California Work Comp News, Issues,
Articles Daily
December 18,  2014:  MPNS-Running a amuck? "...it I
the policy of the City and County of San Francisco
Division of Workers ' Compensation that all prescribed
medications must be pre-authorized by a claims staff and
must be dispensed by a licensed pharmacy in which the
prescribing physician has no financial interest

December 17, 2014; IBR: $3,000.00 for ML other
than QME / AME requested by PTP

December 17, 2014: IBR Holds Reimbursement can
be Higher Than Billed charges (Surgical Facility)

December 16, 2014: Providers Learning PPO
contract Trick with IBRs

December 16, 2014: WC: Some Insurance
Companies Getting Stupid - Running with The
Bank!

December 13, 2014: IBR (2014 DOS) = 29824  
additional $1,453.13 and 29826 additional
$1,453.13  awarded to provider

December 13, 2014: IBR: (2014 DOS) = 99358 /
99359 = NO = 2014=OMFS=(B) = 2014 FS

December 13, 2014: IBR 2014DOS- 99354 - awarded
$114.35

December 12, 2014: Article: 82486 / G0431 2-States
2-Different Interpretations of Medicare $

December 10, 2014: Article: WC MPNs: The Simplest
Defense to Overcome / the Most Costly Providers.===

December 09, 2014: 2015 Guidebook download for
members

December 09, 2014: IBR Decision Lack of
Documents fo 22845-22 / 22851-22 /64550-22-59

December 09, 2014: IBR Decision: 72100 22x7
incorrect  modifier

December 09, 2014: IBR ML 106-94- No Initial ML
FS=0

December 03, 2014: WC Clarity, 2nd Review, URs,
IMRs, RFA, The Law States What it States!
CALIFORNIA WORKERS COMPENSATION COLLECTIONS PUBLICATIONS AND
INFORMATION FOR MEDICAL PROVIDERS AND LIEN CLAIMANTS
All States Work Comp News,
Issues, Articles Daily
December 09, 2014: US Labor
Department helps more than 5,300
Pennsylvania and West Virginia
oil and gas workers recover $4.5M in
back wages for unpaid overtime

December 09, 2014: Florida News:
•2014 WCI Conference - DWC
The Florida Division of Workers'
Compensation, recently participated in
the 69th Annual Workers'
Compensation Educational Conference
with the Workers' Compensation
Institute, in Orlando, Florida. The
Division breakout session included the
following topics: Legislative Updates,
Big Data, Reemployment Services for
Injured Workers, Audits and Carrier
Compliance, and EDI Updates.

December 09, 2014: District of
Columbia: Clinical Laboratory Fee
Schedule (CLFS)
Preliminary Determinations

December 09, 2014: Connecticut Case
Law:It is black letter law that we
cannot consider issues on appeal that
the parties did not properly preserve
for appeal at the trial level. As we
cannot identify a ruling by the trial
commissioner that prejudiced the
respondent in their defense of the
claim, and the respondent presented a
thorough defense to the claim; we
cannot now determine that the
respondent was prejudiced by the
inaccurate date in the claimant’s Form
30C

December 09, 2014: Arkansas News:
Proposed Changes to Rule 099.30

December 09,2014:  Arizona:
Commission to Consider Adoption of
Treatment Guideline Process
July 2014 Collections
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Medical Testing
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Points and authorities for trial
Petitions for Reconsideration
Response to Petition for Reconsideration
Petition to Enforce IBR
Petition for IBR Ineligibility Requirement
Petition to Appeal IBR Decision

Petition for Medical Information by a
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Petition for a Non-IBR Medical Legal Dispute
September 2014
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subscribers 553 page Guidebook  
Medicare  and  States Using Medicare or Codes G0431 /
82486 and Related Billing Codes
Toxicology Billing and Payments: Medicare, Each
States Fee Schedule
What are Valid Arguments and What are Invalid
Arguments
2015 Book Billing and Payments for Drug
Screen, Lab Tests, Toxicology   
Clinical Laboratory Fee Schedule G0431,
G0434, 82486, etc.
Toxicology Billing and Payments
All States Work Comp News,
Issues, Articles Daily
IMR Decisions
IMR-Topical Transdermal Cream
Not Medically Necessary
MRI        Meet Guidelines         
UR Reversed / Certified
Medication        No
documentation         UR Upheld
Medication        No indication
how long patient will take
medication        UR Upheld
Aquatic Therapy         No
indication of duration or number
of visits         UR upheld
8 Additional Chiropractic
Sessions        Failed to show
objective Functional
Improvement         UR Upheld
Left knee under anesthesia        
Medically necessary        UR
reversal / certified
Psychotherapy         Requested
36 visits guidelines 16
recommended more after
showing objective functional
improvement         UR Upheld
Additional Physical
Therapy         Failed to show
objective Functional
Improvement from prior
treatment        UR Upheld
Epidural Steroid        Insufficient
Evidence submitted        UR
Upheld
36 Cardiac Rehabilitation
Treatment        Reasonable and
necessary stated in
guidelines         UR reversal /
certified
Cervical Laminectomy C4-6 /
fusion/ one day in-patient         
Clinical notes fail to evidence
findings…”        UR Upheld
Medication        No
Documentation of functional
deficits…”        
Massive Billing and Documentation Error that Resulted in Millions (lost)
Three (3)  out of Several "Findings and Decisions" Posted Here  Based on Medicare Reimbursement
for Labs Performing Urine Drug 82486 and G0431 Shows Massive Billing and Documentation Error
that Resulted in Millions (lost)  being Paid Incorrectly and or Settled for 2 years?
Download Free to Subscribers:
2015 (243 PAGES) LEGAL
CITATIONS BOOK FOR
TREATMENT AND COLLECTIONS
DISPUTES / OVER 500 LEGAL
CITATIONS CASE  LAW AND
STATUTORY LAW – IN ORDER  
WWW.WORKCOMPLIENS.COM
Millions Flushed away 7 exceptions to Time to File
Liens -- Hospital,s Burn Centers, Trauma Centers
have window for DOI regardless of Date of
Services  Prior to 2012 for exceptions
ISSUES FOR PROVIDERS       

MPNs :
Chavez v. T. D. Hayes (2012) ADJ 6490669, 2012 Cal. Wrk. Comp. P.D. LEXIS 403, WCAB Panel Decision.

MPN:
MARIAM DAVTYAN, VS. THE VONS COMPANIES, INC., Permissibly ADJ8870233  OPINION AND ORDERGRANTING PETITION FOR
7 REMOVAL AND DECISION AFTER REMOVAL

2nd review:
9792.5.5 (b)

RFA       
 9792.9.1(b)(2)

MPN        
(Elliot v. Workers’ Comp. Appeals Bd. (2010) 182 Cal.App.4th 355 [75 Cal.Comp.Cases 81].”

Psyche        
MICAELA LLAMAS, VS. GUILD, INC.; STATE COMPENSATION INSURANCE FUND;  EMPLOYERS COMP GLENDALE,  
ADJ2994393 (Oxnard District Office) April 11, 2014,  OPINION AND ORDER DENYING PETITION FOR RECONSIDERATION :
$10,000.00 IN MEDICAL        Cal Lab Code § 5402 (c)

24 CHIROPRACTIC, ETC        
Brenda X. Flores, Applicant v. Masterpiece Artist, Zenith Insurance Company, Defendants, 2007 Cal. Wrk. Comp. P.
D. LEXIS 18, Opinion Filed May 3, 2007

24 CHIROPRACTIC, ETC.        Cal Lab Code § 4604.5 (d)(1)

24 VISIT CAP        Grom v. Workers' Comp. Appeals Bd.,(2004) 69 Cal. Comp. Cas.  1567; 1572

2nd review        9792.5.5 (c)

2nd review        9792.5.6.

2nd review        9792.5.5 (e)

2nd review        9792.5.5 (f)

5 DAYS         8 CCR § 10507

6 MONTH EMPLOYMENT        Sharon Hammerly vs. Carrow Restaurant  and Mitsui Sumitomo Marine Management (2011) ADJ6990558 Appeals
Board Decision Denying Reconsideration Decided June 22, 2011.

ABOVE FEE SCHEDULE        8 CCR § 9792  (c) Determination of the Fee

ABOVE FEE SCHEDULE        “ Guillermo Bayley, Applicant v. YMCA of the East Bay, Travelers Insurance, Defendants; Stanford University Medical
Center, Lien Claimant W.C.A.B. No. ADJ236752 (SFO 0509283)--WCAB Panel: Commissioners Lowe, Moresi, BrassWorkers' Compensation Appeals
Board (Panel Decision) 2011 Cal. Wrk. Comp. P.D. LEXIS 149 Opinion Filed March 22, 2011  states as follows:

ABOVE FEE SCHEDULE        8 CCR § 9789.22 (j)

ABOVE FEE SCHEDULE

DRG (PER DIEM RATE)        County of Los Angeles v. Sullivan, (1992) 969 F.2d 735, 38 Soc. Sec. Rep. Service 109

ABOVE FEE SCHEDULE
GOULD 1        County of Los Angeles v. Sullivan, (1992) 969 F.2d 735, 38 Soc. Sec. Rep. Service 109

ABOVE FEE SCHEDULE
GOULD 2        Gould v. Workers' Compensation Appeals Bd. (Barry), (1995) 60 Cal. Comp. Cas. (MB) 1109

ABOVE FEE SCHEDULE
EXTRAORDINARY CIRCUMSTANCES
     Guillermo Bayley, Applicant v. YMCA of the East Bay, Travelers Insurance, Defendants; Stanford University Medical Center, Lien Claimant W.C.
A.B. No. ADJ2367528 (SFO 0509283)--WCAB Panel: Commissioners Lowe, Moresi, Brass Workers' Compensation Appeals Board (Panel Decision)
2011 Cal. Wrk. Comp. P.D. LEXIS 149 Opinion Filed March 22, 2011

ABOVE FEE SCHEDULE
EXTRAORDINARY CIRCUMSTANCES
(CITE 3)        Guillermo Bayley, Applicant v. YMCA of the East Bay, Travelers Insurance, Defendants; Stanford University Medical Center, Lien
Claimant W.C.A.B. No. ADJ2367528 (SFO 0509283)--WCAB Panel: Commissioners Lowe, Moresi, Brass Workers' Compensation Appeals Board
(Panel Decision) 2011 Cal. Wrk. Comp. P.D. LEXIS 149 Opinion Filed March 22, 2011

ACCELERATION,
AGGRAVATION, OR "LIGHTING UP" OF A PRE-EXISTING CONDITION        Spillane v. Workers' Comp. Appeals Bd., (1969)269 Cal. App. 2d
346;348, 74 Cal. Rptr. 671; 673,

ACCELERATION,
AGGRAVATION, OR "LIGHTING UP" OF A PRE-EXISTING CONDITION        Pullman Kellogg v. Workers' Comp. Appeals Bd.,(1980)  26 Cal.
3d 450, 454; 161 Cal. Rptr. 783,785; 605 P.2d 422,424;  45 Cal. Comp. Cas.  170, 172

AME
THE WCJ ALSO WAS         Kellogg Co. v. Workers' Compensation Appeals Bd. (Battle), (1996) 61 Cal. Comp. Cas. (MB) 519, 521

AME
MEDICAL LEGAL REPORTS ARE NOT ADMISSIBLE TO SHOW MEDICAL NECESSITY        State Comp. Ins. Fund v. Workers’ Comp.
Appeals Bd. (Sandhagen) (2008) 44 Cal.4th 230 [73 Cal.Comp.Cases 981] (Sandhagen)
AME
(UR)
     Carl Dixon, Applicant v. Phillips Buick, Pontiac & Mazda, Clarendon National Insurance Company, Administered By LWP Claims Solutions,
Defendants, 2010 Cal. Wrk. Comp. P.D. LEXIS 343, Opinion Filed August 23, 2010

AOE/COE – BURDEN OF PROOF        Hand Rehabilitation Center v. Workers' Comp. Appeals Bd. (Obernier) (1995) 34 Cal.App.4th 1204, 1212-
1213 [60 Cal.Comp.Cases 289, 291-292]).
AOE/COE/Off‐duty recreational activity
     City of Anaheim v. WCAB (Quick) (W/D) 78 CCC 41

APPLICANT OF ADJUDICATION
     Cal. Lab. Code § 5405
APPLICANT OF ADJUDICATION
     McDaniel v. Workers' Comp. Appeals Bd., (1990) 218 Cal. App. 3d 1011, 267 Cal. Rptr. 440, 1990 Cal. App. LEXIS 262, 55 Cal. Comp. Cas.  72

APPLICATION OF ADJUDICATION        4903.6.

APPLICATION OF ADJUDICATION
     Cal Lab Code § 5501

APPLICATION OF ADJUDICATION        Labor Code section 5501.5

AUTHENTICATION        The writing must be authenticated by proof showing that the writing is what the proponent claims it is.
AUTHORIZATION        8 CCR 9792.6 (o) "

BIFURCATION
     Argent Medical Lab. v. Workers' Compensation Appeals Bd. (Barrera), (1994) 60 Cal. Comp. Cas. 28, 29;

BILLING         Labor Code § 4603.4

BILLING THE INJURED WORKER        Labor Code § 3751  (b)
BILLS
NOT SIGNED        Maricela Arellano, Applicant v. Telacu, State Compensation Insurance Fund, Defendants, 2009 Cal. Wrk. Comp. P.D. LEXIS
284, Opinion Filed July 13, 2009 the Court held:.
BUNKHOUSE RULE        Truck Ins. Exch. v IAC (Dollarhide) (1946) 27 C2d 813, 167 P2d 705, 11 CCC 94

BUNKHOUSE RULE        Vaught v. State of California, (2007) 157 Cal. App. 4th 1538, 69 Cal. Rptr. 3d 605, 73 Cal. Comp. Cas.  125,

BURDEN OF PROOF        2012 En banc Decision of “Torres”. Case:  Tito Torres v  AJC Sandblasting; and Zurich North America Nov 15, 2012
Case No. ADJ909554 LAO (0824849) and ADJ1856854 (LAO 0837910) 77 Cal. Comp.Cases.

