Provides Work Comp-
Articles,  information.
DECISIONS
City of Laguna Beach v. California Ins.
Guarantee Assn., (2010)
CIGA assumes responsibility for claims only
when no secondary insurer is available.
[Citations.] The Legislature did not establish .
RECOMMENDED
Edurado Alberdin (lead consolidation case);
Robert Wileman; San Juana Ortega; et, al., v.
State compensation Insurance Fund at. al.,
(September 21, 2009) ADJ 2452007 9STK
0169879 the Court stated:

“Here, it cannot be determined that
compensation for all of the lien claims should
be barred because of lack of a fictitious-name
permit.  
This Workers’ Compensation
Administrators Directory was
compiled by Robert W.
McDowell for the North Carolina
Industrial Commission,
September 02, 2010: News:
Department of Insurance
    Commissioner Poizner Announces
    Loma Linda Husband and Wife
    Arrested for Allegedly Forging
    Workers' Comp Insurance
    Documents, While Failing to Cover
    Employees

August 30, 2010: News:
Department of Workers' Compensation:
    Los Angeles court schedules
    conference to discuss consolidation
    of liens  Compound pharmacy liens
    are the subject of the court’s  
    motion to consolidate
August 26,2010: News
Department of Workers' Compensation:
    Division of Workers’ Compensation
    posts proposed amendments to
    benefit notice regulations on DWC
    forum for pre-rulemaking public
    comment

August 19, 2010: News:
Department of Insurance
    Poizner Calls Insurers’ Lawsuit
    “Appalling” in Attempt to Continue
    Illegal Rescissions Insurance
    Commissioner Steve Poizner today
    responded to an insurance industry
    lawsuit to block regulations that
    prevent the practice of unfair
    rescissions in the individual health
    insurance industry.

August 17, 2010: News:
Department of Workers' Compensation:
    Division of Workers’ Compensation
    unveils new EAMS Web site tools

August 12, 2010 News
Orange County  Register
    Group urges 30% workers comp
    rate hike The bureau is a nonprofit
    association of more than 400
    California workers comp insurers.

August 11, 2010: News:
Department of Workers' Compensation:
    Division of Workers' Compensation
    posts proposed revision to the
    hospital outpatient departments and
Work Comp Issues
Work Comp News  
September 03, 2010: Daily Work Comp Issues:
Implants / Outpatient
    Section 9789.38 adopts the federal
    regulation (42 C.F.R. § 419.2) which
    addresses the practices of
    outpatient facilities. It does not
    address the providers of durable
    medical equipment or restrict the
    number of mechanisms for billing for
    durable medical equipment that is
    implantable.

September 01, 2010: Daily Work Comp Issues
Consequence psychiatric injury
    The Court of Appeal held that a
    compensable consequence
    psychiatric injury is not barred by
    the five year statute of limitations
    because it is a new injury for statute
    of limitations purposes. The Court of
    Appeal held that it is the date of the
    applicant's new psychiatric injury
    that determines the timeliness of an
    alleged claim for statute of
    limitations purposes.

August 31, 2010: Daily Work Comp Issues:
Rule §10591. Consolidating Cases
    Giving due consideration to
    whether there are common issues of
    fact and law as well as whether
    judicial economy and expediency
    warrant and justify the request

August 27, 2010: Daily Work Comp Issues:
A Medical/Legal (M/L) Report
    8 CCR § 9793 provides the
    definitions for issues dealing with
    the M/L report. Briefly, only a
    contested claim or a medical issue
    in dispute qualifies for a M/L report.
    All other issues needing a medical
    report do not rise to the status of a
    M/L report.

