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Vol 2, Issue 50

Find Solutions & Strategies                        December 12, 2011

Top 10 Gold2011: The Year in Review
Top 10 Workers' Comp Events, Top 10 Noteworthy Panel Decisions on Liens & more
In This Issue
* NEWS HEADLINES: Baker named Director DIR; Caplane named Chair of WCAB

A Note From the Editor

Robin Kobayashi 2010

Dear WC Professionals: 


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Robin E. Kobayashi, J.D.
LexisNexis Legal & Professional Operations

Herlick Handbook, 2012 Ed.

 New 31st Edition

Available Late Dec. 2011

Educating the WC Community Since 1964


New Editors-in-Chief:

Richard Jacobsmeyer, Esq. Julius Young, Esq.

Barry Bloom


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Happy Holidays

Mona Lisa


top 10 workers comp events

Robert Rassp grayThe Top 10 Workers' Compensation Events in California, by Robert G. Rassp, Esq. The year 2011 has been noteworthy for many events in our workers' compensation system and as much for events that did not occur. So this year, we will add a bonus - the Top Five Events In 2011 That Did Not Occur But Should Have in our workers' compensation system in California. But first, we will share our totally arbitrary, un-scientifically based, non-parametric, not evidence based, and completely anecdotal analysis of the top ten workers' compensation events in California in 2011. That last sentence perfectly describes the AMA Guides, doesn't it? But we digressed, so here goes: 

  1. The Final Decision in Wanda Ogilvie vs. City and County of San Francisco, or "Ogilvie III"
  2. New Faces at the DIR, DWC and Governor's Offices.
  3. Valdez vs. Warehouse Demo Services, MPN Anyone?
  4. Messele vs. Pitco
  5. Baker vs. Workers' Compensation Appeals Board and the "Supremes".
  6. Lien on Me
  7. WCAB Office Vacancies
  8. State Compensation Insurance Fund Lays Off 25% of Its Staff
  9. VR Expert Witnesses Are Back!
  10. What Do We Call The Place Where WCJs Work?

> Read the details.

10 noteworthy panel decisions on liens

P1652 sealHere are our picks for this year's top 10 noteworthy panel decisions involving liens. Thank you to the staff of the California WCAB Noteworthy Panel Decisions Reporter for all your hard work and dedication. subscribers can link to the cases to read the decisions.


1. Maria Cortez v. El Taco De Mexico, 2011 Cal. Wrk. Comp. P.D. LEXIS 13

Liens--Repackaged Pharmaceuticals--WCAB affirmed WCJ's finding that reasonable charge for repackaged medications provided by lien claimant to applicant/cook with injuries to abdomen and in form of hernia on 4/15/2003 and during period 7/2000 through 7/19/2003 was 58 percent of charges billed, when medication was provided to applicant between 8/13/2003 and 4/25/2006, 2003 Official Medical Fee Schedule did not apply to medications provided, and WCAB calculated reasonable rate of reimbursement as 58 percent based upon lien claimant's assertion that it was entitled to full reimbursement of charges, averaged with an adverse inference of zero cost based upon provider's "usual charge" and defendant's history of payment at 66 percent.


> Read the complete list with headnotes.

top 10 workers comp fraud news

Fraud MagnifierWorkers' compensation fraudsters come in all shapes and sizes. Here are 10 news stories from 2011 that caught our eye:

1. Grandpa Used Granddaughter to Sell His Workers' Compensation Drugs

2. Claimant Caught On Video Roofing Before Attending His Workers' Comp Hearing

3. Police Officer Who Shot Himself to Be Fired After Guilty Verdict

4. "Ax Men" Reality Star Pleads Not Guilty to Theft of Disability and Pension Benefits


> Read the complete list with details.

blogs at the lexisnexis workers' comp law community 


Fraud Sign

Workers' Comp Fraud Blotter -  Business Owner Not So Clean After Arrest For Insurance Fraud, by LexisNexis Workers' Compensation Law Community Staff.  Read it.    




Cal Comp CasesApportionment and Fibromyalgia: California Workers' Comp Case Roundup (12/8/2011). The Cal. Comp. Cases cites are now available for the November 2011 issue of California Compensation Cases. Read it.



Cal Comp CasesMissing Exhibits Tie Up Case: Cal. Comp. Cases December Advanced Postings (12/8/2011). Here's the second batch of advanced postings for the December 2011 issue of Cal. Comp. Cases. Read it.



Workers' Comp Executive:

FLASH: Is State Fund's Dividend Plan Illegal?

Copyright 2011 Providence Publications, LLP. All rights reserved. Reprinted with permission.


Other News:

CA: Governor Appoints Christine Baker Director of Dept of Industrial Relations.

CA: Governor Appoints Ronnie Caplane Chair of Workers Comp Appeals Board.

CA: Employers' Stephen Festa Named Vice Chair of CIGA.

CA: DWC Medical Unit Revised Panel Rules Pending Messele Decision.

CA: Unemployment Insurance Fund Debt Means Higher Federal Taxes for Employers.

CA: State's New Independent Contractor Law Increases Stakes for Employee Misclassification.

CA: Court Says Lawmakers Must Determine Adequacy of Heat Protection Rules.

CA: WCIRB Releases Summary of Insurer Experience Through Sept. 30, 2011.

CA: Officials to Crack Down on Underground Economy.

CA: SCIF Board of Directors 12/14/2011 Meeting Agenda Posted.

CA: First Documented Health Care Worker Who Contracted AIDS Reveals Her Identity.

Aetna Announces Plans to "Transition Out" of Workers' Comp Network Business.

US Inspector General Reports 33 Postal Worker Arrests for Workers' Comp Fraud.

CVS Cracks Down on Doctors Who Prescribe Widely Abused Narcotics.

Former NFL Players Claim Use of Toradol Masked Concussions.

Great American Acquires Two Texas Workers Comp Firms.

AIG Aggressively Raising Workers Comp Rates This Year.

NIOSH Provides Updates on Respirator Performance for Nanotech Workers.

RAND Reports Increase in Number of Registered Nurses.

wcab commissioner news

> Joseph Miller is currently serving as Commissioner for 60 days and is seeking reappointment.

enewsletter archives

Take a deep dive into our past eNewsletters for 2011 and prior...warning - some links to articles may not any linking problems to

December 5, 2011: Utilization Review, Interrupted.
November 28, 2011: The Non-Examining Panel QME.
September 26, 2011: The Neutral Risk Doctrine.
September 6, 2011: QME Panel Requests.
August 29, 2011: A Primer on Depositions.
August 15, 2011: Supreme Court COLA Decision.

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 14, 2011: LC 5710 Attorney's Fees.

March 7, 2011: Mediation.

February 28, 2011: Arbitrations.

February 14, 2011: In Memoriam: Carrie Nevans.
February 7, 2011: Good Faith Personnel Actions.
January 31, 2011: Service in EAMS.

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.



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