Vol. 6, Issue 18

Find Solutions & Strategies                 May 4, 2015

Diagnostic Testing: Is it Medical Treatment or Medical-Legal Expense? 
In This Issue
A Note From the Editor
diagnostic testing: is it medical treatment or medical-legal expense?

The crux of the problem is that much of medical treatment, by its very nature, is diagnostic

 

An interesting question arises in determining whether diagnostic testing constitutes "medical treatment" or a valid "medical-legal" expense. If it's deemed medical treatment, then it is subject to UR/IMR. Two recent panel decisions illustrate the complexities of this issue. In the first case, diagnostic test was found to be a medical-legal expense subject to adjudication by the WCAB, whereas, in the second case, the diagnostic testing was medical treatment subject to UR/IMR...read more.

OMFS: yet another death of the extraordinary circumstances exception post-2004

A third WCAB panel finds that the exception has died post-2004 

 

Caduceus DollarIn Murphy v. County of Fresno, 2015 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB rescinded the WCJ's finding that the lien claimant Cedar-Sinai Medical Center was entitled to payment of fees in excess of the inpatient fee schedule set forth in the 2004 OMFS pursuant to 8 Cal. Code Reg. � 9792(c)(2) due to the applicant's urgent injury and extraordinary nature of services provided by lien claimant, and held instead that the lien claimant was only entitled to payment pursuant to the 2004 OMFS and nothing further...read more.

notice of correction: table 1 present value of permanent disablity

It has come to our attention that we inadvertently omitted the revised Table 1, Present Value of Permanent Disability, in the 2015 Edition of Workers' Compensation Laws of California. We apologize for the inconvenience and have included the corrected Table 1 for your use here.

california compensation cases

Cal Comp Cases

Applicant's Impairments Added Rather Than Using Combined Values Chart (4/28/2015). Lexis.com and Lexis Advance subscribers can access the complete headnotes and summaries. Read it.  
california news headlines

CA: WCIRB Posts Presentation From Insurance Hearing Concerning 10.2% Rate Cut.

CA: WCRI: Average Medical Payment Per Claim Decreased Following 2013 Rule Changes.

CA: DWC Posts Draft Interpreter Fee Schedule Rules for Public Comment.

CA: WCIRB Posts Agenda for May 5 Classification and Rating Committee Meeting.

CA: Senate Committee Approves SB 563 Utilization Review Limitations.

CA: Senate Committee Approves SB 128 Right to Die Bill.

CA: CIGA Posts Agendas for May Meetings: Audit, Finance & Investment, Board.

CA: CHSWC Posts Study on Infection Risk of Sharps Injuries for Non-Healthcare Workers.

CA: Bumble Bee, Managers Charged With 3 Felony Counts for Death of Worker in Oven.

CA: Uber Driver Slashed in Face by Passenger Sues for Workers Comp.

CA: 11M Californians Suffer From Top Chronic Conditions.

DOJ Audit Alleges GEO Group Incorrectly Calculated Workers Comp Insurance.

US DOL Proposes Rule to Revise Black Lung Benefits Act.

OSHA Issues Final Confined Spaces Rule to Protect Construction Workers.

Doctors Banned From Billing Medicare Still Billing State Medicaid Programs.

eNewsletter archives

Take a deep dive into our past eNewsletters for 2015 and prior...warning - some links to articles may not work...report any linking problems to [email protected].