wcab applies dubon in two noteworthy panel decisions |
Two recent noteworthy panel decisions issued by the WCAB provide further guidance on the Independent Medical Review process in light of the Dubon en banc decision.
In the first case, the WCAB affirmed the WCJ's finding that the defendant's utilization review denials of the applicant's request for Xyrem and Botox treatments for her orthopedic injuries and fibromyalgia were invalid based upon the failure of all reviewing physicians to sign their reports and the defendant's failure to provide the reviewing physicians with relevant agreed medical examiner reports explaining the necessity of the requested treatments. However, the WCAB deferred its determination as to whether the requested medical treatment was reasonable and necessary, when the WCAB concluded that...read more. |
quality "continuum of care" for worst case lumbar patients |
Study shows return to work, work retention rates dramatically improve
By Teresa McLoughlin Rice, Esq.
Measured by such yardsticks as return-to-work, work retention and reoperation rates, the success of lumbar surgeries in the Workers' Compensation system could be fairly characterized as mixed. This, combined with the reality that lumbar spine surgery rates have been increasing, makes particularly intriguing a recent study suggesting improved outcomes where patients participate in a comprehensive "continuum of care" which includes quality postoperative rehabilitation....read more. |