Vol. 6, Issue 33

Find Solutions & Strategies August 17, 2015

WCAB Panel Takes Strict, Literal Approach to IMR Appeals

In This Issue

* IMR APPEALS

* HEALTHY WORKFORCE

* VOCATIONAL EXPERT

* NEWS: DIR plans to create a closed drug formulary

* eNEWSLETTER ARCHIVES

A Note From the Editor

LexisNexis: Sponsor of the NWCDC 2015

wcab panel takes strict, literal approach to imr appeals

No material mistake of fact exists when IMR reviewer fails to list the actual reports and records reviewed by the IMR physicians

With commentary by Robert G. Rassp, Esq.

In Hacker v. County of San Bernardino-Public Health Department, 2015 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB, in a split panel opinion, held that the WCJ's findings that IMR determinations were not "substantial evidence" because they did not specifically identify the date and author of each report reviewed as part of the IMR process did not support an order setting aside the IMR determinations due to "plainly erroneous express or implied finding of fact" as described in Labor Code � 4610.6(h)(5). The WCAB majority found that nothing in the IMR statute requires...read more.

a healthier workforce: the hot debate over employer responsibility and employee incentives

By Jennifer C. Jordan, Esq., General Counsel, MEDVAL LLC

A Medicare set-aside is sometimes like an exercise in accident reconstruction. And when the MSA gets ugly, as they frequently do, it is typically because of some factor other than the industrial accident itself. Things like, had the employee not been over 300 pounds or had undiagnosed health problems such as heart disease or diabetes at the time of the accident, the claims would likely have been minor and the employee back to work in no time. By the time the claim gets to the MSA stages, there is absolutely nothing that can be done about it but to ponder what if. However, it was interesting to find that--while likely unintentional--the 2015 RIMS Annual Conference in New Orleans provided the workers' compensation industry some good insights as to the solution to many of these issues--a healthier workforce...read more.

california compensation cases

Vocational Expert Evidence Found Unnecessary to Support PTD Award: Cal. Comp. Cases Advanced Postings (8/11/2015). Lexis.com and Lexis Advance online subscribers can read it.

california news headlines

CA: WCIRB to Submit 1/1/2016 Premium Rate Filing to Insurance Commissioner.

CA: Lanier Directs DIR to Begin Process to Create Closed Drug Formulary.

CA: DWC to Hold Meeting on Electronic Transmission of Medical Records, Reports.

CA: Bumble Bee to Pay $6M for Workplace Safety Violation After Worker Cooked in Oven.

CA: Staffing Company Worker Films Injuries, Dangers While Dumping Chemicals.

NASI: WC Benefits for Injured Workers Decline While Employer Costs Rise.

NAIC Releases Study on Workers Comp Large Deductible.

Third Circuit Dismisses Suit Against Cephalon Re Off-Label Marketing of Two Painkillers.

Study: On-Demand Economy Will Include 7.6M People by Year 2020.

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 Robin.E.Kobayashi@lexisnexis.com.

August 10, 2015: Section 132a Trumps a Collective Bargaining Agreement.
August 3, 2015: Timely Utilization Review: WCAB Strictly Applies Bodam Rule.
July 27, 2015: QME Selection Process; SDJB Vouchers.
July 20, 2015: Diagnostic Testing: Medical Treatment or Medical-Legal Expense? (Part 2).
July 13, 2015: Apportionment in Ortho, Psyche and Internal Cases.
CLICK HERE TO ACCESS 2010-2015 ARCHIVES.

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