance.

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

National Workers' Comp & Disability Conference

Las Vegas sign 1

November 10-12, 2010
Las Vegas Convention Center
Click here for info

Featured Speakers Include:
Robert G. Rassp, Esq.
(Executive Round Table)

John Duncan, DIR
Sean McNally, Tom Rankin
(Reform: The Calif. Experience)
featured article
Julius Young thumbnailJerry Brown, by Julius Young. The Meg Whitman campaign ended [Nov. 3], a spectacular failure. So Jerry Brown will soon be forming a gubernatorial team. At the victory celebration Tuesday night at Oakland's Fox Theater, a handful of prominent players in California workers' comp stopped by to savor the moment. Workers' comp isn't likely to be near the top of Brown's agenda, though rate issues could cause it to rise in importance. But within several months we'll see cabinet level appointments being made and we'll know who will be heading agencies such as the DIR. For a moment, let's look back at Brown's governorship of 30 years ago. What did he do in workers' comp? > 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).

Penalties; Delay in Authorization of Medical Treatment; Attorney's Fees. WCAB affirmed award of 25 percent penalty under LC 5814 for defendant's 45-day delay in authorizing medical treatment, when, although WCAB disagreed with WCJ's rationale that defendant's failure to authorize treatment within 10-day period pursuant to utilization review procedure was automatically unreasonable and subjected defendant to a penalty, WCAB agreed that delay in authorizing medical treatment from 3/31/2008 until time of 4/28/2008 Expedited Hearing justified imposition of penalty; WCAB, in a majority decision, rescinded WCJ's award of two attorney's fees under LC 5814.5--one for time applicant's attorney spent litigating issue of medical treatment and a separate fee for attorney's pursuit of penalty on delayed medical treatment--and found that only a single fee was justified because, pursuant to Ramirez v. Drive Financial Services en banc opinion, LC 5814.5 only allows fees for legal services rendered in enforcing an unreasonably delayed prior award, and not for any other purpose. See White panel decision.


Liens; Medical Treatment. WCAB held that lien claimant outpatient surgery center was barred by LC 4903.5(a) from recovering on its lien for services provided in 1/2005 to applicant with industrial injury ending on 10/11/2002, when, although defendant initially had notice that lien claimant provided medical treatment, lien claimant failed to respond after defendant paid less than full amount of lien claimant's bill and informed lien claimant that nothing further would be paid, lien claimant filed lien outside time limits set forth in LC 4903.5(a), defendant did not receive notice of lien until more than two years after lien was filed, and WCAB found that LC 4904(a) does not create an automatic "notice of lien" every time a defendant pays less than amount billed by lien claimant. See Segura panel decision.

Fraud SignWorkers' Comp  Fraud Blotter 11/4/2010 - recent arrests, charges, convictions, investigations. Read it.          


Cal Comp CasesCalifornia Compensation Cases October Advanced Postings 11/2/2010. Read it.

Goldman Magdalin KrikesPresiding Judge Jorja Frank Holds Hearing on Los Angeles WCAB District Office's Notice of Intent to Consolidate Durable Medical Equipment Liens, by Goldman, Magdalin & Krikes. Read it.

Goldman Magdalin KrikesPresiding Judge Jorja Frank Holds Second Hearing Nov 4th on Los Angeles WCAB District Office's Notice of Intent to Consolidate Durable Medical Equipment Liens, by Goldman, Magdalin & Krikes. Read it.

Goldman Magdalin KrikesGovernor Schwarzenegger Signs Multiple Bills Expanding Workers' Compensation Benefits for Public Safety Officers, by Goldman, Magdalin & Krikes. Read it.

CWCICWCI Study Finds Most California Workers' Comp Drugs Are in the Medi-Cal Fee Schedule. Read it.

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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


CA: New Heat Illness Regulations Now in Effect
CA: Opinion: Defeat of Marijuana Proposition Will Keep Workplaces Safe
CA: Chino Man Accused of Workers' Comp Fraud
CA: Laguna Hills Man Sentenced in One of the Largest Workers' Comp Fraud Cases in California History

> CA: Dave Jones Elected Insurance Commissioner

> CA: CAAA Announces New Legislative Team

> US Secretary Solis Renews Charter Of NSH Advisory Committee
Bullying In The Workplace
> NY Times Article on Drug Testing in the Workplace
> What Does Your Agent Expect You To Know About Your Experience Modification Factor?
> GOP to Renew Battle Over Reach of Health Care Reform
> Crawford & Company Announces Improved Results for 3Q
Cigna Reports 3Q Results
> Amerisafe Announces 3Q Results
> Eastern Insurance Holdings Announces 3Q Results
> Genex Agrees to Purchase Intracorp's Workers' Comp Unit
Coventry Health Care Reports 3Q Earnings
> AIG Reports $2.4B Loss Attributable to AIG in 3Q
Genentech's Secret Rebates to Doctors to Encourage Use of Costly Eye Drug
New Study Finds Type of Treatment as Primary Predictor of Return to Work
> New Book Highlights Injured Worker Woes: "Depraved Indifference: the Workers' Compensation System"

> British Columbia: Study Links Shift Work to Higher Risk of Injuries
> Australia: Public Servant Injured While Having Sex on Work Trip Battles for Workers' Compensation Benefits

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.


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.



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