California Banner 2012 Chess Board
Vol. 3, Issue 49

Find Solutions & Strategies                       December 3, 2012

Got TreatmentHow to Expedite Medical Treatment...
  
and avoid penalties
In This Issue
* EXPEDITING MEDICAL TREATMENT
* INTOXICATION DEFENSE
* RASSP & HERLICK
* NEWS: 2.8 percent workers' comp rate increase
* BLOGS: Nov. CCC cites, User funding, Medical mileage rate, Workes' comp fraud
* JOB POSTINGS
* eNEWSLETTER ARCHIVES

A Note From the Editor

Robin Kobayashi 2010     

Dear Work Comp Community:   

 

To receive our free, weekly eNewsletter, sign up here. Read past eNewsletters here.

 

Sincerely,

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

New! Rassp & Herlick Treatise

80117 R12

Available in Print, eBook, Online
  • SB 863 Special Alerts
  • Revised & Updated Chapters
  • Trend Alerts
EXPEDITING MEDICAL TREATMENT

Got Treatment? How to Expedite Medical Treatment and Avoid Penalties. The recent panel decision of Castrillo v. Catholic Health Care West, 2012 Cal. Wrk. Comp. P.D. LEXIS 454, presents an interesting slant on a judge's denial of the applicant's request for penalties. In order to expedite medical treatment and avoid exposure to penalties, the prudent practitioner will master the intricacies of the following two procedures: 1. Medical Treatment (MT) Requests: The physician's MT request must be appropriate and comply with all regulations. A non-compliant MT request will not trigger the Utilization Review (UR) time period. 2. Utilization Review (UR): Once a MT request has been properly served, claims administrators must perform a timely and valid Utilization Review (UR) or it will not be admissible as evidence to support a denial of MT. Read more.

intoxication defense

Sneak PeekThis noteworthy panel decision will be added to the LexisNexis services.

 

Injury AOE/COE; Intoxication Defense. WCAB, affirming its prior decision, rescinded WCJ's finding that applicant's claim was barred by intoxication defense pursuant to LC 3600(a)(4), and held that defendant failed to meet burden of establishing that applicant was intoxicated at time of her injury and that intoxication was proximate cause of her injury, when, although applicant tested positive for amphetamines after her injury and testimony showed that applicant had attempted to get a "clean" urine sample from her daughter prior to testing, WCAB found that a positive drug test, in itself, is insufficient to establish intoxication, that opinion of PQME indicating that lab results indicated very high drug levels with a high probability of causing performance impairment did not constitute substantial evidence because PQME relied, in part, on Wikipedia in forming his opinion and because opinion was too speculative to establish that intoxication caused accident, and that there was no evidence tying exact mechanism of applicant's accident to her alleged intoxication. See Vasquez panel decision.

new! rassp & herlick treatise

The Seventh Edition of Rassp & Herlick, California Workers' Compensation Law has a new look, a new format, and a new title. With workers' compensation reform under SB 863 looming, we thought it would be timely to update, revise and restructure Rassp & Herlick from a treatise to a new and competitive reference resource for practitioners, judges, and other workers' compensation professionals. Read more.

neWS HEADLINES

CA: Insurance Commissioner Recommends 2.8 Percent WC Rate Increase.

CA: AD Announces 2013 Profile Audit Review, Full Compliance Audit Performance Standards.

CA: DWC Posts SB 863 Regulations to Implement the Lien Filing Fee.

CA: DWC Posts Draft SB 863 Rules on Independent Medical Review.

CA: Temporary Total Disability Rates for 2013 Announced.

CA: 1st DCA to Hear Oral Argument in TTD Cap/Industrial Disability Leave Case.

CA: LAO Fiscal Report: Calif. Might Post $1B Surplus in 2014.

CA: California Starts to Rebound From Effects of Great Recession.

CA: Former Workers' Comp Judge Jules Greenberg Has Passed Away.

WCRI Executive Director Explains How to Keep Lawyers Out of Workers' Comp Cases.

Aon Report: WC Claim Severity for Health Care Industry to Rise in 2013.

US Dept of Labor/OSHA Announces New Whistleblower Protection Program Director.

US Sup Ct Allows ACA Religious Challenge at 4th Circuit.

New ACA Rules Foggy on Prescription Drug Coverage, Multistate Plans.

A.M. Best Revises Outlook to Negative of Employers Holdings.

NCCI Releases Calendar-Accident Year Underwriting Results by State for 2011.