BURDEN OF PROOF        En Banc decision of Tito Torres v AJC Sandblasting; and Zurich North America Nov 15, 2012 Case No. ADJ909554 LAO
(0824849) and ADJ1856854 (LAO 0837910) 77 Cal.Comp.Cases
BURDEN OF PROOF        Luis Gonzalez (Luis Gonzalez Valladeres), Applicant v. San Cristobal Distributing, State Compensation Insurance Fund,
Defendants No. ADJ6448504 (Panel Decision)Opinion Filed November 12, 2010; 2010 Cal. Wrk. Comp. P.D. LEXIS 580,

BURDEN OF PROOF        Cal Lab Code § 3202.5


BURDEN OF PROOF
5705. Burden of proof; Affirmative defenses        Cal Lab Code § 3202.5


BURDEN OF PROOF        Tapia v. Skill Masters Staffing (2008) 73 Cal.Comp.Cases 1338, 1340 (Appeals Board en banc) (Tapia), 1340; held

CAUSATION
ACCELERATION, AGGRAVATION        Zemke v. Workers' Comp. Appeals Bd., (1968) 68 Cal. 2d 794, 799; 69 Cal. Rptr. 88, 92;  441 P.2d
928,932;  33 Cal. Comp. Cas. 358

CAUSATION
ACCELERATION, AGGRAVATION,         Zemke v. Workers' Comp. Appeals Bd., (1968) 68 Cal. 2d 794, 799; 69 Cal. Rptr. 88, 92;  441 P.2d
928,932;  33 Cal. Comp. Cas. 358

CAUSATION
ACCELERATION, AGGRAVATION,         Spillane v. Workers' Comp. Appeals Bd., (1969)269 Cal. App. 2d 346;348, 74 Cal. Rptr. 671; 673,

CAUSATION
(SIMMONS) (CITE 2)        En Banc Decision of Simmons v. California, (W.C.A.B. 2005)70 Cal. Comp. Cases 866, 877:

CAUSATION
(SIMMONS) (CITE 1)        En Banc Decision of Simmons v. California, (W.C.A.B. 2005)70 Cal. Comp. Cases 866, 877:

CIGA
EN BANC        Jose L. Martinez vs.Jack Neal & Sons, Inc. July 27, 2004 Case No. (WCAB No. SRO 107686) 69 Cal.Comp.Cases 772

CIGA AND ASSIGNED CLAIMS        CIGA v. WCAB (2012) 77 CCC 143, Court of Appeal, Second Appellate District,
Division Two.

CIGA ISSUES
ASSIGNED CLAIMS        Baxter Healthcare Corp. v. California Ins. Guarantee Assn., (2000) 85 Cal. App. 4th 306, 102 Cal. Rptr. 2d 87,

CIGA ISSUES
ASSIGNED CLAIMS        Black Diamond Asphalt, Inc. v. Superior Court, 114 Cal. App. 4th 109, 7 Cal. Rptr. 3d 466, 2003 Cal. App. LEXIS 1827,
2003 Cal. Daily Op. Service 10641, 2003 D.A.R. 13420 (Cal. App. 3d Dist. 2003
r.
CIGA ISSUES
ASSIGNED CLAIMS        Catholic Healthcare West v. California Ins. Guarantee Assn., (2009) 178 Cal. App. 4th 15, 100 Cal. Rptr. 3d 125,

CIGA ISSUES
ASSIGNED CLAIMS        Insurance code 1063.1 (c)(9)

CIGA ISSUES
ASSIGNED CLAIMS        St. Joseph’s Hospital v. Workers’ Compensation Appeals Bd., 70 Cal. Comp. Cas. (MB) 1612 (Cal. App. 1st Dist. 2005)
the Court held as follows

CIGA ISSUES
ASSIGNED CLAIMS        Mirna Licea v. Minson Corporation; California Insurance Guarantee Association for Phico Insurance Company, in
liquidation ADJ 1857578 (AHM 0089872) decided June 23, 2009

CITABLE DECISIONS WCAB        W

CITING PANEL DECISIONS        CITING PANEL DECISIONS

COMPENSABLE CONSEQUENCES        Divjakinja v. Workers' Compensation Appeals Bd., (2007) 73 Cal. Comp. Cas. 142 144


COMPENSABLE CONSEQUENCES        Pirelli Armstrong Tire Co. v. Workers' Compensation Appeals Bd., (2003) 68 Cal. Comp. Cas. 970, 973

CONSOLIDATING CASES        Rule §10591

CUMULATIVE INJURY        Cal Lab Code § 3208.1.

DATE OF INJURY
POST TERMINATION        Labor Code §5412

DENIED INJURY        Luis Gonzalez (Luis Gonzalez Valladeres), Applicant v. San Cristobal Distributing, State Compensation Insurance Fund,
Defendants No. ADJ6448504 (Panel Decision)Opinion Filed November 12, 2010; 2010 Cal. Wrk. Comp. P.D. LEXIS 580,

DENIED INJURY        CNA Ins. Cos. v. Workers' Compensation Appeals Bd. (Valdez), ( 1997) 62 Cal. Comp. Cas. (MB) 1145, 1146:

DENIED INJURY        Luis Gonzalez (Luis Gonzalez Valladeres), Applicant v. San Cristobal Distributing, State Compensation Insurance Fund,
Defendants No. ADJ6448504 (Panel Decision)Opinion Filed November 12, 2010

DISCOVERY
MOTION TO QUASH (CITE 1)        LIBERTY MUTUAL INSURANCE COMPANY et al., Petitioners, v. THE SUPERIOR COURT OF SAN
MATEO COUNTY, Respondent; GUNDA FRYSINGER, Real Party in Interest. No. A056957 COURT OF APPEAL OF CALIFORNIA, FIRST
APPELLATE DISTRICT, DIVISION FIVE.10 Cal. App. 4th 1282; 13 Cal. Rptr. 2d 363; 1992 Cal. App. November 6, 1992, Decided

DISCOVERY
MOTION TO QUASH (CITE 2)        At any rate the procedure outlined above will prevent undue harassment and oppression of high-level officials
while still providing a plaintiff with several less intrusive mechanisms to obtain the necessary discovery, and allowing for the possibility of conducting
the high-level deposition if warranted.”

DISCOVERY
MOTION TO QUASH (CITE 3)        We conclude it amounts to an abuse of discretion to withhold a protective order when a plaintiff seeks to depose
a corporate president, or corporate officer at the apex of the corporate hierarchy, absent a reasonable indication of the officer's personal knowledge of
the case and absent exhaustion of less intrusive discovery methods.”

DISMISSAL OF INACTIVE LIEN         Dismissal of Inactive Lien Claims for Lack of Prosecution
DISTINCT PART REHABILITATION UNITS        Exempt from the maximum reimbursement formula set forth in subdivision (a) and are paid on a
reasonable cost basis.


DISTINCT PART REHABILITATION UNITS        Distinct part rehabilitation units of an acute care hospital
DRG        Length of stay
DUPLICATE BILLS        
Labor Code section 4603.2(b)(4)
''DURABLE MEDICAL EQUIPMENT        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.
EMPLOYMENT        Independent contractor
EMPLOYMENT        Workers' compensation provides the exclusive remedy against an employer for an injury sustained by an employee in the course
of employment and compensable under the workers' compensation
EN BANC DECISIONS
     En banc decisions of the Appeals Board are binding
EOR        
EVIDENCE        
Cal. Code Regs., tit. 8, § 10770.1(e
EVIDENCE        County of Sacramento v. Worker's Comp. Appeals Bd., (1999) 64 Cal. Comp. Cas. 26,


EVIDENCE        Cal Lab Code  § 5502  (e)(3)
EVIDENCE
(8 CAL. CODE REG. § 9785 DOES NOT REQUIRE PRIMARY TREATING PHYSICIAN TO REFER  TO CONSULTING PHYSICIAN )        Mears
Group v. Workers' Compensation Appeals Bd., (2004) 69 Cal. Comp. Cas. (MB) 1601

EVIDENCE
AUTHENTICATION        The writing is usually not self-authenticating. It needs a testimonial sponsor to prove that the writng was made, signed, or
adopted by the particular relevant person
EVIDENCE
BURDEN OF PROOF        Cal Lab Code § 3202.
EVIDENCE
AME NOT ADMISSIBLE        Kellogg Co. v. Workers' Compensation Appeals Bd. (Battle), (1996) 61 Cal. Comp. Cas. (MB) 519, 521

EVIDENCE
(FAILURE TO INCORPORATE         Tim Bird, Applicant v. Rick Wilson General Contracting, State Compensation Insurance Fund, Defendants,
2008 Cal. Wrk. Comp. P.D. LEXIS 755, Opinion Filed October 28, 2008

EVIDENCE
§ 5705. BURDEN OF PROOF; AFFIRMATIVE DEFENSES        The burden of proof rests upon the party or lien claimant holding the affirmative of
the issue. The following are affirmative defenses, and the burden of proof rests upon the employer to establish them
EVIDENCE
MEDICAL REPORTS NOT SIGNED)        Paul Belcher, Applicant v. Staffmark, Inc./Atlantic Mutual Insurance Company c/o Broadspire,
Defendants, 2009 Cal. Wrk. Comp. P.D. LEXIS 485, Opinion Filed October 30, 2009
EVIDENCE
AT MSC        Stelling Robinson, Petitioner v. Workers Compensation Appeals Board of the State of California and Republic Indemnity Company of
America, Respondents. F008164 Court of Appeal, Fifth Appellate District 52 Cal. Comp. Cas 419:

EVIDENCE
THE PAROL EVIDENCE RULE
     Parol (extrinsic) evidence is not admissible to add to, detract from, or alter the agreement as written.

EXHIBITS        8 CCR § 10629. Filing and Listing of Exhibits
EXTRAORDINARY CIRCUMSTANCES        Extraordinary” as “going beyond what is usual, regular, common, or customary
FEE SCHEDULE
BACK TO 2003 IF NOT INCLUDED        Labor Code § 5307.1(e)
FEE SCHEDULE        8 CCR § 9789.22 (j) .
FEE SCHEDULE
USUAL AND CUSTOMARY        8 CCR § 9789.22 (j) charges
FICTITIOUS NAME        CNA Ins. Cos. v. Workers' Compensation Appeals Bd. (Valdez), (1997) 62 Cal. Comp. Cas. (MB) 1145, 1146

FICTITIOUS-NAME PERMIT        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 0169879the Court stated:
FICTITIOUS-NAME PERMIT        Stokes v. Patton State Hospital (2007) 72 CCC 996, Appeals Board
Significant Panel Decision.

FILING AND SERVICE OF LIEN CLAIMS.§10770        §10770. Filing and Service of Lien Claims.
FUTURE MEDICAL        As a consequence, the WCAB would have continuing jurisdiction to enforce an award as apposed [sic] to rescinding,
altering, or "amending an award.”

FUTURE MEDICAL        Appeals Board retains jurisdiction beyond the five-year statute to enforce its continuing awards.

FUTURE MEDICAL
JURISDICTION        (Future medical) appeals board has continuing jurisdiction over all its orders, decisions, and awards made and entered under the
provisions of this division
HEARING NOTICES        
Cal. Ins. Guarantee Assoc. v. Workers' Comp. Appeals Bd (Norwood) (2006) 71 Cal.Comp.Cases 808, 811 (writ denied )
HOME HEALTH CARE        Allgreen Landscape v. WCAB (Mota) (2012) 77 CCC 541, Court of Appeal,
Fourth Appellate District, Division Three, writ denied.

HOSPITAL EXEMPTION        Most if not all of our hospital have a distinct part rehabilitation unit.

IBR
9792.5.10.  INDEPENDENT BILL REVIEW - DOCUMENT FILING.        9792.5.10 (a)
IMR
UTILIZATION REVIEW SB 863   LABOR CODE § 4610.
     Labor Code § 4610.
(g)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(d)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(e)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(f)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(g)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(h) (1)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(i)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(j)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(k)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(l)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(m)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(n
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     IMR
IMR  LABOR CODE § 4610.6. SB 863
     Labor Code § 4610.6.

IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(b)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(c)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(d)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(e)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(e)
IMR  LABOR CODE § 4610.6. SB 863        
Labor Code § 4610.6.
(g)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(h)
IMR  LABOR CODE § 4610.6. SB 863        
Labor Code § 4610.6.
(i)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(j)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(k)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(l)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(m)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(n)
INDEPENDENT CONTRACTOR        Cal Lab Code § 3353
INJURED WORKER        Cal Lab Code § 3202
INTERPRETER
EN BANC DECISIONS
     Jose Guitron v.Santa Fe Extruders; and State Compensation Insurance fund March 17, 2011 Case No. ADJ163338 (LAO 0873468) 76 Cal. Comp.
Cases 228

INTOXICATION
(BURDEN OF PROOF)        Barrett Business Services, Inc./Clark Roofing, PSI v. Workers' Compensation Appeals Bd., (2007)  73 Cal. Comp. Cas.
(MB) 133

JURISDICTION        Great Western Power Co. v. Industrial Acci. Com. (1925) 196 Cal 593, 602; 238 P 662, 666; 1925 Cal LEXIS 344, 14, 15.

