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Find Solutions & Strategies October 24, 2011 |
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 The PQME Process Runs Amok
A tragic-comedy unfolds in a physician deposition
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A Note From the Editor | |
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Dear WC Professionals:
Thanks to our contributors for this issue: Robert G. Rassp, Esq., Julius Young, Esq., and Richard Jacobsmeyer, Esq.
We're almost sold out of our 2010 Edition of the Medicare Secondary Payer handbook. Be sure to purchase your copy now at the discounted price of $145 so that you can get the 2011 Edition for free. The price for the 2011 Edition is going up to $185. See box below.
Sincerely,
Robin E. Kobayashi, J.D.
LexisNexis Legal & Professional Operations
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MSP SPECIAL OFFER | |
New 2011 Edition
Has Gone to Press!
New content includes
Calif. WCMSA Requirements
By Robert G. Rassp, Esq. | |
Buy the 2010 Edition for $145; Get the 2011 Edtiion FREE.
Alert! Only 28 copies of the 2010 Edition left. Act now to save $$.
To order, call 1-800-223-1940 and use Promotional Code JCM139695.
This offer ends 11/14/2011 or when the 2010 stock is depleted. |
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pqme process, by robert g. rassp, esq. | |
 The PQME Process Runs Amok - A Tragic-Comedy, by Robert G. Rassp, Esq.
This story is true. The names were changed to protect the guilty. This story is a great example of what is wrong with the panel QME process under Labor Code sections 4062.1 and 4062.2.
There are many cases where claims administrators are paying for medical reports and deposition testimony from panel QME physicians that are not substantial evidence and would not hold up before a trial judge or the WCAB. This results in delays of resolving medical issues in our cases and causes increased costs for the claims administrators and employers.
When a new evaluating physician has to be selected because of an incompetent panel QME physician you receive in the end longer and unnecessary periods of payments of TTD benefits and double the costs of medical-legal evaluations. Not to mention increased defense attorneys fees. > Read more. |
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baker redux, by julius young, esq. | |
 The California Supreme Court has spoken again about COLAs.
Call it Baker Redux.
In response to a Petition for Rehearing filed by San Jose attorney Arthur Johnson, the California Supreme Court issued a modified opinion that can be found here.
Johnson's Petition for Rehearing had noted that the Baker decision, issued in August 2011, used the term "seamless transition" in reference to the transition from temporary disability benefits (which have a COLA under Labor Code 4453) to permanent total disability benefits (which have a COLA in certain circumstances under Labor Code 4659(c).
> Read more. |
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baker modified, by RICHARD M. JACOBSMEYER, ESQ. |
 Supreme Court Declines Rehearing in Baker, Modifies Opinion Without Change in Result. The California Supreme Court has issued its decision denying the Petition for Rehearing filed by applicant in Baker v W.C.A.B. (XYZZX).
The court did make some modifications to its opinion that to some extent addressed the issues raised in applicant attorney's Petition but to some extent the Court's language suggests a lack of understanding of some aspects of workers' compensation. > Read more. |
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sneak preview: recent panel decision | |
Reminder: Practitioner should check the subsequent history of a panel decision before citing to it.
Permanent Disability; Rating; Total Disability. WCAB rescinded WCJ's finding that applicant with traumatic brain injury was entitled to award of 88 percent PD, after apportionment, based upon recommended rating, and held that applicant was entitled to an award of 100 percent PD without apportionment, when both AME and WCJ determined that applicant was totally precluded from open labor market, WCAB stated that cases of presumptive PTD under LC 4662 may be treated differently than cases in which there is a finding of PPD (up to 99.75%) under LC 4660, as evidence by fact that there are separate sections for computing disability payments in cases of partial disability (LC 4658(d)) and total disability (LC 4659(b)), that WCJ's finding of PPD was not supported by substantial evidence, and that in cases of presumed PTD pursuant to LC 4662, apportionment does not make sense unless percentage of PD could exceed 100 percent. See Edwards panel decision.
NOTE: This free eNewsletter reports only a handful of panel decisions each month. If you want notification of all 50 to 65 noteworthy panel decisions added each month to the Lexis database, please consider purchasing our new panel decisions reporter. Panel decisions are citeable, but not binding precedent. |
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| blogs at the lexisnexis workers' comp law community | |
Workers' Comp Fraud Blotter - Claimant Caught On Video Roofing Before Attending His Workers' Comp Hearing, by LexisNexis Workers' Compensation Law Community Staff. Read it.
 Rebuttal of the AMA Guides - Cal. Comp. Cases October Advanced Postings (10/21/2011). Here's the fourth batch of advanced postings for the October 2011 issue. Lexis.com subscribers can link to the complete headnotes and summaries. Read it.
 CWCI Summarizes 2011 California Workers' Comp Enacted Legislation, by California Workers' Compensation Institute. Read it.
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enewsletter archives | |
July 11, 2011: QME Regulations: Face to Face Meetings.
July 5, 2011: PQME Supplemental Reports.
June 20, 2011: Sanctions: Three-Cent Dispute.
June 13, 2011: A Balanced Approach to Litigation.
June 6, 2011: Post-Valdez Defense Protocols.
May 31, 2011: Stress-Related Compensable Consequence Injuries.
May 23, 2011: Developing the Record.
May 16, 2011: Overpayments.
May 9, 2011: Third Party Cases.
May 2, 2011: Temporary Total Disability.
April 25, 2011: Non-MPN Physician Reports.
April 18, 2011: 2011 Alphabet Soup.
April 11, 2011: Rule 38 and Medical Examiner Reports.
April 4, 2011: Penalties Post SB-899.
March 21, 2011: Workers' Comp and Earthquakes.
March 7, 2011: Mediation.
February 28, 2011: Arbitrations.
January 24, 2011 (addendum): Sanctions; EAMS rules.
January 24, 2011: Public Self-Insured Employers.
January 17, 2011: CHSWC Report on Liens.
January 10, 2011: Temporary Workers.
January 3, 2011: Permanent Total Disability & Total Loss of Future Earning Capacity.
CLICK HERE TO ACCESS 2010 ARCHIVES. |
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