Blog

Are Saturdays Business Days for the Purposes of Utilization Review?

Posted by:  Sure S. Log on May 23, 2019 2:59:39 PM

Topics: Case Law Updates

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.

Read more

Case Law Updates for November 2018

Posted by:  Michael W. Sullivan on Nov 5, 2018 3:05:08 PM

Topics: Case Law Updates

To keep Sullivan on Comp up to date on a monthly basis, our team dives into each panel decision and new laws to include an explanation of how each case fits within the workers' compensation scheme. Below is a sampling of this month's updates. Complete discussions of these topics can be found on Sullivan on Comp.

Read more

Case Law Updates for April 2018

Posted by:  Michael W. Sullivan on Apr 25, 2018 11:00:00 AM

Topics: Case Law Updates

To keep Sullivan on Comp up to date on a monthly basis, our team dives into each panel decision and new laws to include an explanation of how each case fits within the workers' compensation scheme. Below is a sampling of this month's updates. Complete discussions of these topics can be found on Sullivan on Comp.

Read more

What Qualifies as a Request for a Medical Evaluation Pursuant to Labor Code 4060?

Posted by:  Sure S. Log on Apr 25, 2018 10:45:00 AM

Topics: Case Law Updates

In disputed cases, parties often rush to request a panel QME in a desired specialty. Per Labor Code § 4062.2(b), when an employee is represented by an attorney seeking an evaluation under § 4060, a QME panel may be requested "No earlier than the first working day that is at least 10 days after the date of mailing of a request for a medical evaluation pursuant to Section 4060 ...." The mailbox rule extends this time period for five calendar days if the physical address of the party being served with the first written proposal is within California. But what is a "request for a medical evaluation pursuant to Section 4060"?

Read more

Use of the Fifth Amendment in Workers' Compensation

Posted by:  Sure S. Log on Mar 20, 2018 5:00:00 PM

Topics: Case Law Updates

The Fifth Amendment to the United States Constitutes protects individuals from being forced to testify against themselves. Although the Fifth Amendment itself states that a person shall not "be compelled in any criminal case to be a witness against himself," it has been held that, "It also privileges a person not to answer official questions in any other proceeding, civil or criminal, formal or informal, where he or she reasonably believes the answers might incriminate him or her in a criminal case." (Spielbauer v. County of Santa Clara (2009) 45 Cal. 4th 704, 714.) Accordingly, the Fifth Amendment privilege against self-incrimination also is recognized in workers' compensation proceedings.

Read more

Case Law Updates for March 2018

Posted by:  Michael W. Sullivan on Mar 5, 2018 8:00:00 AM

Topics: Case Law Updates

To keep Sullivan on Comp up to date on a monthly basis, our team dives into each panel decision and new laws to include an explanation of how each case fits within the workers' compensation scheme. Below is a sampling of this month's updates. Complete discussions of these topics can be found on Sullivan on Comp.

Read more

Case Law Updates for February 2018

Posted by:  Michael W. Sullivan on Feb 9, 2018 9:56:04 AM

Topics: Case Law Updates

To keep Sullivan on Comp up to date on a monthly basis, our team dives into each panel decision and new laws to include an explanation of how each case fits within the workers' compensation scheme. Below is a sampling of this month's updates. Complete discussions of these topics can be found on Sullivan on Comp.

Read more

Case Law Updates for December 2017

Posted by:  Michael W. Sullivan on Dec 14, 2017 8:00:00 AM

Topics: Case Law Updates

To keep Sullivan on Comp up to date on a monthly basis, our team dives into each panel decision and new laws to include an explanation of how each case fits within the workers' compensation scheme. Below is a sampling of this month's updates. Complete discussions of these topics can be found on Sullivan on Comp.

Read more

Case Law Updates for November 2017

Posted by:  Michael W. Sullivan on Nov 3, 2017 11:00:00 AM

Topics: Case Law Updates

To keep Sullivan on Comp up to date on a monthly basis, our team dives into each panel decision and new laws to include an explanation of how each case fits within the workers' compensation scheme. Below is a sampling of this month's updates. Complete discussions of these topics can be found on Sullivan on Comp.

Read more

Case Law Updates for October 2017

Posted by:  Michael W. Sullivan on Oct 18, 2017 10:30:00 AM

Topics: Case Law Updates

To keep Sullivan on Comp up to date on a monthly basis, our team dives into each panel decision and new laws to include an explanation of how each case fits within the workers' compensation scheme. Below is a sampling of this month's updates. Complete discussions of these topics can be found on Sullivan on Comp.

Read more