JURISDICTION        Fox v. Workers' Comp. Appeals Bd., No. B056838 , (1992), 4 Cal. App. 4th 1196; 6 Cal. Rptr. 2d 252;57 Cal. Comp. Cas 149;

JURISDICTION        Tomlinson v. Superior Court of Stanislaus County, (1944) 66 Cal. App. 2d 640, 643, 644; 152 P.2d 517, 1944 Cal. App. LEXIS
288, 5, 6; 9 Cal. Comp. Cas. (MB) 316, 318;
"
JURISDICTION
(OVER FUTURE MEDICAL TREATMENT)        Cal Lab Code § 5803
KNOWLEDGE OF INJURY        Cal Lab Code § 5402

LABOR CODE § 4600(A)        Labor Code § 4600(a)
LACHES        Panel Decision of Jorge Samayoa, Applicant v. X-Tra Help, California Compensation Insurance Company, In Liquidation, CIGA,
Defendants
LACHES        LACHES
LACHES: UNCLEAN HANDS        County of Los Angeles v. Workers' Compensation Appeals Bd.,(2002)  67 Cal. Comp. Cas. (MB) 1349; 1353

LAW
INTERPRETATION        American Nat. Ins. Co. v. Low, 84 Cal. App. 4th 914, 101 Cal. Rptr. 2d 288, 2000 Cal. App. LEXIS 859, 2000 Cal. Daily
Op. Service 9023, 2000 D.A.R. 11961 (Cal. App. 2d Dist. 2000

LAW
INTERPRETING        Burlington N. & Santa Fe Ry. Co. v. Puc, (2003)  112 Cal. App. 4th 881, 5 Cal. Rptr. 3d 503,

LAW
INTERPRETATION        County of Orange v. FST Sand & Gravel, Inc., 63 Cal. App. 4th 353, 73 Cal. Rptr. 2d 633, 1998 Cal. App. LEXIS 353, 98
Cal. Daily Op.

LAW
INTERPRETING        DuBois v. Workers' Comp. Appeals Bd., (1993) 5 Cal. 4th 382, 20 Cal. Rptr. 2d 523, 853 P.2d 978,

LAW
INTERPRETING        Jose Facundo-Guerrero, Petitioner v. Workers' Compensation Appeals Board, Nurserymen's Exchange, et al., Respondents,
(2008) 73 Cal. Comp. Cas 785; 77 Cal. Rptr. 3d 731,:

LENGTH OF STAY        LENGTH OF STAY
LIABILITY IS NOT REJECTED WITHIN 90 DAYS        Cal Lab Code § 5402

LIEN        County of Los Angeles v. Workers' Compensation Appeals Bd.,(2002)  67 Cal. Comp. Cas. (MB) 1349; 1351

Lien Assignments
     Barrientos v. Alamo Motor Lodge; SCIF (BPD) (2013 Cal. Wrk. Comp. P.D. LEXIS 285):

LIEN CLAIMS
SERVICE OF §10770 FILING AND        §10770..
LIEN FILING TIME
SB 863
LABOR CODE § 4903.5.
     Labor Code § 4903.5.

LIEN FILING TIME
SB 863
LABOR CODE § 4903.5.
     Labor Code § 4903.5 (b)
LIEN FILING TIME
SB 863
LABOR CODE § 4903.5.
     Labor Code § 4903.5 (c)
LIEN FILING TIME
SB 863
LABOR CODE § 4903.5.
     Labor Code § 4903.5 (d)
LIEN FILING TIME
SB 863
LABOR CODE § 4903.6.        Labor Code § 4903.6.
LIEN FILING TIME
SB 863
LABOR CODE § 4903.6.        Labor Code § 4903.6 (c
LIEN FILING TIME
SB 863
LABOR CODE § 4903.6.        

Labor Code § 4903.6 (d)
LIEN FILING TIME
SB 863
LABOR CODE § 4903.        Labor Code § 4903.6 (e)
LIENS        
LIENS FUTURE MEDICAL TREATMENT        Barbara Ann Hingtgen, Applicant v. County of San Bernardino, PSI, Defendant (2012) W.C.A.B. No.
ADJ446534 (SBR 0216831)—writ denied case

LIENS: TIME TO FILE        CHARLES KINDELBERGER, vs. CITY OF LOS ANGELES, permissibly self- AND DECISION Case Nos. May 24,
2013;ADJ586942 (VNO 0384663) ADJ687483 (VNO 0384664) OPINION AND ORDER GRANTING PETITION FOR RECONSIDERATION

LIENS: TIME TO FILE        section 4903.5, subdivision (a)
LONG TERM CARE HOSPITALS        8 CCR 9789.22
MEDICAL  NECESSITY
AME REPORT        Kellogg Co. v. Workers' Compensation Appeals Bd. (Battle), (1996) 61 Cal. Comp. Cas. (MB) 519, 521

MEDICAL CONTROL        Cal Lab Code § 4600 (c)
MEDICAL CONTROL        Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd. (Bolton) (1983) 34 Cal. 3d 159, 161-162 [666 P.2d 14,
193 Cal. Rptr. 157] [48 Cal.Comp.Cases 566 The California Supreme Court has noted that:

MEDICAL LEGAL        
MEDICAL LEGAL        Cal Lab Code § 4620

MEDICAL LEGAL        Kellogg Co. v. Workers' Compensation Appeals Bd. (Battle), (1996) 61 Cal. Comp. Cas. (MB) 519, 521
MEDICAL LEGAL        Chevron Texaco Products Company/Chevron Corp. v. Workers' Compensation Appeals Bd., (2003) writ denied 68 Cal.
Comp. Cas. (MB) 765; 767, held:

MEDICAL LEGAL (REPORTS ARE NOT ADMISSIBLE TO SHOW MEDICAL NECESSITY)        State Comp. Ins. Fund v. Workers’ Comp.
Appeals Bd. (Sandhagen) (2008) 44 Cal.4th 230 [73 Cal.Comp.Cases 981] (Sandhagen)
Medical legal defines "medical-legal expenses        Labor Code section
MEDICAL NECESSITY        Grom v. Workers' Comp. Appeals Bd.,(2004) 69 Cal. Comp. Cas.  1567; 1572

MEDICAL NECESSITY        Regents of the University of California v. Workers' Compensation Appeals Bd., (2005) 70 Cal. Comp. Cas. 1733; 1735
(writ denied)

MEDICAL NECESSITY        Grom v. Workers' Comp. Appeals Bd.,  (2004) 69 Cal. Comp. Cas. (MB) 1567, 1572;

MEDICAL NECESSITY
CERVANTES (CITE 1)        Cervantes v. Workers' Comp. Appeals Bd., (En Banc) (2009) 74 Cal. Comp. Cas.  1336, 1355,
MEDICAL NECESSITY
ELLIOTT V. WORKERS' COMP. APPEALS BD        Elliott v. Workers' Comp. Appeals Bd., (2010) 182 Cal. App. 4th 355,  75 Cal. Comp. Cas.  81

MEDICAL NECESSITY
FOR NON-INDUSTRIAL INJURY        Granado v. Workmen’s Comp. App. Bd. (1968) 69 Cal. 2d 399, 404
MEDICAL NECESSITY        Kenneth Grom vs. Shasta Wood Products [(2004) 69 Cal. Comp. Cases 1567 (WCAB significant panel decision)].

MEDICAL REPORT
FAILURE TO INCORPORATE OR REVIEW OF THE PTP        .
Labor Code § 4061.5
MEDICAL REPORTS
NOT SIGNED        Paul Belcher, Applicant v. Staffmark, Inc./Atlantic Mutual Insurance Company c/o Broadspire, Defendants, 2009 Cal. Wrk.
Comp. P.D. LEXIS 485, Opinion Filed October 30, 2009

MOTION TO QUASH
DISCOVERY
(CITE 1)        LIBERTY MUTUAL INSURANCE COMPANY et al., Petitioners, v. THE SUPERIOR COURT OF SAN MATEO COUNTY,
Respondent; GUNDA FRYSINGER, Real Party in Interest. No. A056957 COURT OF APPEAL OF CALIFORNIA, FIRST APPELLATE DISTRICT,
DIVISION FIVE.10 Cal. App. 4th 1282; 13 Cal. Rptr. 2d 363; 1992 Cal. App. November 6, 1992, Decided

MOTION TO QUASH
DISCOVERY
(CITE 2)        LIBERTY MUTUAL INSURANCE COMPANY et al., Petitioners, v. THE SUPERIOR COURT OF SAN MATEO COUNTY,
Respondent; GUNDA FRYSINGER, Real Party in Interest. No. A056957 COURT OF APPEAL OF CALIFORNIA, FIRST APPELLATE DISTRICT,
DIVISION FIVE.10 Cal. App. 4th 1282; 13 Cal. Rptr. 2d 363; 1992 Cal. App. November 6, 1992, Decided

MOTION TO QUASH
DISCOVERY
(CITE 3)        LIBERTY MUTUAL INSURANCE COMPANY et al., Petitioners, v. THE SUPERIOR COURT OF SAN MATEO COUNTY,
Respondent; GUNDA FRYSINGER, Real Party in Interest. No. A056957 COURT OF APPEAL OF CALIFORNIA, FIRST APPELLATE DISTRICT,
DIVISION FIVE.10 Cal. App. 4th 1282; 13 Cal. Rptr. 2d 363; 1992 Cal. App. November 6, 1992, Decided

MPN        Section 9767.5.
MPN        Section 9767.6. (b)
MPN        Section 9767.7 (a)
MPN        Section 9767.7 (b)
MPN        Section 9767.1(a) (1)
MPN        Section 9767.1(a) (1)(5)
MPN        Section 9767.3 (c) (1)
MPN        Section 9767.10.
MPN        Section 9767.3 (c) (1) (3)
MPN
TRANSFER OF TREATMENT INTO MPN        8 CCR § 9767.9(f)
MPN
MEDICAL CONTROL        Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd. (Bolton) (1983) 34 Cal. 3d 159, 161-162 [666 P.2d 14,
193 Cal. Rptr. 157] [48 Cal.Comp.Cases 566 The California Supreme Court has noted that:

MPN        Labor Code  §4616.3 and California Code of Regulations, title 8, section 9767.12(a). Section 4616.3 provides:

MPN        Voss v. Workers' Comp. Appeals Bd., (1974)10 Cal. 3d 583, 588; 516 P.2d 1377, 1380, , 39 Cal. Comp. Cas.  56

MPN        En Banc Decision of  Bruce Knight, United Parcel Service; and Liberty Mutual Insurance Company October 10, 2006  71 Cal. Comp. Cases
1423, 1431

MPN        En Banc Decision of  Bruce Knight, United Parcel Service; and Liberty Mutual Insurance Company October 10, 2006  71 Cal. Comp. Cases
1423, 1431


MPN        “ Jennifer Balkowitsch, Applicant v. Home Depot, PSI, adjusted by Sedgwick Claims Management Services, Defendants, 2008 Cal. Wrk.
Comp. P.D. LEXIS 567, Opinion Filed August 11, 2008

MPN        Joaquin Valencia, Applicant v. Taylor Fresh Foods, Zurich North America, Defendants, 2008 Cal. Wrk. Comp. P.D. LEXIS 596, Opinion
Filed August 6, 2008

MPN        Walter Roque, Applicant v. Louise's Trattoria, Liberty Mutual Insurance Company, Defendants, 2008 Cal. Wrk. Comp. P.D. LEXIS 349,
Opinion Filed April 21, 2008

MPN
PROCEDURES        Lab. Code, § 4616.3(b); see also Cal. Code Regs., tit. 8, § 9767.12(a)(6).
MPN        Section 4616.2(d)(3)
MPN
TRANSFERRING MEDICAL TREATMENT INTO MPN (BABBIT EN BANC)        Babbit v. Ow Jing, 72 CCC 70, 73  (WCAB en banc 2007)

MPN
(OFFER OF MEDICAL TREATMENT)        Barrett Business Services, Inc. v. Workers' Compensation Appeals Bd., (2008) 74 Cal. Comp. Cas. (MB)
49

MPN
(OFFER OF MEDICAL TREATMENT)        Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd. (Bolton) (1983) 34 Cal. 3d 159, 164 ;
48 Cal.Comp.Cases 566, 569
MPN
EN BANC DECISION OF KNIGHT        Bruce Knight, United Parcel Service; and Liberty Mutual Insurance Company October 10, 2006  71 Cal.
Comp. Cases 1423

MPN
EN BANC DECISION
     Elayne Valdez v.Warehouse Demo Services; Zurich North America, Adjusted by ESIS Case No. ADJ7048296 April 20, 2011
Elayne Valdez v.Warehouse Demo Services; Zurich North America, Adjusted by ESIS Case No. ADJ7048296 April 20, 2011

MPN
REASONABLE OFFER OF MEDICAL TREATMENT        Voss v. Workers' Comp. Appeals Bd. (1974) 10 Cal.3d 583, 588 [516 P.2d 1377, 111 Cal.
Rptr. 241] [39 Cal.Comp.Cases 56
MPN
OFFER OF MEDICAL TREATMENT        Labor Code  §4616.3 and California Code of Regulations, title 8, section 9767.12(a). Section 4616.3
provides:

