Stevens v State Compensation Insurance Fund

Following the denial of home health care and additional medications, the injured worker filed a Petition for Writ of Mandate and a Petition for Review challenging the constitutionality of IMR.  The case involves a 100% PD award with extensive medical care for a 1997 lower extremity injury with psychiatric overlay, and chronic pain.  The treating physician prescribed pain medication and home health care, which utilization review denied in July of 2013.  IMR upheld the denial in February 2014.

The Writ of Mandate in Stevens was a straightforward attack on the validity of IMR under the state Constitution.  The petition alleges that section 4610.6 is a denial of due process because it precludes the right to a fair hearing, the right to cross examine the IMR physician, and because there is no meaningful judicial review.

Status: On June 18, the 1^st District Court of Appeal denied both the petition for writ

Discussion:
Unfortunately, the District Court of Appeal provided no rationale for their denial and because the petition for writ of mandate depends on the worker having exhausted all of her administrative remedies, which was not accomplished here, it may be that the denial was based on a procedural defect.  The issue of the constitutional validity of IMR has not been determined.

While this concludes this appeal, because CAAA is supporting the constitutional challenge to IMR, I suspect that the applicant’s attorney, Joe Waxman, may appeal this to the Supreme Court.  If the procedural defect in Stevens cannot be remedied, then the alternate strategy would be to identify a new case to take up to the District Court of Appeal, as the WCAB cannot adjudicate constitutional validity.

MMc