Vol. 6, Issue 48

Find Solutions & Strategies November 30, 2015

A Medical Provider Network Conundrum:

The Second Opinion Process

In This Issue

* MPN SECOND OPINION

* PRO ATHLETES; NOVEMBER CCC CITES NOW AVAILABLE

* NEWS: Prescription Opioid Use After Lumbar Fusion

* eNEWSLETTER ARCHIVES

Season's Greetings

a medical provider network conundrum: the second opinion process

How does an injured worker obtain treatment from a different specialist once he has selected the initial MPN doctor?

In Bautista v. Arlon Graphics, 2015 Cal. Wrk. Comp. P.D. LEXIS --, a split panel WCAB affirmed the WCJ's finding that the applicant machine operator with a 4/6/2014 admitted industrial injury to his ribs, pulmonary system, lumbar spine, and right ankle and alleged consequential injury his psyche and sleep was not entitled to obtain a second opinion regarding his psychiatric condition in the defendant's Medical Provider Network (MPN) pursuant to Labor Code � 4616.3 and 8 Cal. Code Reg. � 9767.7. The WCAB majority found that under Labor Code � 4616.3(c) and 8 Cal. Code Reg. � 9767.7, the injured worker has the right to obtain a second opinion physician if he or she disputes either the diagnosis or treatment prescribed by the primary treating physician. Here, the applicant did not dispute the treatment for his orthopedic injury received by the primary treating physician...read more.

california compensation cases

Hockey Player's Claim Barred When Filed One Day After Labor Code 3600.5 Amendments Became Operative: Cal. Comp. Cases Advanced Postings (11/24/2015). Lexis.com and Lexis Advance online subscribers can read it.

Cal Comp Cases

November CCC Cites Now Available: Calif. Workers' Comp Case Roundup (11/28/2015). Lexis.com and Lexis Advance online subscribers can read it.

california news headlines

CA: DIR Reports Work-Related Injury, Illness Rate Lowest in 13 Years.

CA: Senator Schedules Dec. 2 Oversight Hearing Re: Los Angeles Work Comp Issues.

CA: Five to Plead Guilty in Pacific Hospital Kickback Scheme.

NCOIL Commits to Investigate Opt-Out Work Comp, Stand Up to Federal Intervention.

Third Circuit Rules Temp Workers Can Sue for Bias in Workplace.

Telecommuting Challenges How to Measure, Regulate and Compensate Work.

Telecommuting Could Change What Qualifies as "Work".

On-Demand Companies Reclassifying Workers to Build Up Their Businesses.

Study Examines Prescription Opioid Use After Lumbar Fusion in Work Comp Setting.

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.

November 23, 2015: Housekeeping Services Expenses Recovered as Medical Treatment.
November 16, 2015: Rules for Hearing Representatives.
November 9, 2015: Defendant Bound by a Stipulation Due to Unilateral Mistake.
November 2, 2015: Constitutionality of IMR Upheld.
October 26, 2015: Multiple Carrier Cumulative Trauma.
CLICK HERE TO ACCESS 2010-2015 ARCHIVES.

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