On Aug. 27, 2020, in Gund v. County of Trinity, the California Supreme Court issued a decision that highlights what injured workers must give up as part of the compensation bargain.
Due to the spread of the novel coronavirus, California Gov. Gavin Newsom issued an executive order on March 19, 2020. It requires all individuals living in California to stay home or at their place of residence, except for what are deemed to be essential activities. Services that remain open include grocery stores, gas stations, pharmacies, banks, laundromats and many government and public service functions, including law enforcement, emergency services and utility maintenance and repair.[1]
The novel coronavirus, now called COVID-19, is spreading rapidly around the world. There are confirmed cases in every state in our union. Everyone has a duty to act proactively to prevent the spread of the disease. In addition to other measures, the Centers for Disease Control and Prevention recommends "social distancing," which it defines as "remaining out of congregate settings, avoiding mass gatherings, and maintaining distance (approximately 6 feet or 2 meters) from others when possible." It defines "congregate settings" as "crowded public places where close contact with others may occur, such as shopping centers, movie theaters, stadiums."[1] Accordingly, the Division of Workers' Compensation (DWC) and the Workers' Compensation Appeals Board (WCAB) have taken emergency action to limit the number of people who appear at the WCAB district offices around the state. On March 16, 2020, the DWC and WCAB announced a modified hearing calendar and emergency rules on filing.[2] From March...
The DWC has decided to take direct action to help contain the corona virus. Here is the notification they sent today: https://www.dir.ca.gov/DIRNews/2020/2020-18.html.
As is now common knowledge, Covid-19, commonly called the "novel coronavirus" or just the "coronavirus," is spreading rapidly across the many parts of the world, including California. Countries around the world are taking dramatic steps to combat the spread of the virus. What does this mean for workers' compensation in California?
A California Court of Appeal ruling this month held that an industrially injured employee may not receive temporary disability benefits when he or she takes time off from work to attend medical treatment appointments.
For injuries occurring on or after Jan. 1, 2004, an employee who suffers residual effects from an injury and is unable to return to work is entitled to a supplemental job displacement benefit. The benefit comes in the form of a nontransferable voucher, and often is referred to by practitioners simply as the "voucher."
Since 2004, an employer is required to conduct a utilization review (UR) in order to dispute a request for medical treatment. Under the current law, if an injured worker challenges a UR determination to deny or modify a request for treatment, the worker must request an independent medical review (IMR) from an organization contracted by the administrative director. If, however, the UR determination is untimely, it is not subject to an IMR. Instead, the determination of medical necessity may be made by the WCAB. (Dubon v. World Restoration, Inc. (2014) 79 CCC 1298 (WCAB en banc).) So, it's crucial for employers to conduct their URs in a timely manner.
In 2016, the California Legislature passed two bills to combat workers' compensation fraud, AB 1244 and SB 1160. As a result of this legislation, per LC 4615, any lien and any accrual of interest related to the lien, are automatically stayed on the filing of criminal charges against a physician or provider for an offense involving fraud against the workers’ compensation system, medical billing fraud, insurance fraud or fraud against the Medicare or Medi-Cal programs.
In 2004, the Legislature made a diametric change to the law on apportionment. Labor Code § 4663 was amended to allow apportionment to causation. Under this statute, employers are only liable for the percentage of permanent disability directly caused by the injury arising out of and in the course of employment.