NCCI Releases Policy Year Underwriting Results by State for 2011.

LEXISNEXIS workers' comp community BLOGS

 

Cal Comp CasesNovember CCC Cites Now Available. Tribute to Hon. Melanie Schodde. Lexis.com subscribers can read it.   

 

 

 

 

CWCIState Regulators Release 2013 California Workers Comp User Funding and Assessment Rates, by CWCI. Read it.

 

 

  

CWCINew California Workers' Comp Medical Mileage Rate for Travel On or After 1/1/13, by CWCI. Read it.

 

 

 

 

Fraud SignWorkers' Comp Fraud Blotter: Tree Service Business Owner Pleads Guilty to Workers' Comp FraudRead it and other news items for the past week.

job postings

New Button Applicant Legal Secretary. Downtown Los Angeles law practice is seeking a workers' compensation APPLICANT Legal Secretary with a minimum of two (2) years of workers' compensation applicant experience. Must have EAMS experience, excellent communication skills, work well under pressure, pay attention to detail, and possess the ability to multitask in a fast pace environment. This is a great opportunity to grow with a law firm with a small workers' compensation department. Please do not apply for this job if you do not have experience and are not able to handle an applicant workers' compensation case from beginning to end. Please email resume and hourly salary expectation. Must be available for immediate hire. Jacobson & Han LLP. Call (213) 620-0222.

 

Work Comp Defense Paralegal - Telecommuting (Northridge). Two solo practitioners representing employers and insurance companies seek legal secretary/paralegal with five or more years experience in the workers' compensation defense arena to work on an as-needed basis from home. Possible assignments would include drafting all types of letters (e.g., to applicant's attorneys, clients, physicians, and lien claimants), review of medical records, legal research, preparation of settlement analyses, administrative tasks, etc. The work assigned would range from the mundane to more complicated legal matters requiring experience and expertise, and case exposure would generally begin from case inception to case resolution, including the handling of liens. This position is perfect for someone looking for part-time work. If interested, please fax your resume and an hourly compensation request for consideration. Contact Jasmeen Ahdi Ubhi at jubhi.esq@gmail.com or (805) 813-8043.

 

Applicant's Attorneys. Law Offices of Ramin R. Younessi, an established mid-size plaintiff/applicant's employment and workers' compensation firm is seeking to add two additional attorneys to our vibrant and energetic team. Applicants must have at least 1 year of experience in actively handling workers' compensation matters and have the ability to manage two supporting paralegals. Excellent negotiation skills are a must. Come work with our dynamic team in a friendly and collaborative environment. Salary is very competitive and contains vacation, bonuses, standard mileage and cost reimbursements, cell phone, bar dues, health benefits, and most importantly long term job security. Please forward all of the following for consideration: Resume, salary history, and writing sample. Salary ranges from $100k to $160k. Contact: jobs@younessilaw.com or (323) 777-7777.

 

Department of Industrial Relations (DIR). $4,674 to $10,477/month DOE. Litigate a variety of labor and employment matters at admin. and civil trial and appellate levels including, workers' comp., prevailing wage/public works, and public employment. Travel throughout SoCal may be required. Send a State Application (Form STD 678) with a resume and 2 recent writing samples to: DIR, Office of the Director - Legal Unit, Attn: Hiring Coordinator, 320 W. 4th Street, Ste. 600, Los Angeles, CA 90013, or by email to juribe@dir.ca.gov.

 

Associate Attorneys and Legal Assistants (Mid-Wilshire): Workers' Compensation defense firm located in Los Angeles (mid-Wilshire) is seeking associate attorneys, paralegal, legal assistants who can assist in Lien Negotiations. Some experience preferred but willing to train. Also seeking assistant for payroll/accounting/billing department. Knowledge in Timeslips, Quickbooks a Plus, would do half day legal assisting work. Salary + Benefits include 401k, health and dental, parking, Profit Sharing. Please email your resume (PDF) at mdelacruz@hay-fel.com or via fax at 213-385-9511 Attention: Maribeth.

 

Post jobs for free in this eNewsletter. Contact Robin.E.Kobayashi@lexisnexis.com for information.

enewsletter archives

ArchivesTake a deep dive into our past eNewsletters for 2012 and prior...warning - some links to articles may not work...report any linking problems to Robin.E.Kobayashi@lexisnexis.com.

November 26, 2012: The Return to Work Fund: What We Know & Don't Know.
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