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AME, Interpreter Lien Complaints Catch Officials Attention

California Department of Industrial Relations director Christine Baker and Division of Workers’ Compensation administrative director Rosa Moran are continuing their listening tour in Southern California and are hearing a lot of complaints about delays in obtaining medical care, delays in payment for uncontested services and were told that these are adding up to delays in … Read More »

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Defense Copy Services Urge Payers to Take the Initiative

Defense attorney copy services say that regardless of whether the Division of Workers’ Compensation (DWC) decides to implement a fee schedule, employers need to step up and say that they’re not going to pay for any copy service items that are either unnecessary or unreasonable. Diann Cohen, director of training and marketing for defense copy … Read More »

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WCAB Modifies AME/QME Timeline Decision

Moving to eliminate confusion and the potential disruption of thousands of workers’ comp cases, the Workers’ Compensation Appeals Board (WCAB) is clarifying an earlier decision resolving questions about the timelines for selecting agreed medical evaluators (AMEs) and requesting qualified medical evaluator (QME) panels. The modified decision states clearly that its ruling in Messele v. Pitco … Read More »

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Employers and Injured Workers Fight Over Benefit

Employers are urging Assemblyman Gil Cedillo (D-Los Angeles) and supporters of his legislation proposing a restructure of the supplemental job displacement benefit (SJDB) provisions to accept amendments. They say they want to make the process more beneficial and less complex for both injured workers and employers. Employers say they’re close to a deal and could … Read More »

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Sanctionable Offenses Drive Lawyers’ Fines

Workers’ comp judges and commissioners at the Workers’ Compensation Appeals Board have long had the authority to sanction attorneys and others involved in workers’ comp proceedings for boorish behavior or procedural violations, but they have not always wielded that power as often as they could. That is changing, says one prominent WCAB commissioner. “I was … Read More »

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WCAB Approves Almaraz/Guzman Application

That the Workers’ Compensation Appeals Board (WCAB) decision in the Almaraz/Guzman cases is still the law of the land is clearly evident in a recent panel decision that upheld an award of permanent disability when none would have been found prior to the cases. Under a strict application of the AMA Guides, applicant Patrick McKenna would … Read More »

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WCAB Decision Expands Employer Liability

A recent Workers’ Compensation Appeals Board panel decision is causing angst among those in the payer community who fear that no matter how well they monitor claims and conduct utilization review, employers may still end up on the hook for thousands of dollars in unnecessary expenses. In this case, the employer is required to pay … Read More »

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Roundup (5)

Additional Fees The California Insurance Guarantee Association and two carriers were awarded additional attorney fees for defending a case filed by Premier Medical Management Systems. Other carriers stand to gain, too. Los Angeles Superior Court Judge Ruth Kwan awarded CIGA $63,000 in fees for its successful defense, while Intercare Insurance Services will receive $20,000 and … Read More »

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