MPN: ACCESS        

Robles v. WCAB (W/D) 78 CCC 168

MSC        8 CCR § 10629. Filing and Listing of Exhibits
MSC        County of Sacramento v. Worker's Comp. Appeals Bd., (1999) 64 Cal. Comp. Cas. 26,
MSC        Cal Lab Code § 5502 (d)  (3)
MSC        County of Sacramento, Petitioner vs. Workers Compensation Appeals Board, Glennis Weatherall, Jodie Weatherall (Decedent), et al.,
Respondents,  (2000) 65 Cal. Comp. Cas 1; 77 Cal. App. 4th 1114; 92 Cal. Rptr. 2d 290,


MSC        
NECESSITY        Grom v. Workers' Comp. Appeals Bd.,(2004) 69 Cal. Comp. Cas.  1567; 1572

NECESSITY        Regents of the University of California v. Workers' Compensation Appeals Bd., (2005) 70 Cal. Comp. Cas. (MB) 1733:

NECESSITY        Kenneth Grom vs. Shasta Wood December 8, 2004(WCAB No. RDG 0091839) 69 Cal.Comp.Cases 1567

NECESSITY        Granado v. Workmen’s Comp. App. Bd. (1968) 69 Cal. 2d 399, 404 [71 Cal. Rptr. 678, 445 P.2d 294]; states as follows:
required of the employer
NECESSITY OF MEDICAL TREATMENT        Kellogg Co. v. Workers' Compensation Appeals Bd. (Battle), (1996) 61 Cal. Comp. Cas. (MB) 519,
521

NECESSITY OF MEDICAL TREATMENT        State Comp. Ins. Fund v. Workers’ Comp. Appeals Bd. (Sandhagen) (2008) 44 Cal.4th 230 [73 Cal.
Comp.Cases 981] (Sandhagen)
NON-ATTAORNEY  REPS (SB 863)
LABOR CODE § 4907.        Labor Code § 4907.
NON-INDUSTRIAL INJURY        Granado v. Workmen’s Comp. App. Bd. (1968) 69 Cal. 2d 399, 404 [71 Cal. Rptr. 678, 445 P.2d 294]; states as
follows:

NOTICE OF INJURY        Leprino Foods v. Workers' Compensation Appeals Bd., (2007)  72 Cal. Comp. Cas. (MB) 605; 612,

NOTICE OF INJURY        Chaparral Construction & Development v. Workers' Compensation Appeals Bd.,(2006)  71 Cal. Comp. Cas.  879 writ
denied

NOTICE OF INTENT        DeWitt Fox v. WCAB (1992), 6 Cal Rptr. 2d 252; 57 Cal.  Comp. Cas 149).

OWNERSHIP OF LIENS
SB 863
LABOR CODE § 4903.8.
     Labor Code § 4903.8.

OWNERSHIP OF LIENS
SB 863
LABOR CODE § 4903.8.
     Labor Code § 4903.8.

PANEL DECISIONS        Griffith v. Workers' Comp. Appeals Bd. (1989) 209 Cal.App.3d 1260, 1264, fn. 2 [257 Cal. Rptr. 813, 54 Cal. Comp.
Cases 145])

PAROL EVIDENCE RULE        THE PAROL EVIDENCE RULE
PENALTIES AND INTEREST
CALIFORNIA LABOR CODE § 4603.2(B)        California Labor Code § 4603.2(b)
PER DIEM RATE        Title 8, California Code of Regulations §9789.22(i)(1)
PER DIEM RATE        County of Los Angeles v. Sullivan, (1992) 969 F.2d 735, 38 Soc. Sec. Rep. Service 109

PERMANENT &STATIONARY        Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd., (1983) 34 Cal. 3d 159, 168; 666 P.2d 14,21;
48 Cal. Comp. Cas.  566, (1983
PETITION        LC § 5902.
PETITION FOR RECONSIDERATION        10842(a),
PETITION FOR RECONSIDERATION        Labor Code § 5903.
PETITION FOR RECONSIDERATION        8 CCR § 10842.
PETITION FOR RECONSIDERATION          8 CCR § 10507.
PETITIONS
     8 CCR § 10450. Petitions
PETITIONS FOR RECONSIDERATION / REMOVAL ETC        8 CCR § 10848. Supplemental Petitions
PETITIONS FOR RECONSIDERATION, REMOVAL, AND DISQUALIFICATION AND ANSWERS
     8 CCR § 108428 CCR § 10842

POST  TERMINATION        Leprino Foods v. Workers' Compensation Appeals Bd., (2007)  72 Cal. Comp. Cas. (MB) 605; 612,

POST TERMINATION        Labor Code section 3600(a)(10) (A
POST TERMINATION        Jesus Hernandez, Applicant v. Warner Bros. Studios, PSI, Defendant, 2009 Cal. Wrk. Comp. P.D. LEXIS 353, Opinion
Filed July 9, 2009

POST TERMINATION        Cal Lab Code § 3600
POST TERMINATION        Cal Lab Code § 5400
POST TERMINATION        Cal Lab Code § 5411 Date of injury
POST TERMINATION
DATE OF INJURY        Cal Lab Code § 5412 .  Date of injury; Occupational disease or cumulative injury

POST TERMINATION        Chaparral Construction & Development v. Workers' Compensation Appeals Bd.,(2006)  71 Cal. Comp. Cas. (MB) 879
writ denied

POST TERMINATION        Leprino Foods v. Workers' Compensation Appeals Bd., (2007)  72 Cal. Comp. Cas. (MB) 605; 612,

PPO
AUTHENTICATION        Fed. R. Evid. 901-903 Fed. R. Evid. 901-903
PPO
EXCLUSIVE REMEDY        Angelotti v. The Walt Disney Co., (2011) 192 Cal. App. 4th 1394,1403; 121 Cal. Rptr. 3d 863,869;

PPO
BILL REVIEW        John Miranda, Jr., Applicant v. The Pacific Lumber Company, Defendant, 2004 Cal. Wrk. Comp. P.D. LEXIS 90, Opinion Filed
October 12, 2004

PPO
BALZANO
BILL REVIEW        Balzano v. City of Los Angeles (April 13, 2005 Order Denying Reconsideration VNO 235609) 33 CWCR 10; 2005 Cal. Wrk.
Comp. P.D. LEXIS 16,

PPO
MOLINA SCIF / BLUE CROSS        Molina v. State Compensation Insurance Fund (February 7, 2005), Order Denying Reconsideration ANA
332752) 33 CWCR 136, 2005 Cal. Wrk. Comp. P.D. LEXIS 193

PPO
(JURISDICTION BELL CASE)        Bell v. Samaritan Medical Clinic, Inc., (1976) 60 Cal. App. 3d 486, 131 Cal. Rptr. 582, 1 41 Cal. Comp. Cas.  415

PPO
     HCA Health Services of Georgia v. Employer Health Insurance  22 F. Supp 2d 1390 (11th Cir 2001)

PPO
JURISDICTION
MIRANDA CASE        John Miranda, Jr., Applicant v. The Pacific Lumber Company, Defendant, 2004 Cal. Wrk. Comp. P.D. LEXIS 90, Opinion
Filed October 12, 2004

PPO
LABOR CODE § 4609(A)        Labor Code § 4609(a
PPO
LABOR CODE § 5304        Labor Code § 5304
PPO
SCIF NOT A PARTY TO ASSERT ARBITRATION        Molina v. State Compensation Insurance Fund (February 7, 2005, Order Denying
Reconsideration ANA 332752) 33 CWCR 136, 2005 Cal. Wrk. Comp. P.D. LEXIS 193

PPO
5304 ISSUE        Molina v. State Compensation Insurance Fund (February 7, 2005, Order Denying Reconsideration ANA 332752) 33 CWCR 136,
2005 Cal. Wrk. Comp. P.D. LEXIS
PPO
SCIF NOT A PARTY        Molina v. State Compensation Insurance Fund (February 7, 2005, Order Denying Reconsideration ANA 332752) 33
CWCR 136, 2005 Cal. Wrk. Comp. P.D. LEXIS
PPO
PAYOR ISSUES        Molina v. State Compensation Insurance Fund (February 7, 2005, Order Denying Reconsideration ANA 332752) 33 CWCR
136, 2005 Cal. Wrk. Comp. P.D. LEXIS
PPO
APPLIES ONLY TO BLUE CROSS EMPLOYEES        Nico Zuniga, Applicant v. Herb Stewart, State Compensation Insurance Fund, Defendants,
2002 Cal. Wrk. Comp. P.D. LEXIS 104, Opinion Filed June 13, 2002

PPO
EXPRESS
AGREEMENT ISSUE        Nico Zuniga, Applicant v. Herb Stewart, State Compensation Insurance Fund, Defendants, 2002 Cal. Wrk. Comp. P.D.
LEXIS 104, Opinion Filed June 13, 2002

PPO
PAROL EVIDENCE ISSUE        Nico Zuniga, Applicant v. Herb Stewart, State Compensation Insurance Fund, Defendants, 2002 Cal. Wrk. Comp. P.
D. LEXIS 104, Opinion Filed June 13, 2002

PPO
WATERS CASE        Sarah Waters, Applicant v. Los Angeles Clippers Basketball Club, Inc., TIG Specialty Insurance Solutions c/o Cambridge
Integrated Services Group, Inc., Defendants, 2005 Cal. Wrk. Comp. P.D. LEXIS 15, Opinions Filed February 7, 2005 and April 26, 2005

PPO
SENATE BILL 559,        Senate Bill 559
PPO
OLSUKKA CASE        Susan Olsukka v. City of Sacramento SAC 329274 ORDER DENYING RECONSIDERATION AUGUST 11, 2005


PPO        Tony Hoy, Applicant v. Northrop Grumman Corporation, Insurance Company of the State of Pennsylvania, AIG Claims, Defendants, 2006
Cal. Wrk. Comp. P.D. LEXIS

PPO
HOY CASE
(PAYOR LIST NOT A CONTRACT)        .” Tony Hoy, Applicant v. Northrop Grumman Corporation, Insurance Company of the State of
Pennsylvania, AIG Claims, Defendants, 2006 Cal. Wrk. Comp. P.D. LEXIS 1, Opinion Filed February 7, 2006


PPO        Virginia Woodruff, Applicant v. Greenfield Trucking, State Compensation Insurance Fund, Defendants, 2007 Cal. Wrk. Comp. P.D. LEXIS
93, Opinion Filed September 4, 2007

PPO
PAYOR ISSUE
     Virginia Woodruff, Applicant v. Greenfield Trucking, State Compensation Insurance Fund, Defendants, 2007 Cal. Wrk. Comp. P.D. LEXIS 93,
Opinion Filed September 4, 2007

PPO
4609 ISSUE        Virginia Woodruff, Applicant v. Greenfield Trucking, State Compensation Insurance Fund, Defendants, 2007 Cal. Wrk. Comp. P.D.
LEXIS 93, Opinion Filed September 4, 2007

PPO
EXPRESS AGREEMENT ISSUE
     Virginia Woodruff, Applicant v. Greenfield Trucking, State Compensation Insurance Fund, Defendants, 2007 Cal. Wrk. Comp. P.D. LEXIS 93,
Opinion Filed September 4, 2007

PPO
DEEP DISCOUNT (PUBLIC POLICY)        Virginia Woodruff, Applicant v. Greenfield Trucking, State Compensation Insurance Fund, Defendants,
2007 Cal. Wrk. Comp. P.D. LEXIS 93, Opinion Filed September 4, 2007

PPO
ZUNIGA        Zuniga, Applicant v. Herb Stewart, State Compensation Insurance Fund, Defendants, 2002 Cal. Wrk. Comp. P.D. LEXIS 104, Opinion
Filed June 13, 2002in which the court held as follows:

PPO ISSUE        Tri-City Medical Center v. Workers' Compensation Appeals Board, (2010) 75 Cal. Comp. Cases 790 (writ denied)
.
PRE-EXISTING DISEASE / INJURY        Spillane v. Workers' Comp. Appeals Bd., (1969) 269 Cal. App. 2d 346;348, 74 Cal. Rptr. 671; 673
PRE-EXISTING DISEASE / INJURY        Hart v. Workers' Comp. Appeals Bd.,(1978)  82 Cal. App. 3d 619; 626, 147 Cal. Rptr. 384; 389:

PRE-TRIAL CONFERENCE STATEMENT        

County of Sacramento v. Worker's Comp. Appeals Bd., (1999) 64 Cal. Comp. Cas. 26,

PRE-TRIAL CONFERENCE STATEMENT        Cal Lab Code  § 5502  (e)(3)
PSYCHE        Labor Code §4660.1. (c) (1)
PSYCHE        Labor Code § 4660.1

PSYCHE
COMPENSABLE CONSEQUENCE        Pirelli Armstrong Tire Co. v. Workers' Compensation Appeals Bd., (2003) 68 Cal. Comp. Cas. 970, 973

PSYCHE        Grom v. Workers' Comp. Appeals Bd.,(2004) 69 Cal. Comp. Cas.  1567; 1572
PSYCHE        Regents of the University of California v. Workers' Compensation Appeals Bd., (2005) 70 Cal. Comp. Cas. 1733; 1735 (writ denied)

PSYCHE
     Ernestina Molina, Applicant v. Den-Mat, Zenith Insurance Company, Defendants (2004)32 Cal. Workers Comp Rptr 293;  W.C.A.B. No. GRO
0028061; WCAB Panel Decision 2004 Cal. Wrk. Comp. P.D. LEXIS 80

PSYCHE ACOEM
     ACOEM Guidelines (at page 114)
Psyche injury        MICAELA LLAMAS, VS. GUILD, INC.; STATE COMPENSATION INSURANCE FUND; EMPLOYERS COMP GLENDALE,
ADJ2994393 (Oxnard District Office) April 11, 2014, OPINION AND ORDER DENYING PETITION FOR RECONSIDERATION :

PSYCHE TREATMENT
6 MONTH EMPLOYMENT
     Sharon Hammerly vs. Carrow Restaurant  and Mitsui Sumitomo Marine Management (2011) ADJ6990558 Appeals Board Decision Denying
Reconsideration Decided June 22, 2011
PSYCHE TREATMENT
6 MONTHS EMPLOYMENT
     Matea v. Workers' Comp. Appeals. Bd. (2006) 144 Cal.App.4th 1435 [71 Cal.Comp.Cases 1522, 1522].
.
PSYCHE TREATMENT
NOT PLED        Divjakinja v. Workers' Compensation Appeals Bd., (2007) 73 Cal. Comp. Cas. 142 144
.


