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Ramirez v. WCAB

Last Activity: 5/23/2017

The Court of Appeal held that the Legislature's plenary authority over UR and IMR was sufficient to overcome applicant's constitutional challenges to the medical dispute resolution process. Applicant has now filed a Petition for Review with the Supreme Court, SCIF has filed its Answer, and CWCI has lodged a letter in opposition.

Southern Ins v. WCAB (Berrios-Segovia)

Last Activity: 5/22/2017

The Court of Appeal held that the arbitrator was incorrect when he found that, as a matter of law, the insurer could not rescind a workers' compensation insurance policy based on allegation that policy was procured by fraud. The decision outlines the correct procedures to rescind a WC policy, and to enforce the rescission. The appellate decision was ordered published on May 22, 2017.

City of Jackson v. WCAB (Rice)

Last Activity: 5/18/2017

In a published decision, the Court of Appeal held that apportionment to causation may properly include apportionment to a combination of genetic and environmental factors. The Court concluded that there is no relevant distinction between allowing apportionment based on a preexisting congenital or pathological condition and allowing apportionment based on a preexisting degenerative condition caused by heredity or genetics. Applicant's Petition for Rehearing was denied on May 18.

Baker v. WCAB

Last Activity: 4/17/2017

In a case now pending at the Court of Appeal, the Board Panel Decision below held that the IMR timelines are merely directory of a government action, and an untimely IMR determination is nonetheless valid and binding upon the parties. Oral argument was held on April 17, 2017.

Hallmark Marketing v. WCAB (Southard)

Last Activity: 4/12/2017

Court of Appeal originally granted defense Petition for Writ, where the Board Panel Decision below held that an untimely IMR was invalid, and medical necessity could be determined by the WCJ. The parties settled the dispute, and the case has been dismissed.

King v. CompPartners

Last Activity: 4/12/2017

In a case now pending at the California Supreme Court, the Court of Appeal has held that a physician-patient relationship existed between plaintiffs (an injured worker and his wife) and the URO/UR physicians, and that plaintiffs should be allowed to amend their complaint in an effort to establish a violation of a duty of care.

Waveform Lab v. EK Health

Last Activity: 3/02/2017

In an unpublished decision from the Court of Appeal, it was held that the UR process was not an official proceeding subject to anti-SLAPP [strategic lawsuit against public participation] procedures. Waveform has alleged that EK Health and others conspired to defame Waveform and consistently denied authorization for H-Wave device in treatment of individual patients, in violation of the Cartwright Act, and the case has now been transferred to federal court with Trial set for 10/24/2017.

CHP v. WCAB (Margaris)

Last Activity: 7/13/2016

In a published decision based upon a finding that statutory time limits applicable to government action are merely directory (rather than mandatory or jurisdictional), the Court of Appeal held that an untimely IMR determination is valid and binding on the parties.

Cornejo v. Younique Cafe

Last Activity: 4/12/2016

The registration and bonding requirements of B&P Code sections 22450 and 22455 do not apply to a lien claimant copy service seeking to recover fees that are medical-legal expenses under LC section 4620(a), if the lien claimant is an agent and/or independent contractor of a member of the State Bar at the time the documents are photocopied.

Stevens v. WCAB

Last Activity: 10/27/2015

The Court of Appeal found that the statutory review processes for medical treatment, utilization review, and independent medical review are a constitutional exercise of the Legislature's plenary authority to create a complete workers' compensation system.

Contra Costa County v. WCAB (Dahl)

Last Activity: 9/23/2015

In determining the employee's final permanent disability rating, whether the injured worker is amenable to vocational rehabilitation is a factor that must be considered, and the injured worker must establish that the industrial injury rendered her incapable of rehabilitation.

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