August 26, 2010: Daily Work comp Issues:
Filing an Application
    Pursuant to Labor Code section
    5405, proceedings for the collection
    of benefits must commence within
    one year of the date of injury,
    expiration of the period covered by
    the last payment of disability
    indemnity, or the last date for which
    medical benefits were furnished.
    When the injured worker is not
    pursuing the claim, the lien claimant
    stands in the shoes of the injured
    worker and can initiate proceedings
    by filing an application; but the lien
    claimant's application also must be
    timely. (Kaiser Foundation Hospitals
    v. Workers' Comp. Appeals Bd.
    (Martin) (1985) 39 Cal.3d 57 [50 Cal.
    Comp.Cases 411]; Kaiser
    Foundation Hospitals v. Workers'
    Comp. Appeals Bd. (Webb) (1977) 19
    Cal.3d 329 [42 Cal.Comp.Cases 302].


August 25, 2010: Daily Work Comp Issues:
Equity:
    The disallowance of the liens based
    on the facts as stated above
    outweigh the equitable consequence
    of ordering the forfeiture of fees for
    services to the enrichment of the
    defendants who received the
    benefits of those services knowing
    the physician who provided those
    services.

August 24, 2010: Daily Work Comp Issues:
 AB 933,  Workers' compensation:
    Existing law requires every
    employer to establish a medical
    treatment utilization review process,
    in compliance with specified
    requirements, either directly or
    through its insurer or an entity with
    which the employer or insurer
    contracts for these services. This
    bill would require the physician to
    be licensed by California state law.

August 20, 2010: Daily Work Comp Issues:
Pain Management
    The ACOEM Guidelines (at page
    114)  asserts that, “Pain should be
    considered an experience, not a
    sensation, an injury or a disease,”   
    At page 315; “The physician should
    discuss the physical and
    psychological mechanisms of pain
    at each encounter.”

August 19, 2010: Daily Work Comp Issues:
Restitution
    Approving restitution in these cases
    would set a precedent which would
    have unfortunate consequences

August 18, 2010: Daily Work Comp Issues:
Psychiatric Injury
    It can be sufficient if the medical
    evidence supports the conclusion
    that applicant's perceptions ofkplace
    stress were objectively reasonable.
Mirna Licea v. Minson Corporation;
California Insurance Guarantee Association
for Phico Insurance Company, in liquidation
ADJ 1857578 (AHM 0089872) decided June
23, 2009
. any claim asserted by an assignee . . . ." (§
1063.1, subd. (c)(9)(ii).)"
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Elliott v. Workers' Comp. Appeals Bd.,
(2010) 182 Cal. App. 4th 355
second spinal surgery opinion
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COLLECTIONS NEWSLETTER
Cervantes v. Workers' Comp. Appeals Bd.,
(En Banc) (2009) 74 Cal. Comp. Cas.  1336

procedures and timelines  objections to a
treating physician’s recommendation for
spinal surgery
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CALIFORNIA WORKERS COMPENSATION COLLECTIONS FOR
LIEN CLAIMANT REPRESENTATION AND
MEDICAL PROVIDERS
August 31, 2010: Article:
Consolidation of liens of compound
pharmacy
    The most important and interesting
    thing that is going to come out of the
    consolidation prior to the hearing on
    Oct. 6, 2010, is what issues the board
    feels is common to all  compound
    pharmacy cases.

July 30, 2010: Article:
Review Companies and PPOs
    When there is clear case of selling
    contract discounts via a bill review
    company the Courts nor the California
    Law Makers   (Labor Code § 4609)  
    have tolerated such abuse

July 26, 2010: Article:
Compensable Consequence Injuries   
    The California law of workers'
    compensation has long followed a
    principal commonly known as the
    ''compensable consequences''
    doctrine.

July 06, 2010: Article
Cal Lab Code § 4903.5
    The Workers Compensation Appeals
    Board agreed with this assertion that a
    medical provider would not know
    when the case had been resolved if
    the settlement documents had not
    been served on the medical provider,
    therefore stopping the running of the
    six month to file a lien when the case
    is resolved until the medical provider
    was served with those documents.

