Deferring Utilization Review
Dec 18, 2024 Deferring Utilization Review As stated in Labor Code § 4610(a), utilization review is the process a defendant uses to “prospectively, retrospectively, or concurrently review and approve, modify, or deny, based in whole or in part on medical necessity to cure and relieve, treatment recommendations by physicians, …” (emphasis added). UR is the process […]
WCAB Clarifies Roles of Physicians and Vocational Experts Under Ogilvie
It has long been recognized that an applicant’s ability to participate in vocational retraining is a significant factor in assessing the worker’s permanent disability. (LeBoeuf v. WCABÂ (1983) 48 CCC 587, 597.) In 2004, the Legislature enacted Senate Bill (SB) 899, and among the provisions was a requirement that permanent disability give consideration to an applicant’s […]
Understanding Accumulation of Permanent Disability Under LC 4664(c)(1)
Labor Code § 4664(c)(1) states, “The accumulation of all permanent disability awards issued with respect to any one region of the body in favor of one individual employee shall not exceed 100 percent over the employee’s lifetime unless the employee’s injury or illness is conclusively presumed to be total in character pursuant to Section 4662.” […]
Injuries Barred by Criminal Convictions Under LC 3600(a)(8)
Labor Code § 3600(a)(8) is an affirmative defense that bars a claim for compensation when the injury is “caused by the commission of a felony, or a crime which is punishable as specified in subdivision (b) of Section 17 of the Penal Code, by the injured employee, for which he or she has been convicted.” That […]
Understanding the Commercial Traveler Rule
Under the commercial traveler rule, an employee traveling on the employer’s business is regarded as acting within the course of employment during the entire period of his or her travel. Workers’ compensation coverage applies to the travel itself and also to other aspects of the trip reasonably necessary for the sustenance, comfort and safety of […]
The Initial Physical Aggressor Defense Under LC 3600(a)(7)
Understanding the Initial Physical Aggressor Defense Under California Labor Code § 3600(a)(7) by Sure S. Log Attorney of CounselMichael Sullivan & Associates, LLP Introduction to Labor Code § 3600(a)(7) Labor Code § 3600(a)(7) establishes the initial physical aggressor defense. It explains that a claim is not compensable when the injury arises “out of […]
Understanding the Impact of California Minimum Wage Changes on TD Rates
April 23rd, 2024Sure LogAttorney of Counsel, Michael Sullivan & Associates, LLP Effective April 1, 2024, the minimum wage for many California fast-food workers increased from $16 to $20 an hour. The changes were brought by Assembly Bill (AB) 1228, which was signed by Gov. Gavin Newsom on Sept. 28, 2023. AB 1228 added Labor Code […]
Change of Treating Physician After Discharge from Care
April 17th, 2024Sure LogAttorney of Counsel, Michael Sullivan & Associates, LLP Nearly one-quarter century ago, in Tenet/Centinela Hospital Medical Center v. WCAB (Rushing) (2000) 80 Cal. App. 4th 1041, the Court of Appeal held that when a treating physician has declared the employee’s injury to be permanent and stationary, has released the employee to return to work […]
WCAB Issues En Banc Order and Notice of Intent to Impose Sanctions for Filing Frivolous Petitions for Reconsideration
April 11th, 2024Sure LogAttorney of Counsel, Michael Sullivan & Associates, LLP When a party disputes an order, decision, or award issued by a workers’ compensation judge (WCJ), there are two options for appeal. Pursuant to Labor Code § 5900, a party may file a petition for reconsideration of a “final order, decision, or award made […]
WCAB Issues Significant Panel Decision That It Will Continue to Follow Shipley
March 28th, 2024Sure LogAttorney of Counsel, Michael Sullivan & Associates, LLP As discussed in an earlier Special Report,[1] for more than 30 years, the Workers’ Compensation Appeals Board (WCAB) relied on Shipley v. WCAB (1992) 7 Cal. App. 4th 1104 to decide petitions for reconsideration, even if it did not act timely on a petition pursuant to Labor […]