Just a couple of weeks ago, a large-scale workers’ comp fraud ring was discovered in Southern California. More than two dozen doctors, pharmacists and business owners in California are now facing insurance fraud charges in a $40 million fraudulent workers’ compensation medical billing and kickback operation uncovered by federal, state, and local regulators. Defendants Tanya […]

Focusing on the “Forgotten” Aspects of Workers’ Comp Most of the focus of various workers’ compensation studies are on the back-end of workers’ comp. Meaning the studies on medical costs, the litigation process, indemnity cost trends, loss adjustment and medical cost containment expense, prescribing practices, provider abuse and quite a few other topics. These are […]

Attack on the Constitutionality of Independent Medical Review A second California Court of Appeal district has now ruled that an independent medical review (IMR) is constitutional. That’s the decision made in the March 29, 2017 California Court of Appeal Third Appellate District case of Daniel Ramirez v. WCAB. In a certified opinion, Justice Cole Blease, […]

Back in 2013, a case was presented where a worker’s injuries were caused by his intoxication and not by the concrete slab he fell on. The Longshore Act provides that no compensation shall be payable if the injury “was occasioned solely by the intoxication of the employee” [33 U.S.C.S. § 903(c)]. In 2013, the Ninth […]

With 2016 in the rear-view mirror, it’s time to take a look at the Top 10 developments in California workers’ comp during 2016. The Division of Workers’ Compensation regulatory activity continued, although at a slower pace than prior years. 2016 was a relatively slow year for workers’ comp in the California appellate courts. Many California […]

A large-scale study on the total of California cumulative trauma claims has been released by the California Workers’ Compensation Institute (CWCI). These CT claims are essentially occupational wear and tear claims and include occupational disease claims. As pointed out by the report, California does not have limitations on these claims that many other states impose. […]