PSYCHE TREATMENT FOR TREATMENT OF PHYSICAL INJURY        Sharon Hammerly vs. Carrow Restaurant  and Mitsui Sumitomo Marine
Management (2011) ADJ6990558 Appeals Board Decision Denying Reconsideration Decided June 22, 2011
Psychiatric Injuries/Good Faith Personnel Actions
     County of San Bernardino v. WCAB (McCoy) (2011) 77 CCC 219, Court of
Appeal, Fourth Appellate District, Division Two
Psychiatric Injuries/Six Month Exclusion
     State Compensation Insurance Fund v. WCAB (Garcia) (2012) 77 CCC 307,
Court of Appeal, Second Appellate District, Division Three.

PSYCHIATRIC INJURY        Cal Lab Code § 3208.1
PTP / MPN        
REASONABLENESS OF MEDICAL BILLS        Giroux Glass, Inc. v. Workers' Compensation Appeals Bd., 70 Cal. Comp. Cas. (MB) 490 (Cal. App.
4th Dist. 2005)

REFERRAL BY PTP        Mears Group v. Workers' Compensation Appeals Bd., (2004) 69 Cal. Comp. Cas. (MB) 1601

REFERRALS        Cal Lab Code § 139.31
RESTITUTION        American Psychometric Consultants Inc. v. Workers' Compensation Appeals Bd., (1995) 36 Cal. App. 4th 1626, 43 Cal. Rptr.  
2d 254, 60 Cal. Comp. Cas. (MB) 559
RESTITUTION        American Psychometric Consultants Inc. v. Workers' Compensation Appeals Bd., (1995) 36 Cal. App. 4th 1626, 43 Cal. Rptr.
2d 254, 1995 60 Cal. Comp. Cas. (MB) 559, 1995
SANCTIONS        Labor Code § 5813

SANCTIONS        
Labor Code § 5813 and 8 Cal. Code Reg. § 10561(a)

SANCTIONS
8 CCR § 10561. SANCTIONS        8 CCR § 10561. Sanctions
SIGNIFICANT PANEL DECISIONS        Kenneth Grom vs. Shasta Wood December 8, 2004(WCAB No. RDG 0091839) 69 Cal.Comp.Cases 1567

SIX MONTH EMPLOYMENT        

Wal-Mart Stores v. Workers' Comp. Appeals Board  (Garcia) (2003) 112 Cal.App.4th 1435 [68 Cal.Comp.Cases 1575
SPECIFIC INJURY        Cal Lab Code § 3208.1. "Specific" and "cumulative" injuries
SPINAL SURGERY        California Insurance Guarantee Association; and Broadspire (Servicing Facility), September 19, 2009 A DJ3675309 (SAL
0081669) ADJ2967795 (SAL 0101259) ADJ3517685 (SAL 0077391)ADJ1962561 (SAL 0077392
STIPULATIONS        Mary Gillett, Applicant v. Los Angeles Unified School District, Sedgwick Pasadena, Defendants (2010) W.C.A.B. Nos.
ADJ1601344 (MON 0275791), ADJ2934340 (MON 0275793), ADJ2221693 (MON 0275795)- Workers' Compensation Appeals Board (Panel
Decision)2010 Cal. Wrk. Comp. P.D. LEXIS 44 Opinion Filed February 4, 2010

STIPULATIONS AND ISSUES        Cal Lab Code  § 5502  (e)(3)
STIPULATIONS AND ISSUES        Stelling Robinson, Petitioner v. Workers Compensation Appeals Board of the State of California and Republic
Indemnity Company of America, Respondents. F008164 Court of Appeal, Fifth Appellate District 52 Cal. Comp. Cas 419:

SUPPLEMENTAL PETITIONS        8 CCR § 10848.
TREATING FOR NON-INDUSTRIAL BODY PART        Granado v. Workmen’s Comp. App. Bd. (1968) 69 Cal. 2d 399, 404 [71 Cal. Rptr. 678,
445 P.2d 294 “

TREATMENT 4600        
UEF
EN BANC        Daniel Milbauer vs. Erez Boostan December 18, 2003 Case No. (WCAB No. LAO 722567) 68 Cal.Comp.Cases 1834

UR: UTIMELY / DEFECTIVE URS        En Banc Decision / Defective and Untimely Utilization Review   Jose Dubon v.World Restoration, Inc.; and
State Compensation Insurance Fund Oct. 6, 2014 Case No: ADJ4274323 (ANA 0387677) - ADJ1601669 (ANA 0388466) 79 Cal. Comp. Cases
USAUL AND CUSTOMARY FEES        ILIA JAROSTCHUK vs SAN FRANCISCO 49ERS Case No. ADJ7865722 ORDER DENYING PETITION
FORECONSIDERATION

USUAL AND CUSTOMARY        CNA Ins. Cos. v. Workers' Compensation Appeals Bd. (Valdez), ( 1997) 62 Cal. Comp. Cas. (MB) 1145, 1146:
USUAL AND CUSTOMARY
TAPIA CASE        Tapia v. Workers' Comp. Appeals Bd., (2008) 73 Cal. Comp. Cas. (MB) 1338, 1340; held

USUAL AND CUSTOMARY FEES        Luis Gonzalez (Luis Gonzalez Valladeres), Applicant v. San Cristobal Distributing, State Compensation
Insurance Fund, Defendants No. ADJ6448504 (Panel Decision)Opinion Filed November 12, 2010
UTILIZATION REVIEW        8 CCR § 9792.7(b)(3))
UTILIZATION REVIEW        Carl Dixon, Applicant v. Phillips Buick, Pontiac & Mazda, Clarendon National Insurance Company, Administered By
LWP Claims Solutions, Defendants, 2010 Cal. Wrk. Comp. P.D. LEXIS 343, Opinion Filed August 23, 2010

UTILIZATION REVIEW        Labor Code § 4610 (g) (3)(A)
UTILIZATION REVIEW
LABOR CODE SECTION 4610(A)        Labor Code section 4610(a)'
UTILIZATION REVIEW
EN BANC        En Banc Decision of Lisa Simmons vs. State of California, Dept of Mental Health (Metropolitan State Hospital), Legally Uninsured; and
State Compensation Insurance Fund (Adjusting Agent), June 17, 2005 Case No. (WCAB No. LBO 0340807) 70 Cal. Comp. Cases 866, 869, 870

UTILIZATION REVIEW        Labor Code section 4610(g)(1)
UTILIZATION REVIEW
SANDHAGEN        State Comp. Ins. Fund v. Workers’ Comp. Appeals Bd. (Sandhagen) (2008) 44 Cal.4th 230 [73 Cal.Comp.Cases 981] (Sandhagen
UTILIZATION REVIEW SB 863  LABOR CODE § 4604.5.
     Labor Code § 4604.5.(a)

UTILIZATION REVIEW SB 863  LABOR CODE § 4604.5.
     Labor Code § 4604.5.  (b)
Utilization Review/ Home health care        Salguero v. ins. Company of the West (BPD) 41 CWCR 246

Verification        Lucena v. Diablo Auto Body (2000) 65 Cal.Comp.Cases 1425 (Significant Panel Decision),
WRIT DENIED CASES        Farmers Ins. Group of Companies v. Workers’ Comp. Appeals Bd. (Sanchez) (2002) 104 Cal.App.4th 684, 689, fn. 4
[67 Cal.Comp.Cases 1545]; Bowen v. Workers’ Comp. Appeals Bd. (1999) 73 Cal.App.4th 15, 21, fn. 10 [64 Cal.Comp.Cases 745].)

ISSUES FOR PROVIDERS        NOTES

MPNs        Chavez v. T. D. Hayes (2012) ADJ 6490669, 2012 Cal. Wrk. Comp. P.D. LEXIS
403, WCAB Panel Decision.
MPN        MARIAM DAVTYAN, VS. THE VONS COMPANIES, INC., Permissibly ADJ8870233  OPINION AND ORDERGRANTING PETITION
FOR 7 REMOVAL AND DECISION AFTER REMOVAL
2nd review        9792.5.5 (b)
RFA        9792.9.1(b)(2)
MPN        (Elliot v. Workers’ Comp. Appeals Bd. (2010) 182 Cal.App.4th 355 [75 Cal.Comp.Cases 81].”
Psyche        MICAELA LLAMAS, VS. GUILD, INC.; STATE COMPENSATION INSURANCE FUND;  EMPLOYERS COMP GLENDALE,  
ADJ2994393 (Oxnard District Office) April 11, 2014,  OPINION AND ORDER DENYING PETITION FOR RECONSIDERATION :
$10,000.00 IN MEDICAL        Cal Lab Code § 5402 (c)
24 CHIROPRACTIC, ETC        Brenda X. Flores, Applicant v. Masterpiece Artist, Zenith Insurance Company, Defendants, 2007 Cal. Wrk. Comp. P.
D. LEXIS 18, Opinion Filed May 3, 2007

24 CHIROPRACTIC, ETC.        Cal Lab Code § 4604.5 (d)(1)

24 CHIROPRACTIC, ETC.        Cal Lab Code § 4604.5 (d)(3)
24 VISIT CAP        Grom v. Workers' Comp. Appeals Bd.,(2004) 69 Cal. Comp. Cas.  1567; 1572

24 VISIT CAP        . In this case, the Appeals Board has made a strong statement that the need to relieve injured workers from their pain still remains
a major mission of medical treatment
2nd review        9792.5.5 (c)
2nd review        9792.5.6.
2nd review        9792.5.5 (e)
2nd review        9792.5.5 (f)
5 DAYS         8 CCR § 10507
6 MONTH EMPLOYMENT        Sharon Hammerly vs. Carrow Restaurant  and Mitsui Sumitomo Marine Management (2011) ADJ6990558 Appeals
Board Decision Denying Reconsideration Decided June 22, 2011.

ABOVE FEE SCHEDULE        8 CCR § 9792  (c) Determination of the Fee

ABOVE FEE SCHEDULE        “ Guillermo Bayley, Applicant v. YMCA of the East Bay, Travelers Insurance, Defendants; Stanford University Medical
Center, Lien Claimant W.C.A.B. No. ADJ236752 (SFO 0509283)--WCAB Panel: Commissioners Lowe, Moresi, BrassWorkers' Compensation Appeals
Board (Panel Decision) 2011 Cal. Wrk. Comp. P.D. LEXIS 149 Opinion Filed March 22, 2011  states as follows:

ABOVE FEE SCHEDULE        8 CCR § 9789.22 (j)
ABOVE FEE SCHEDULE
DRG (PER DIEM RATE)        County of Los Angeles v. Sullivan, (1992) 969 F.2d 735, 38 Soc. Sec. Rep. Service 109
ABOVE FEE SCHEDULE
GOULD 1        County of Los Angeles v. Sullivan, (1992) 969 F.2d 735, 38 Soc. Sec. Rep. Service 109
ABOVE FEE SCHEDULE
GOULD 2        Gould v. Workers' Compensation Appeals Bd. (Barry), (1995) 60 Cal. Comp. Cas. (MB) 1109

ABOVE FEE SCHEDULE
EXTRAORDINARY CIRCUMSTANCES
     Guillermo Bayley, Applicant v. YMCA of the East Bay, Travelers Insurance, Defendants; Stanford University Medical Center, Lien Claimant W.C.
A.B. No. ADJ2367528 (SFO 0509283)--WCAB Panel: Commissioners Lowe, Moresi, Brass Workers' Compensation Appeals Board (Panel Decision)
2011 Cal. Wrk. Comp. P.D. LEXIS 149 Opinion Filed March 22, 2011

ABOVE FEE SCHEDULE
EXTRAORDINARY CIRCUMSTANCES
(CITE 3)        Guillermo Bayley, Applicant v. YMCA of the East Bay, Travelers Insurance, Defendants; Stanford University Medical Center, Lien
Claimant W.C.A.B. No. ADJ2367528 (SFO 0509283)--WCAB Panel: Commissioners Lowe, Moresi, Brass Workers' Compensation Appeals Board
(Panel Decision) 2011 Cal. Wrk. Comp. P.D. LEXIS 149 Opinion Filed March 22, 2011

