California Banner 2012 Chess Board
Vol. 3, Issue 51

Find Solutions & Strategies                      December 17, 2012

Cocktail MartiniHoliday Cheer and the Workplace
  
What happens when an intoxicated employee is injured at work?
In This Issue
* INTOXICATION
* EMERGENCY TREATMENT
* WCJ NEWS: Bodnar, Kitchens, Silberman
* NEWS: Emergency regs, CHSWC reports
* BLOGS: Knee Injury, Medical Payments, The Fluke, Fraud
* eNEWSLETTER ARCHIVES

 A Note From the Editor

 American Ribbon 

Dear Work Comp Community:   

  

Our eNewsletter will be on vacation for two weeks. We'll return on January 7, 2013.

 

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Sincerely,

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

SB 863 Seminar

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How to Use SB 863 to Best Represent Your Clients
 
 Jan. 12, 2013, 9am-5:15pm
 
Judge Mark Kahn (Ret.), Judge Colleen Casey, Robert Rassp, Esq., Presiding Judge Paige Levy
 
National University (West Los Angeles campus)
 
Click here for more information
intoxication

CocktailWhen Holiday Cheer Spills Over to the Workplace. This is the time of year to eat, drink and be merry, right? Perhaps it is worthwhile to  take a moment and consider what happens, from a workers' compensation perspective, when an intoxicated employee suffers an injury at work. Can that employee recover workers' compensation benefits? Labor Code � 3600(a)(4) provides that liability for an industrial injury shall exist where the injury is not caused by the intoxication, by alcohol or the unlawful use of a controlled substance, of the injured employee. This is not very difficult to understand: an employee has an industrial injury, it is later determined that he or she was intoxicated at the time of injury. He or she cannot recover benefits, right? Not so fast...read more.

ur & emergency treatment

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

 

Utilization Review; Spinal Surgery Second Opinion. WCAB affirmed WCJ's finding that applicant with back injury was not precluded by his failure to follow LC 4062(b) spinal surgery second opinion process from receiving TDI for a period of disability following spinal fusion surgery which included removal of previously placed disc replacement materials due to allergic reaction, when WCAB found that provisions of LC 4062(b) did not apply pursuant to R 9788.01(l)(4) because applicant's surgery was required due to a "bona fide medical emergency," that R 9788.01(l)(4) is not inconsistent with LC 4062(b) and is...read more

wcj news
> Judge Shelley M. Bodnar of the San Bernardino District Office has retired.
> Judge Thomas Kitchens of the Van Nuys District Office has retired.
> Judge Leonard J. Silberman of the Santa Ana District Office will retire the end of December.
neWS HEADLINES

CA: DWC to Submit Five Proposed Emergency Rulemaking Actions to OAL.

CA: DWC to Submit SJDB Emergency Regs to OAL.

CA: CHSWC Posts Working Paper on Impact of Experience Rating on Small Employers.

CA: CHSWC Posts Final Memo re Requirement for Insurer Review of Employer's IIPP.

CA: CHSWC Posts Final Release re Impact of AMA-Based PDRS in California.

CA: CHSWC Elects Martin Brady as New Chair.

CA: WCIRB Governing Committee Posts Dec. 12 Agenda.

CA: SCIF Investigator Uses Good Old-Fashioned Detective Work to Root Out Fraud.

CA: Construction Industry Says SB 863 Will Help Reduce Underground Economy.

CA: Columnist Warns SB 863 to Lead to Relapse of Workers Comp "Ill Reform".

CA: Ex-Reserve Deputy, Security Firm Owner Convicted in Workers' Comp Fraud Case.

CA: School Janitor Involved in Sex Romp Sentenced for Workers' Comp Fraud Case.

Study Finds Opt Out/Privatization a Significant Trend in Workers' Compensation.

Towers Watson: Commercial Insurance Prices Continue to Climb, Loss Ratios Improving.

AIA, PCI Urge Action on Medicare Secondary Payer Bills by Year End.

Managed Care Advisors Wins Govt. Contract With Transportation Security Administration.

Reed Group Posts White Paper on EEOC and ADA.

Suzanne Emmet Named President of Kids Chance of America.

LEXISNEXIS workers' comp community BLOGS

 

Cal Comp CasesCompensable Knee Injury Upheld for Soccer Playing Applicant: December Cal. Comp. Cases Advanced Postings. Lexis.com subscribers can read it.   

 

 

 

CWCI  

CWCI Study Tracks Growth of California Workers' Comp Medical Payments, by California Workers' Compensation Institute. Read it

 

 

 

Karen Yotis

Liberal Republicans, Consensus Politics and a Fluke: The WILG Looks Back on 40 Years of Worker Advocacy, by Karen C. Yotis, Esq. The background on the National Commission on State Workmen's Compensation Laws. Read it.  

 

 

 

Fraud SignWorkers' Comp Fraud Blotter: Doctor Banned From Treating Injured Workers. Read it and other news items for the past week.

ur & emergency treatment, continued...
URvalid, that although R 9788.01(l)(4) does not define "bona fide medical emergency", term should be construed in a manner consistent with LC 4610(g)(2) so as to apply in cases of imminent health threats, and that medical evidence establishing deterioration of applicant's condition following initial disc replacement surgery and significant improvement after metallic disc was removed was sufficient to show that applicant's condition constituted an imminent and serious threat to his health so as to be a "bona fide medical emergency"; WCAB found that applicant's failure to request authorization for surgery, thereby preventing defendant from undertaking UR, did not preclude TDI award when, in contrast to LC 4062(b), LC 4610 does not relieve a defendant from liability for TDI if an employee proceeds with a particular treatment before a defendant has opportunity to complete UR. See Moser panel decision.

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 [email protected].

December 10, 2012: The Proposed Independent Medical Review Regulations.
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