California Banner 2012 Chess Board
Vol. 5, Issue 29

Find Solutions & Strategies                                       July 21, 2014

The Suspended QME
  
Should a suspended QME be able to write admissible medical-legal reports?
In This Issue
* SUSPENDED QME
* DEFECTIVE UR
* DRUG FORMULARY
* WCAB JOB OPENINGS
* PENALTY RE OPIOID MEDS
* NEWS: DIR/DWC reports SB 863 impact, challenges
* RASSP & HERLICK: Now completely rewritten!
* eNEWSLETTER ARCHIVES
A Note From the Editor
Dubon is still good law while the WCAB reconsiders its divisive en banc opinion that struck a blow to IMR. Catch up on the latest UR challenges at the Board. If a second Dubon en banc is issued, they'll talk abut that, too. Attend "Dealing With Dubon" July 26 in Long Beach. See box below. 

 

Join our community today. Sign up here for our free eNewsletter.

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

Registration is Open!   

Dealing With Dubon:
The En Bancs, Facts and
Friction of IMR. Plus,
Midyear Case Law Update.
  
Presiding Judge Paige Levy
Marina del Rey
Judge Craig Glass
Oxnard-Marina del Rey
Maurice Abarr, Esq.
attorney for Jose Dubon
Corey Ingber, Esq.
Dennis Thomas, Esq.
  
Saturday, July 26
Long Beach Grand Event Center
  
4 MCLEs. Whatever Happens
to Dubon, We'll Talk About It.
  
Enroll at lawworm.com
or call (310) 822-1955.
  
Presented by LawWorm.com, an
MCLE provider with the CA Bar.
  
should a suspended qme be able to write admissible medical-legal reports?

When suspended physicians are allowed to write reports that are admissible and can serve as a basis for determining a worker's eligibility for benefits, it brings the integrity of the entire QME process into question.

 

Doctor JudgeRecently, the Workers' Compensation Appeals Board issued a decision in McKinney v. United Parcel Service, 2014 Cal. Wrk. Comp. P.D. LEXIS --. McKinney was a driver/dockworker for United Parcel Service. He alleged an injury on August 8, 2008 to his psyche as well as his neck and back. The matter proceeded to trial and the WCJ found that the psychiatric injury was compensable in light of the QME's failure to appropriately address causation consistent with Rolda v. Pitney Bowes, Inc. The WCJ further found that the orthopedic injuries were not compensable relying on the orthopedic QME's opinions...read more.

ur decision defective when ur delay notice signed only by ur nurse, not licensed physician

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

 

UR stethoscopeIn Newton v. Jack-In-The-Box, 2014 Cal. Wrk. Comp. P.D. LEXIS --, a WCAB panel has issued a notice of its intention to award an applicant medical treatment in the form of aquatic therapy twice per week for a period of four weeks, as prescribed by the applicant's treating physician. The WCAB disagreed with the WCJ's determination that the defendant's UR decision was materially defective as described in Dubon for its failure to include a list of all the medical records reviewed...However, the WCAB did find that the UR decision was defective pursuant to the provisions of Labor Code � 4610(e), which provides that...read more.

drug formularies, texas style: coming soon to a state near you?
Will a drug formulary work in California and other states?
 

Karen C. Yotis, Esq., our Feature Resident Columnist, provides insights into workplace issues and the nuts and bolts of the workers' comp world.

 

As policymakers, risk managers, and insurers seek to contain medical expenditures in workers' compensation claims, pharmacy charges are lined up squarely in the cost containment crosshairs. Some government programs and an ever-growing number of commercial insurers are using closed drug formularies to keep a lid on pharmacy costs. In a recent investigation titled Impact of a Texas-Like Formulary in Other States that WCRI published in June 2014, authors Vennela Thumula and Te-Chun Liu may be moving this cost containment tool that some detractors refer to as "cook book medicine" a few baby steps closer to becoming a nationwide best practice...read more.

wcab seeks candidates for two staff attorney positions
The Workers' Compensation Appeals Board, Office of the Commissioners in San Francisco, seeks candidates to fill two full time permanent staff attorney vacancies: Industrial Relations Counsel II   $6,347 - $8,141 salary plus benefits / Industrial Relations Counsel III $7,682 - $9,857 salary plus benefits...read more.
california compensation cases

Cal Comp CasesPenalty for Abruptly Withdrawing Authorization for Opioid Pain Medication: Cal. Comp. Cases July Advanced Postings (7/16/2014). Lexis.com and Lexis Advance subscribers can read it and other cases reported last week.

california news headlines

CA: Governor Appoints Frank Brass to Workers' Compensation Appeals Board.

CA: DWC Report on SB 863 Reforms Shows Progress, Challenges With New Laws.

CA: WCJ Sounds Off on UR/IMR Process: Loynachan v. County of Los Angeles.

CA: Cal Chamber Posts Status Report on Business-Related Bills.

CA: DWC to Hold Public Hearing Sept. 3 re Proposed Benefit Notice Rule Changes.

CA: DWC Medical Unit Accepting Applications for QME Exam Oct. 18.

CA: Julius Young Launches Long Awaited Workers Comp Zone "2.0" Blog.

CA: Smart's Publishing Launches New Website/Blog "The Insurance 411".

CDC Publishes National Action Plan for Infertility, Workplace Exposures.

CDC Urges Use of Acclimatization as Part of Heat Illness Prevention Plan.

DOL Sues US Postal for Firing Worker Who Reported Unsafe Working Conditions.

Sixth Circuit: Health Care Provider May Bring MSP Private Action Against an NGHP.

Onex Corp. to Purchase York Risk Management for $1.33B.

Rassp & herlick: completely rewritten & reorganized - 3 year overhaul finished!

We are pleased to announce that all chapters in this two-volume set on California Workers' Compensation Law are now completely rewritten and updated with the latest SB 863-related changes. Updates for customers are shipping now. Read the flyer. 

 

Not a Rassp & Herlick subscriber yet? To order, contact Judi Dunham-Matias at 1-937-247-8179 or [email protected]. 

 

 

enewsletter archives

ArchivesTake a deep dive into our past eNewsletters for 2014 and prior...warning - some links to articles may not work...report any linking problems to [email protected].
 
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