ACCELERATION,
AGGRAVATION, OR "LIGHTING UP" OF A PRE-EXISTING CONDITION        Spillane v. Workers' Comp. Appeals Bd., (1969)269 Cal. App. 2d
346;348, 74 Cal. Rptr. 671; 673,

ACCELERATION,
AGGRAVATION, OR "LIGHTING UP" OF A PRE-EXISTING CONDITION        Pullman Kellogg v. Workers' Comp. Appeals Bd.,(1980)  26 Cal.
3d 450, 454; 161 Cal. Rptr. 783,785; 605 P.2d 422,424;  45 Cal. Comp. Cas.  170, 172

AME
THE WCJ ALSO WAS         Kellogg Co. v. Workers' Compensation Appeals Bd. (Battle), (1996) 61 Cal. Comp. Cas. (MB) 519, 521

AME
MEDICAL LEGAL REPORTS ARE NOT ADMISSIBLE TO SHOW MEDICAL NECESSITY        State Comp. Ins. Fund v. Workers’ Comp.
Appeals Bd. (Sandhagen) (2008) 44 Cal.4th 230 [73 Cal.Comp.Cases 981] (Sandhagen)
AME
(UR)
     Carl Dixon, Applicant v. Phillips Buick, Pontiac & Mazda, Clarendon National Insurance Company, Administered By LWP Claims Solutions,
Defendants, 2010 Cal. Wrk. Comp. P.D. LEXIS 343, Opinion Filed August 23, 2010

AOE/COE – BURDEN OF PROOF        Hand Rehabilitation Center v. Workers' Comp. Appeals Bd. (Obernier) (1995) 34 Cal.App.4th 1204, 1212-
1213 [60 Cal.Comp.Cases 289, 291-292]).
AOE/COE/Off‐duty recreational activity
     City of Anaheim v. WCAB (Quick) (W/D) 78 CCC 41

APPLICANT OF ADJUDICATION
     Cal. Lab. Code § 5405
APPLICANT OF ADJUDICATION
     McDaniel v. Workers' Comp. Appeals Bd., (1990) 218 Cal. App. 3d 1011, 267 Cal. Rptr. 440, 1990 Cal. App. LEXIS 262, 55 Cal. Comp. Cas.  72

APPLICATION OF ADJUDICATION        4903.6.

APPLICATION OF ADJUDICATION
     Cal Lab Code § 5501

APPLICATION OF ADJUDICATION        Labor Code section 5501.5

AUTHENTICATION        The writing must be authenticated by proof showing that the writing is what the proponent claims it is.
AUTHORIZATION        8 CCR 9792.6 (o) "

BIFURCATION
     Argent Medical Lab. v. Workers' Compensation Appeals Bd. (Barrera), (1994) 60 Cal. Comp. Cas. 28, 29;

BILLING         Labor Code § 4603.4

BILLING THE INJURED WORKER        Labor Code § 3751  (b)
BILLS
NOT SIGNED        Maricela Arellano, Applicant v. Telacu, State Compensation Insurance Fund, Defendants, 2009 Cal. Wrk. Comp. P.D. LEXIS
284, Opinion Filed July 13, 2009 the Court held:.
BUNKHOUSE RULE        Truck Ins. Exch. v IAC (Dollarhide) (1946) 27 C2d 813, 167 P2d 705, 11 CCC 94

BUNKHOUSE RULE        Vaught v. State of California, (2007) 157 Cal. App. 4th 1538, 69 Cal. Rptr. 3d 605, 73 Cal. Comp. Cas.  125,

BURDEN OF PROOF        2012 En banc Decision of “Torres”. Case:  Tito Torres v  AJC Sandblasting; and Zurich North America Nov 15, 2012
Case No. ADJ909554 LAO (0824849) and ADJ1856854 (LAO 0837910) 77 Cal. Comp.Cases.

BURDEN OF PROOF        En Banc decision of Tito Torres v AJC Sandblasting; and Zurich North America Nov 15, 2012 Case No. ADJ909554 LAO
(0824849) and ADJ1856854 (LAO 0837910) 77 Cal.Comp.Cases
BURDEN OF PROOF        Luis Gonzalez (Luis Gonzalez Valladeres), Applicant v. San Cristobal Distributing, State Compensation Insurance Fund,
Defendants No. ADJ6448504 (Panel Decision)Opinion Filed November 12, 2010; 2010 Cal. Wrk. Comp. P.D. LEXIS 580,

BURDEN OF PROOF        Cal Lab Code § 3202.5
BURDEN OF PROOF
5705. Burden of proof; Affirmative defenses        Cal Lab Code § 3202.5
BURDEN OF PROOF        Tapia v. Skill Masters Staffing (2008) 73 Cal.Comp.Cases 1338, 1340 (Appeals Board en banc) (Tapia), 1340; held

CAUSATION
ACCELERATION, AGGRAVATION        Zemke v. Workers' Comp. Appeals Bd., (1968) 68 Cal. 2d 794, 799; 69 Cal. Rptr. 88, 92;  441 P.2d
928,932;  33 Cal. Comp. Cas. 358

CAUSATION
ACCELERATION, AGGRAVATION,         Zemke v. Workers' Comp. Appeals Bd., (1968) 68 Cal. 2d 794, 799; 69 Cal. Rptr. 88, 92;  441 P.2d
928,932;  33 Cal. Comp. Cas. 358

CAUSATION
ACCELERATION, AGGRAVATION,         Spillane v. Workers' Comp. Appeals Bd., (1969)269 Cal. App. 2d 346;348, 74 Cal. Rptr. 671; 673,

CAUSATION
(SIMMONS) (CITE 2)        En Banc Decision of Simmons v. California, (W.C.A.B. 2005)70 Cal. Comp. Cases 866, 877:

CAUSATION
(SIMMONS) (CITE 1)        En Banc Decision of Simmons v. California, (W.C.A.B. 2005)70 Cal. Comp. Cases 866, 877:

CIGA
EN BANC        Jose L. Martinez vs.Jack Neal & Sons, Inc. July 27, 2004 Case No. (WCAB No. SRO 107686) 69 Cal.Comp.Cases 772

CIGA AND ASSIGNED CLAIMS        CIGA v. WCAB (2012) 77 CCC 143, Court of Appeal, Second Appellate District,
Division Two.

CIGA ISSUES
ASSIGNED CLAIMS        Baxter Healthcare Corp. v. California Ins. Guarantee Assn., (2000) 85 Cal. App. 4th 306, 102 Cal. Rptr. 2d 87,
CIGA ISSUES
ASSIGNED CLAIMS        Black Diamond Asphalt, Inc. v. Superior Court, 114 Cal. App. 4th 109, 7 Cal. Rptr. 3d 466, 2003 Cal. App. LEXIS 1827,
2003 Cal. Daily Op. Service 10641, 2003 D.A.R. 13420 (Cal. App. 3d Dist. 2003
r.
CIGA ISSUES
ASSIGNED CLAIMS        Catholic Healthcare West v. California Ins. Guarantee Assn., (2009) 178 Cal. App. 4th 15, 100 Cal. Rptr. 3d 125,
CIGA ISSUES
ASSIGNED CLAIMS        Insurance code 1063.1 (c)(9)

CIGA ISSUES
ASSIGNED CLAIMS        St. Joseph’s Hospital v. Workers’ Compensation Appeals Bd., 70 Cal. Comp. Cas. (MB) 1612 (Cal. App. 1st Dist. 2005)
the Court held as follows

CIGA ISSUES
ASSIGNED CLAIMS        Mirna Licea v. Minson Corporation; California Insurance Guarantee Association for Phico Insurance Company, in
liquidation ADJ 1857578 (AHM 0089872) decided June 23, 2009
CITABLE DECISIONS WCAB        WCAB en banc WCAB Significant Panel decisions (SPDCWCR panel decision summaries WCAB panel decisions
are
CITING PANEL DECISIONS        CITING PANEL DECISIONS
COMPENSABLE CONSEQUENCES        Divjakinja v. Workers' Compensation Appeals Bd., (2007) 73 Cal. Comp. Cas. 142 144


COMPENSABLE CONSEQUENCES        Pirelli Armstrong Tire Co. v. Workers' Compensation Appeals Bd., (2003) 68 Cal. Comp. Cas. 970, 973

CONSOLIDATING CASES        Rule §10591
CUMULATIVE INJURY        Cal Lab Code § 3208.1.
DATE OF INJURY
POST TERMINATION        Labor Code §5412
DENIED INJURY        Luis Gonzalez (Luis Gonzalez Valladeres), Applicant v. San Cristobal Distributing, State Compensation Insurance Fund,
Defendants No. ADJ6448504 (Panel Decision)Opinion Filed November 12, 2010; 2010 Cal. Wrk. Comp. P.D. LEXIS 580,
DENIED INJURY        CNA Ins. Cos. v. Workers' Compensation Appeals Bd. (Valdez), ( 1997) 62 Cal. Comp. Cas. (MB) 1145, 1146:

DENIED INJURY        Luis Gonzalez (Luis Gonzalez Valladeres), Applicant v. San Cristobal Distributing, State Compensation Insurance Fund,
Defendants No. ADJ6448504 (Panel Decision)Opinion Filed November 12, 2010
DISCOVERY
MOTION TO QUASH (CITE 1)        LIBERTY MUTUAL INSURANCE COMPANY et al., Petitioners, v. THE SUPERIOR COURT OF SAN
MATEO COUNTY, Respondent; GUNDA FRYSINGER, Real Party in Interest. No. A056957 COURT OF APPEAL OF CALIFORNIA, FIRST
APPELLATE DISTRICT, DIVISION FIVE.10 Cal. App. 4th 1282; 13 Cal. Rptr. 2d 363; 1992 Cal. App. November 6, 1992, Decided

DISCOVERY
MOTION TO QUASH (CITE 2)        At any rate the procedure outlined above will prevent undue harassment and oppression of high-level officials
while still providing a plaintiff with several less intrusive mechanisms to obtain the necessary discovery, and allowing for the possibility of conducting
the high-level deposition if warranted.”

DISCOVERY
MOTION TO QUASH (CITE 3)        We conclude it amounts to an abuse of discretion to withhold a protective order when a plaintiff seeks to depose
a corporate president, or corporate officer at the apex of the corporate hierarchy, absent a reasonable indication of the officer's personal knowledge of
the case and absent exhaustion of less intrusive discovery methods.”

DISMISSAL OF INACTIVE LIEN         Dismissal of Inactive Lien Claims for Lack of Prosecution
DISTINCT PART REHABILITATION UNITS        Exempt from the maximum reimbursement formula set forth in subdivision (a) and are paid on a
reasonable cost basis.


DISTINCT PART REHABILITATION UNITS        Distinct part rehabilitation units of an acute care hospital
DRG        Length of stay
DUPLICATE BILLS        
Labor Code section 4603.2(b)(4)
''DURABLE MEDICAL EQUIPMENT        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.
EMPLOYMENT        Independent contractor
EMPLOYMENT        Workers' compensation provides the exclusive remedy against an employer for an injury sustained by an employee in the course
of employment and compensable under the workers' compensation
EN BANC DECISIONS
     En banc decisions of the Appeals Board are binding
EOR        
EVIDENCE        
Cal. Code Regs., tit. 8, § 10770.1(e
EVIDENCE        County of Sacramento v. Worker's Comp. Appeals Bd., (1999) 64 Cal. Comp. Cas. 26,


EVIDENCE        Cal Lab Code  § 5502  (e)(3)
EVIDENCE
(8 CAL. CODE REG. § 9785 DOES NOT REQUIRE PRIMARY TREATING PHYSICIAN TO REFER  TO CONSULTING PHYSICIAN )        Mears
Group v. Workers' Compensation Appeals Bd., (2004) 69 Cal. Comp. Cas. (MB) 1601

EVIDENCE
AUTHENTICATION        The writing is usually not self-authenticating. It needs a testimonial sponsor to prove that the writng was made, signed, or
adopted by the particular relevant person
EVIDENCE
BURDEN OF PROOF        Cal Lab Code § 3202.
EVIDENCE
AME NOT ADMISSIBLE        Kellogg Co. v. Workers' Compensation Appeals Bd. (Battle), (1996) 61 Cal. Comp. Cas. (MB) 519, 521

EVIDENCE
(FAILURE TO INCORPORATE         Tim Bird, Applicant v. Rick Wilson General Contracting, State Compensation Insurance Fund, Defendants,
2008 Cal. Wrk. Comp. P.D. LEXIS 755, Opinion Filed October 28, 2008

EVIDENCE
§ 5705. BURDEN OF PROOF; AFFIRMATIVE DEFENSES        The burden of proof rests upon the party or lien claimant holding the affirmative of
the issue. The following are affirmative defenses, and the burden of proof rests upon the employer to establish them
EVIDENCE
MEDICAL REPORTS NOT SIGNED)        Paul Belcher, Applicant v. Staffmark, Inc./Atlantic Mutual Insurance Company c/o Broadspire,
Defendants, 2009 Cal. Wrk. Comp. P.D. LEXIS 485, Opinion Filed October 30, 2009
EVIDENCE
AT MSC        Stelling Robinson, Petitioner v. Workers Compensation Appeals Board of the State of California and Republic Indemnity Company of
America, Respondents. F008164 Court of Appeal, Fifth Appellate District 52 Cal. Comp. Cas 419:

EVIDENCE
THE PAROL EVIDENCE RULE
     Parol (extrinsic) evidence is not admissible to add to, detract from, or alter the agreement as written.