June 25, 2010 Article:
PPO Discounts  / Hartford
    The reason for the inconsistencies by
    the Courts with the purchases and
    selling of contract discounts is that the
    defendants put on an admirable magic
    show at trial and in their recons so
    that the Courts cannot see through the
    mazes of smoke and mirrors. The
    selling and purchasing of contract
    discounts is just plan wrong, nothing
    more, and nothing less

June 05, 2010: Article:
Transfer of  Care into the MPN
    "Medical, surgical, chiropractic,
    acupuncture, and hospital treatment,
    including nursing, medicines, medical
    and surgical supplies, crutches, and
    apparatus, including orthotic and
    prosthetic devices and services, that
    is reasonably required to cure or
    relieve the injured worker from the
    effects of his or her injury shall be
    provided by the employer. In the case
    of his or her neglect or refusal
    reasonably to do so, the employer is
    liable for the reasonable expense
    incurred by or on behalf of the
    employee in providing treatment."

June 03, 2010: En Banc Decision
Director Rule 30(d)(3)
    California Code of Regulations, title 8,
    section 30(d)(3) (Administrative
    Director Rule 30(d)(3)), which states
    that when a claim has been entirely
    denied by the defendant only the
    employee may request a panel of
    Qualified Medical Evaluators, is
    invalid because it conflicts with Labor
    Code sections 4060(c) and 4062.2 and
    exceeds the scope of section 5402(b

Medical Provider Alert: May 25, 2010
    Recently I saw an EOB from Comp IQ
    that not only reduced the Hospital Bill
    under a questionable PPO contract but
    also took an additional 25%
    (approximately $7,000.00) reduction
    without explanation. Unsure if this is a
    one-time error or a questionable policy
    of Comp IQ, but providers should
    examine these EOBs carefully and
    make sure all the numbers are
    accurate

May 22, 2010: Article:
Article On: Assembly Bill 1177 (AB
1177) chaptering California Labor
Code §5307.11

Phrase of the Week -CIGA May 2010
    "The Defendant’s assert, that the one
    word in  Insurance Code § 1063.1 that
    being the word “assignment” and the
    one word in the relationship between
    the medical provider and its Collection
    Company, “Assigns for Collection”,
    allows CIGA to be the recipient of
    unjust enrichment in not paying the
    obligations of an insolvent insurance
    carrier, which was and is the sole
    purpose for the creation of CIGA. "  

Phrase of the Week - Discovery
    “Attached to the Notice is a notice for
    production of documents that is a
    veritable laundry list of documents,
Providing free information for medical providers in the collection of industrial injury medical bills
Update September 03, 2010
"2010 Workers’ Compensation
Lien Claimants’ Guidebook”
10 Collection Issues Booklets Included
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Two Volumes
Plus shipping and handling  allow one to
two weeks for delivery
Two Volumes of Methods for collections,
demand letters, sample trial briefs on
each issue, sample motions, responses,
petitions, applicability of case and
statutory law, and much more
www.workcompliens.com
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MPNs (Medical Provider Networks  - Treating Outside MPNs'                         $75.00
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Collection Issues to be Aware of:                                                                    $25.00
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Responding to Notice to Disallow Lien                                                            $10.00
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How to Prepare a Trial Brief                                                                          $25.00
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Utilization Review Made Simple                                                                     $25.00
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Work Comp Collection Issues Booklets - Booklets from 20 to 60 pages (depending on subject) of case law, strategies, sample trial briefs, motions and
petitions.  For order of 3 or more hard copies mailed  in addition to email in PDF and Word Document.
"Collection Issue Booklets"
Booklets from 20 to 60 pages
(depending on subject) of case law,
strategies, sample trial briefs, motions
and petitions.  For order of 3 or more
hard copies mailed  in addition to
email in PDF and Word Document.
Lien Procedures
The DWC has announced new lien
procedures for the Los Angeles District
Lien Unit.
http://www.lexisnexis.com
Nori Corp's List of Workers'
Compensation Insurance Companies  
Contact List  
http://www.noricorp.net/insurancelist.html
"Collection Issue Booklets"
Booklets from 20 to 60 pages (depending on subject) of case law, strategies, sample trial briefs, motions and petitions.  For order of 3 or more
hard copies mailed  in addition to email in PDF and Word Document.