Vol. 5, Issue 47

Find Solutions & Strategies                 November 24, 2014

Lawyer clockW.C.A.B. Publishes New UR Timeliness Decision
 
Each step of UR process must be timely, not just the end result
In This Issue
* UR TIMELINESS
* TELEMEDICINE
* UR: McCOOL
* NEW & FURTHER DISABILITY
* NEWS: Dubon II appealed to 2nd DCA
* eNEWSLETTER ARCHIVES
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W.C.A.B. Publishes new ur timeliness decision

By Richard M. Jacobsmeyer, Esq.

 

The W.C.A.B. has issued a Significant Panel Decision reaffirming its language in Dubon v. World Restoration (Dubon II) regarding the W.C.A.B.'s ability to determine medical issues where UR is not completed in a timely fashion and also provided a detailed discussion as to the necessary steps for UR to be timely. In Timothy Bodam v. San Bernardino County/Dept of Social Services, the Board, in denying a Petition for Removal from defendant from an order to develop the record on the issue of applicant's need for surgery, ruled that timeliness of UR is an issue for the W.C.A.B. to determine and if UR is not timely, the W.C.A.B. has jurisdiction to decide the issue of medical necessity. In determining if UR is timely, the W.C.A.B. also determined that each individual element of the step by step process for UR must be timely, not just the end result...read more.

telemedicine and the injured worker
WCAB finds injured worker, now residing in Nevada, entitled to further medical treatment in form of telephonic therapy

 

With commentary by Robert G. Rassp, Esq.

 

Robert Rassp grayIn Oranje v. Crestwood Behavioral Health, 2014 Cal. Wrk. Comp. P.D. LEXIS --, a WCAB panel affirmed the WCJ's finding that an applicant who suffered an admitted industrial injury to her left arm, left hand and psyche on 3/14/2010 in California but now lives in Nevada, was entitled to further medical treatment in form of counseling, including "telephonic therapy" with California marriage and family therapist (MFT) Chris Jones...read more.

mccool

By Julius Young, Esq.

 

Julius Young thumbnailCan an insurer submit medication prescription requests to utilization review (UR) even where those medications have been repeatedly authorized before? That question has been hotly debated in California workers' comp circles after a recent WCAB Significant Panel Decision, Patterson v. The Oaks Farm (2014) 79 CCC 910. The issue comes up again and again in cases, including cases of workers injured decades ago. The scenario goes like this. Medications are approved, sometimes for years without question. But emboldened by the availability of UR and the 2013 advent of Independent Medical Review dispute resolution procedures, the insurer...read more.

california compensation cases

Cal Comp CasesPsyche Injury Known to Exist Prior to Issuance of Stipulated Awards Was Not New and Further Disability: Cal. Comp. Cases December Advanced Postings  (11/18/2014). Lexis.com and Lexis Advance subscribers can read it.

california news headlines

CA: Injured Worker Appeals Dubon II Decision to 4th DCA.

CA: CalOSHA Updates Website With Ebola Virus Information.

CA: Trucker Strike Hits L.A. and Long Beach Ports.

Massey Energy Ex-CEO Pleads Not Guilty for 2010 Mine Accident.

eNewsletter archives

Take a deep dive into our past eNewsletters for 2014 and prior...warning - some links to articles may not work...report any linking problems to Robin.E.Kobayashi@lexisnexis.com.
 
November 17, 2014: Tips for Stips & More.
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