EXHIBITS        8 CCR § 10629. Filing and Listing of Exhibits
EXTRAORDINARY CIRCUMSTANCES        Extraordinary” as “going beyond what is usual, regular, common, or customary
FEE SCHEDULE
BACK TO 2003 IF NOT INCLUDED        Labor Code § 5307.1(e)
FEE SCHEDULE        8 CCR § 9789.22 (j) .
FEE SCHEDULE
USUAL AND CUSTOMARY        8 CCR § 9789.22 (j) charges
FICTITIOUS NAME        CNA Ins. Cos. v. Workers' Compensation Appeals Bd. (Valdez), (1997) 62 Cal. Comp. Cas. (MB) 1145, 1146

FICTITIOUS-NAME PERMIT        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 0169879the Court stated:
FICTITIOUS-NAME PERMIT        Stokes v. Patton State Hospital (2007) 72 CCC 996, Appeals Board
Significant Panel Decision.

FILING AND SERVICE OF LIEN CLAIMS.§10770        §10770. Filing and Service of Lien Claims.
FUTURE MEDICAL        As a consequence, the WCAB would have continuing jurisdiction to enforce an award as apposed [sic] to rescinding,
altering, or "amending an award.”

FUTURE MEDICAL        Appeals Board retains jurisdiction beyond the five-year statute to enforce its continuing awards.

FUTURE MEDICAL
JURISDICTION        (Future medical) appeals board has continuing jurisdiction over all its orders, decisions, and awards made and entered under the
provisions of this division
HEARING NOTICES        
Cal. Ins. Guarantee Assoc. v. Workers' Comp. Appeals Bd (Norwood) (2006) 71 Cal.Comp.Cases 808, 811 (writ denied )
HOME HEALTH CARE        Allgreen Landscape v. WCAB (Mota) (2012) 77 CCC 541, Court of Appeal,
Fourth Appellate District, Division Three, writ denied.

HOSPITAL EXEMPTION        Most if not all of our hospital have a distinct part rehabilitation unit.

IBR
9792.5.10.  INDEPENDENT BILL REVIEW - DOCUMENT FILING.        9792.5.10 (a)
IMR
UTILIZATION REVIEW SB 863   LABOR CODE § 4610.
     Labor Code § 4610.
(g)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(d)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(e)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(f)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(g)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(h) (1)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(i)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(j)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(k)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(l)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(m)
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     Labor Code § 4610.5.
(n
IMR
UTILIZATION REVIEW SB 863    LABOR CODE § 4610.5.
     IMR
IMR  LABOR CODE § 4610.6. SB 863
     Labor Code § 4610.6.

IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(b)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(c)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(d)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(e)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(e)
IMR  LABOR CODE § 4610.6. SB 863        
Labor Code § 4610.6.
(g)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(h)
IMR  LABOR CODE § 4610.6. SB 863        
Labor Code § 4610.6.
(i)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(j)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(k)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(l)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(m)
IMR  LABOR CODE § 4610.6. SB 863        Labor Code § 4610.6.
(n)
INDEPENDENT CONTRACTOR        Cal Lab Code § 3353
INJURED WORKER        Cal Lab Code § 3202
INTERPRETER
EN BANC DECISIONS
     Jose Guitron v.Santa Fe Extruders; and State Compensation Insurance fund March 17, 2011 Case No. ADJ163338 (LAO 0873468) 76 Cal. Comp.
Cases 228

INTOXICATION
(BURDEN OF PROOF)        Barrett Business Services, Inc./Clark Roofing, PSI v. Workers' Compensation Appeals Bd., (2007)  73 Cal. Comp. Cas.
(MB) 133

JURISDICTION        Great Western Power Co. v. Industrial Acci. Com. (1925) 196 Cal 593, 602; 238 P 662, 666; 1925 Cal LEXIS 344, 14, 15.

JURISDICTION        Fox v. Workers' Comp. Appeals Bd., No. B056838 , (1992), 4 Cal. App. 4th 1196; 6 Cal. Rptr. 2d 252;57 Cal. Comp. Cas 149;

JURISDICTION        Tomlinson v. Superior Court of Stanislaus County, (1944) 66 Cal. App. 2d 640, 643, 644; 152 P.2d 517, 1944 Cal. App. LEXIS
288, 5, 6; 9 Cal. Comp. Cas. (MB) 316, 318;
"
JURISDICTION
(OVER FUTURE MEDICAL TREATMENT)        Cal Lab Code § 5803
KNOWLEDGE OF INJURY        Cal Lab Code § 5402

LABOR CODE § 4600(A)        Labor Code § 4600(a)
LACHES        Panel Decision of Jorge Samayoa, Applicant v. X-Tra Help, California Compensation Insurance Company, In Liquidation, CIGA,
Defendants
LACHES        LACHES
LACHES: UNCLEAN HANDS        County of Los Angeles v. Workers' Compensation Appeals Bd.,(2002)  67 Cal. Comp. Cas. (MB) 1349; 1353

LAW
INTERPRETATION        American Nat. Ins. Co. v. Low, 84 Cal. App. 4th 914, 101 Cal. Rptr. 2d 288, 2000 Cal. App. LEXIS 859, 2000 Cal. Daily
Op. Service 9023, 2000 D.A.R. 11961 (Cal. App. 2d Dist. 2000

LAW
INTERPRETING        Burlington N. & Santa Fe Ry. Co. v. Puc, (2003)  112 Cal. App. 4th 881, 5 Cal. Rptr. 3d 503,

LAW
INTERPRETATION        County of Orange v. FST Sand & Gravel, Inc., 63 Cal. App. 4th 353, 73 Cal. Rptr. 2d 633, 1998 Cal. App. LEXIS 353, 98
Cal. Daily Op.

LAW
INTERPRETING        DuBois v. Workers' Comp. Appeals Bd., (1993) 5 Cal. 4th 382, 20 Cal. Rptr. 2d 523, 853 P.2d 978,

LAW
INTERPRETING        Jose Facundo-Guerrero, Petitioner v. Workers' Compensation Appeals Board, Nurserymen's Exchange, et al., Respondents,
(2008) 73 Cal. Comp. Cas 785; 77 Cal. Rptr. 3d 731,:

LENGTH OF STAY        LENGTH OF STAY
LIABILITY IS NOT REJECTED WITHIN 90 DAYS        Cal Lab Code § 5402

LIEN        County of Los Angeles v. Workers' Compensation Appeals Bd.,(2002)  67 Cal. Comp. Cas. (MB) 1349; 1351

Lien Assignments
     Barrientos v. Alamo Motor Lodge; SCIF (BPD) (2013 Cal. Wrk. Comp. P.D. LEXIS 285):

LIEN CLAIMS
SERVICE OF §10770 FILING AND        §10770..
LIEN FILING TIME
SB 863
LABOR CODE § 4903.5.
     Labor Code § 4903.5.

LIEN FILING TIME
SB 863
LABOR CODE § 4903.5.
     Labor Code § 4903.5 (b)
LIEN FILING TIME
SB 863
LABOR CODE § 4903.5.
     Labor Code § 4903.5 (c)
LIEN FILING TIME
SB 863
LABOR CODE § 4903.5.
     Labor Code § 4903.5 (d)
LIEN FILING TIME
SB 863
LABOR CODE § 4903.6.        Labor Code § 4903.6.
LIEN FILING TIME
SB 863
LABOR CODE § 4903.6.        Labor Code § 4903.6 (c
LIEN FILING TIME
SB 863
LABOR CODE § 4903.6.        

Labor Code § 4903.6 (d)
LIEN FILING TIME
SB 863
LABOR CODE § 4903.        Labor Code § 4903.6 (e)
LIENS        
LIENS FUTURE MEDICAL TREATMENT        Barbara Ann Hingtgen, Applicant v. County of San Bernardino, PSI, Defendant (2012) W.C.A.B. No.
ADJ446534 (SBR 0216831)—writ denied case

LIENS: TIME TO FILE        CHARLES KINDELBERGER, vs. CITY OF LOS ANGELES, permissibly self- AND DECISION Case Nos. May 24,
2013;ADJ586942 (VNO 0384663) ADJ687483 (VNO 0384664) OPINION AND ORDER GRANTING PETITION FOR RECONSIDERATION

LIENS: TIME TO FILE        section 4903.5, subdivision (a)
LONG TERM CARE HOSPITALS        8 CCR 9789.22
MEDICAL  NECESSITY
AME REPORT        Kellogg Co. v. Workers' Compensation Appeals Bd. (Battle), (1996) 61 Cal. Comp. Cas. (MB) 519, 521

MEDICAL CONTROL        Cal Lab Code § 4600 (c)
MEDICAL CONTROL        Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd. (Bolton) (1983) 34 Cal. 3d 159, 161-162 [666 P.2d 14,
193 Cal. Rptr. 157] [48 Cal.Comp.Cases 566 The California Supreme Court has noted that:

MEDICAL LEGAL        
MEDICAL LEGAL        Cal Lab Code § 4620

MEDICAL LEGAL        Kellogg Co. v. Workers' Compensation Appeals Bd. (Battle), (1996) 61 Cal. Comp. Cas. (MB) 519, 521
MEDICAL LEGAL        Chevron Texaco Products Company/Chevron Corp. v. Workers' Compensation Appeals Bd., (2003) writ denied 68 Cal.
Comp. Cas. (MB) 765; 767, held:

MEDICAL LEGAL (REPORTS ARE NOT ADMISSIBLE TO SHOW MEDICAL NECESSITY)        State Comp. Ins. Fund v. Workers’ Comp.
Appeals Bd. (Sandhagen) (2008) 44 Cal.4th 230 [73 Cal.Comp.Cases 981] (Sandhagen)
Medical legal defines "medical-legal expenses        Labor Code section
MEDICAL NECESSITY        Grom v. Workers' Comp. Appeals Bd.,(2004) 69 Cal. Comp. Cas.  1567; 1572

MEDICAL NECESSITY        Regents of the University of California v. Workers' Compensation Appeals Bd., (2005) 70 Cal. Comp. Cas. 1733; 1735
(writ denied)

MEDICAL NECESSITY        Grom v. Workers' Comp. Appeals Bd.,  (2004) 69 Cal. Comp. Cas. (MB) 1567, 1572;

MEDICAL NECESSITY
CERVANTES (CITE 1)        Cervantes v. Workers' Comp. Appeals Bd., (En Banc) (2009) 74 Cal. Comp. Cas.  1336, 1355,
MEDICAL NECESSITY
ELLIOTT V. WORKERS' COMP. APPEALS BD        Elliott v. Workers' Comp. Appeals Bd., (2010) 182 Cal. App. 4th 355,  75 Cal. Comp. Cas.  81

MEDICAL NECESSITY
FOR NON-INDUSTRIAL INJURY        Granado v. Workmen’s Comp. App. Bd. (1968) 69 Cal. 2d 399, 404
MEDICAL NECESSITY        Kenneth Grom vs. Shasta Wood Products [(2004) 69 Cal. Comp. Cases 1567 (WCAB significant panel decision)].

MEDICAL REPORT
FAILURE TO INCORPORATE OR REVIEW OF THE PTP        .
Labor Code § 4061.5
MEDICAL REPORTS
NOT SIGNED        Paul Belcher, Applicant v. Staffmark, Inc./Atlantic Mutual Insurance Company c/o Broadspire, Defendants, 2009 Cal. Wrk.
Comp. P.D. LEXIS 485, Opinion Filed October 30, 2009

MOTION TO QUASH
DISCOVERY
(CITE 1)        LIBERTY MUTUAL INSURANCE COMPANY et al., Petitioners, v. THE SUPERIOR COURT OF SAN MATEO COUNTY,
Respondent; GUNDA FRYSINGER, Real Party in Interest. No. A056957 COURT OF APPEAL OF CALIFORNIA, FIRST APPELLATE DISTRICT,
DIVISION FIVE.10 Cal. App. 4th 1282; 13 Cal. Rptr. 2d 363; 1992 Cal. App. November 6, 1992, Decided

MOTION TO QUASH
DISCOVERY
(CITE 2)        LIBERTY MUTUAL INSURANCE COMPANY et al., Petitioners, v. THE SUPERIOR COURT OF SAN MATEO COUNTY,
Respondent; GUNDA FRYSINGER, Real Party in Interest. No. A056957 COURT OF APPEAL OF CALIFORNIA, FIRST APPELLATE DISTRICT,
DIVISION FIVE.10 Cal. App. 4th 1282; 13 Cal. Rptr. 2d 363; 1992 Cal. App. November 6, 1992, Decided

MOTION TO QUASH
DISCOVERY
(CITE 3)        LIBERTY MUTUAL INSURANCE COMPANY et al., Petitioners, v. THE SUPERIOR COURT OF SAN MATEO COUNTY,
Respondent; GUNDA FRYSINGER, Real Party in Interest. No. A056957 COURT OF APPEAL OF CALIFORNIA, FIRST APPELLATE DISTRICT,
DIVISION FIVE.10 Cal. App. 4th 1282; 13 Cal. Rptr. 2d 363; 1992 Cal. App. November 6, 1992, Decided

