Gov. Newsom’s New WCAB Appointment

The Workers’ Compensation Appeals Board will see the return of a familiar face with Gov. Gavin Newsom’s reappointment of Marguerite Sweeney to the board (see photo). A former applicant attorney, … Read More »

On Any Given Workday

On any given workday, hundreds of claims professionals are going door to door throughout our communities interviewing doctors for Medical Provider Networks (MPNs).

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Newest WCAB Commissioner’s Appointment

The Senate Rules Committee headed by Senate Pro Tem Darrel Steinberg (D-Sacramento) is recommending that the full Senate ratify the appointment of a former applicant attorney to the Workers’ Compensation Appeals Board (WCAB). The committee unanimously approved Gov. Jerry Brown’s 2012 appointment of Marguerite Sweeney to the seven-seat panel where she has now served for … Read More »

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Plenty of Complaints About Utilization Review Process

The Division of Workers’ Compensation wanted to hear from the workers’ comp community about what  works and what still needs to be fixed with the utilization review process, and by the end of the session it had received an earful of complaints and nearly as many suggestions for improvement. Now the real test is to see … Read More »

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Challenge to WCAB Guidelines for Spinal Surgery UR

Arguments are now before the Sixth District Court of Appeal to determine if the Workers’ Compensation Appeals Board (WCAB) overstepped its authority when it ruled last fall that carriers and self-insured employers — not the applicant—have the burden of seeking a second opinion if the utilization review (UR) process denies a request for spinal surgery. … Read More »

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No Fees For Challenging UR Decisions, Supreme Court Says

Employers and carriers can use utilization review to challenge a requested medical treatment after an award of future medical without fear of having to pay the injured worker’s attorney fees if the decision is challenged and ultimately overturned. That’s the gist of a ruling handed down by the California Supreme Court yesterday in Smith v. … Read More »

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East Predicts No PD Increase

ANAHEIM — “The planned regulatory increase in permanent disability [benefits] will not happen in July,” said Tim East, director of risk management for The Walt Disney Company, speaking to a group of self-insured employers last week at the California Self-Insurers Association’s 82nd annual meeting and educational conference. “Too much water has passed under the bridge. … Read More »

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Supreme Court Hears Sandhagen Arguments

SAN FRANCISCO— The question of whether California’s utilization review process is mandatory for all worker’s comp cases and is the sole remedy available to employers seeking to challenge recommended medical treatments is now under consideration by the California Supreme Court. The court heard oral arguments in State Compensation Insurance Fund v. Workers’ Compensation Appeals Board … Read More »

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