MPN        Section 9767.5.
MPN        Section 9767.6. (b)
MPN        Section 9767.7 (a)
MPN        Section 9767.7 (b)
MPN        Section 9767.1(a) (1)
MPN        Section 9767.1(a) (1)(5)
MPN        Section 9767.3 (c) (1)
MPN        Section 9767.10.
MPN        Section 9767.3 (c) (1) (3)
MPN
TRANSFER OF TREATMENT INTO MPN        8 CCR § 9767.9(f)
MPN
MEDICAL CONTROL        Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd. (Bolton) (1983) 34 Cal. 3d 159, 161-162 [666 P.2d 14,
193 Cal. Rptr. 157] [48 Cal.Comp.Cases 566 The California Supreme Court has noted that:

MPN        Labor Code  §4616.3 and California Code of Regulations, title 8, section 9767.12(a). Section 4616.3 provides:

MPN        Voss v. Workers' Comp. Appeals Bd., (1974)10 Cal. 3d 583, 588; 516 P.2d 1377, 1380, , 39 Cal. Comp. Cas.  56

MPN        En Banc Decision of  Bruce Knight, United Parcel Service; and Liberty Mutual Insurance Company October 10, 2006  71 Cal. Comp. Cases
1423, 1431

MPN        En Banc Decision of  Bruce Knight, United Parcel Service; and Liberty Mutual Insurance Company October 10, 2006  71 Cal. Comp. Cases
1423, 1431


MPN        “ Jennifer Balkowitsch, Applicant v. Home Depot, PSI, adjusted by Sedgwick Claims Management Services, Defendants, 2008 Cal. Wrk.
Comp. P.D. LEXIS 567, Opinion Filed August 11, 2008

MPN        Joaquin Valencia, Applicant v. Taylor Fresh Foods, Zurich North America, Defendants, 2008 Cal. Wrk. Comp. P.D. LEXIS 596, Opinion
Filed August 6, 2008

MPN        Walter Roque, Applicant v. Louise's Trattoria, Liberty Mutual Insurance Company, Defendants, 2008 Cal. Wrk. Comp. P.D. LEXIS 349,
Opinion Filed April 21, 2008

MPN
PROCEDURES        Lab. Code, § 4616.3(b); see also Cal. Code Regs., tit. 8, § 9767.12(a)(6).
MPN        Section 4616.2(d)(3)
MPN
TRANSFERRING MEDICAL TREATMENT INTO MPN (BABBIT EN BANC)        Babbit v. Ow Jing, 72 CCC 70, 73  (WCAB en banc 2007)

MPN
(OFFER OF MEDICAL TREATMENT)        Barrett Business Services, Inc. v. Workers' Compensation Appeals Bd., (2008) 74 Cal. Comp. Cas. (MB)
49

MPN
(OFFER OF MEDICAL TREATMENT)        Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd. (Bolton) (1983) 34 Cal. 3d 159, 164 ;
48 Cal.Comp.Cases 566, 569
MPN
EN BANC DECISION OF KNIGHT        Bruce Knight, United Parcel Service; and Liberty Mutual Insurance Company October 10, 2006  71 Cal.
Comp. Cases 1423

MPN
EN BANC DECISION
     Elayne Valdez v.Warehouse Demo Services; Zurich North America, Adjusted by ESIS Case No. ADJ7048296 April 20, 2011
Elayne Valdez v.Warehouse Demo Services; Zurich North America, Adjusted by ESIS Case No. ADJ7048296 April 20, 2011

MPN
REASONABLE OFFER OF MEDICAL TREATMENT        Voss v. Workers' Comp. Appeals Bd. (1974) 10 Cal.3d 583, 588 [516 P.2d 1377, 111 Cal.
Rptr. 241] [39 Cal.Comp.Cases 56
MPN
OFFER OF MEDICAL TREATMENT        Labor Code  §4616.3 and California Code of Regulations, title 8, section 9767.12(a). Section 4616.3
provides:

MPN: ACCESS        

Robles v. WCAB (W/D) 78 CCC 168

MSC        8 CCR § 10629. Filing and Listing of Exhibits
MSC        County of Sacramento v. Worker's Comp. Appeals Bd., (1999) 64 Cal. Comp. Cas. 26,
MSC        Cal Lab Code § 5502 (d)  (3)
MSC        County of Sacramento, Petitioner vs. Workers Compensation Appeals Board, Glennis Weatherall, Jodie Weatherall (Decedent), et al.,
Respondents,  (2000) 65 Cal. Comp. Cas 1; 77 Cal. App. 4th 1114; 92 Cal. Rptr. 2d 290,


MSC        
NECESSITY        Grom v. Workers' Comp. Appeals Bd.,(2004) 69 Cal. Comp. Cas.  1567; 1572

NECESSITY        Regents of the University of California v. Workers' Compensation Appeals Bd., (2005) 70 Cal. Comp. Cas. (MB) 1733:

NECESSITY        Kenneth Grom vs. Shasta Wood December 8, 2004(WCAB No. RDG 0091839) 69 Cal.Comp.Cases 1567

NECESSITY        Granado v. Workmen’s Comp. App. Bd. (1968) 69 Cal. 2d 399, 404 [71 Cal. Rptr. 678, 445 P.2d 294]; states as follows:
required of the employer
NECESSITY OF MEDICAL TREATMENT        Kellogg Co. v. Workers' Compensation Appeals Bd. (Battle), (1996) 61 Cal. Comp. Cas. (MB) 519,
521

NECESSITY OF MEDICAL TREATMENT        State Comp. Ins. Fund v. Workers’ Comp. Appeals Bd. (Sandhagen) (2008) 44 Cal.4th 230 [73 Cal.
Comp.Cases 981] (Sandhagen)
NON-ATTAORNEY  REPS (SB 863)
LABOR CODE § 4907.        Labor Code § 4907.
NON-INDUSTRIAL INJURY        Granado v. Workmen’s Comp. App. Bd. (1968) 69 Cal. 2d 399, 404 [71 Cal. Rptr. 678, 445 P.2d 294]; states as
follows:

NOTICE OF INJURY        Leprino Foods v. Workers' Compensation Appeals Bd., (2007)  72 Cal. Comp. Cas. (MB) 605; 612,

NOTICE OF INJURY        Chaparral Construction & Development v. Workers' Compensation Appeals Bd.,(2006)  71 Cal. Comp. Cas.  879 writ
denied

NOTICE OF INTENT        DeWitt Fox v. WCAB (1992), 6 Cal Rptr. 2d 252; 57 Cal.  Comp. Cas 149).

OWNERSHIP OF LIENS
SB 863
LABOR CODE § 4903.8.
     Labor Code § 4903.8.

OWNERSHIP OF LIENS
SB 863
LABOR CODE § 4903.8.
     Labor Code § 4903.8.

PANEL DECISIONS        Griffith v. Workers' Comp. Appeals Bd. (1989) 209 Cal.App.3d 1260, 1264, fn. 2 [257 Cal. Rptr. 813, 54 Cal. Comp.
Cases 145])

PAROL EVIDENCE RULE        THE PAROL EVIDENCE RULE
PENALTIES AND INTEREST
CALIFORNIA LABOR CODE § 4603.2(B)        California Labor Code § 4603.2(b)
PER DIEM RATE        Title 8, California Code of Regulations §9789.22(i)(1)
PER DIEM RATE        County of Los Angeles v. Sullivan, (1992) 969 F.2d 735, 38 Soc. Sec. Rep. Service 109

PERMANENT &STATIONARY        Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd., (1983) 34 Cal. 3d 159, 168; 666 P.2d 14,21;
48 Cal. Comp. Cas.  566, (1983
PETITION        LC § 5902.
PETITION FOR RECONSIDERATION        10842(a),
PETITION FOR RECONSIDERATION        Labor Code § 5903.
PETITION FOR RECONSIDERATION        8 CCR § 10842.
PETITION FOR RECONSIDERATION          8 CCR § 10507.
PETITIONS
     8 CCR § 10450. Petitions
PETITIONS FOR RECONSIDERATION / REMOVAL ETC        8 CCR § 10848. Supplemental Petitions
PETITIONS FOR RECONSIDERATION, REMOVAL, AND DISQUALIFICATION AND ANSWERS
     8 CCR § 108428 CCR § 10842

POST  TERMINATION        Leprino Foods v. Workers' Compensation Appeals Bd., (2007)  72 Cal. Comp. Cas. (MB) 605; 612,

POST TERMINATION        Labor Code section 3600(a)(10) (A
POST TERMINATION        Jesus Hernandez, Applicant v. Warner Bros. Studios, PSI, Defendant, 2009 Cal. Wrk. Comp. P.D. LEXIS 353, Opinion
Filed July 9, 2009

POST TERMINATION        Cal Lab Code § 3600
POST TERMINATION        Cal Lab Code § 5400
POST TERMINATION        Cal Lab Code § 5411 Date of injury
POST TERMINATION
DATE OF INJURY        Cal Lab Code § 5412 .  Date of injury; Occupational disease or cumulative injury

POST TERMINATION        Chaparral Construction & Development v. Workers' Compensation Appeals Bd.,(2006)  71 Cal. Comp. Cas. (MB) 879
writ denied

POST TERMINATION        Leprino Foods v. Workers' Compensation Appeals Bd., (2007)  72 Cal. Comp. Cas. (MB) 605; 612,

PPO
AUTHENTICATION        Fed. R. Evid. 901-903 Fed. R. Evid. 901-903
PPO
EXCLUSIVE REMEDY        Angelotti v. The Walt Disney Co., (2011) 192 Cal. App. 4th 1394,1403; 121 Cal. Rptr. 3d 863,869;

PPO
BILL REVIEW        John Miranda, Jr., Applicant v. The Pacific Lumber Company, Defendant, 2004 Cal. Wrk. Comp. P.D. LEXIS 90, Opinion Filed
October 12, 2004

PPO
BALZANO
BILL REVIEW        Balzano v. City of Los Angeles (April 13, 2005 Order Denying Reconsideration VNO 235609) 33 CWCR 10; 2005 Cal. Wrk.
Comp. P.D. LEXIS 16,

PPO
MOLINA SCIF / BLUE CROSS        Molina v. State Compensation Insurance Fund (February 7, 2005), Order Denying Reconsideration ANA
332752) 33 CWCR 136, 2005 Cal. Wrk. Comp. P.D. LEXIS 193

PPO
(JURISDICTION BELL CASE)        Bell v. Samaritan Medical Clinic, Inc., (1976) 60 Cal. App. 3d 486, 131 Cal. Rptr. 582, 1 41 Cal. Comp. Cas.  415

PPO
     HCA Health Services of Georgia v. Employer Health Insurance  22 F. Supp 2d 1390 (11th Cir 2001)

PPO
JURISDICTION
MIRANDA CASE        John Miranda, Jr., Applicant v. The Pacific Lumber Company, Defendant, 2004 Cal. Wrk. Comp. P.D. LEXIS 90, Opinion
Filed October 12, 2004

PPO
LABOR CODE § 4609(A)        Labor Code § 4609(a
PPO
LABOR CODE § 5304        Labor Code § 5304
PPO
SCIF NOT A PARTY TO ASSERT ARBITRATION        Molina v. State Compensation Insurance Fund (February 7, 2005, Order Denying
Reconsideration ANA 332752) 33 CWCR 136, 2005 Cal. Wrk. Comp. P.D. LEXIS 193

PPO
5304 ISSUE        Molina v. State Compensation Insurance Fund (February 7, 2005, Order Denying Reconsideration ANA 332752) 33 CWCR 136,
2005 Cal. Wrk. Comp. P.D. LEXIS
PPO
SCIF NOT A PARTY        Molina v. State Compensation Insurance Fund (February 7, 2005, Order Denying Reconsideration ANA 332752) 33
CWCR 136, 2005 Cal. Wrk. Comp. P.D. LEXIS
PPO
PAYOR ISSUES        Molina v. State Compensation Insurance Fund (February 7, 2005, Order Denying Reconsideration ANA 332752) 33 CWCR
136, 2005 Cal. Wrk. Comp. P.D. LEXIS
PPO
APPLIES ONLY TO BLUE CROSS EMPLOYEES        Nico Zuniga, Applicant v. Herb Stewart, State Compensation Insurance Fund, Defendants,
2002 Cal. Wrk. Comp. P.D. LEXIS 104, Opinion Filed June 13, 2002

PPO
EXPRESS
AGREEMENT ISSUE        Nico Zuniga, Applicant v. Herb Stewart, State Compensation Insurance Fund, Defendants, 2002 Cal. Wrk. Comp. P.D.
LEXIS 104, Opinion Filed June 13, 2002

PPO
PAROL EVIDENCE ISSUE        Nico Zuniga, Applicant v. Herb Stewart, State Compensation Insurance Fund, Defendants, 2002 Cal. Wrk. Comp. P.
D. LEXIS 104, Opinion Filed June 13, 2002

PPO
WATERS CASE        Sarah Waters, Applicant v. Los Angeles Clippers Basketball Club, Inc., TIG Specialty Insurance Solutions c/o Cambridge
Integrated Services Group, Inc., Defendants, 2005 Cal. Wrk. Comp. P.D. LEXIS 15, Opinions Filed February 7, 2005 and April 26, 2005

PPO
SENATE BILL 559,        Senate Bill 559
PPO
OLSUKKA CASE        Susan Olsukka v. City of Sacramento SAC 329274 ORDER DENYING RECONSIDERATION AUGUST 11, 2005


PPO        Tony Hoy, Applicant v. Northrop Grumman Corporation, Insurance Company of the State of Pennsylvania, AIG Claims, Defendants, 2006
Cal. Wrk. Comp. P.D. LEXIS

PPO
HOY CASE
(PAYOR LIST NOT A CONTRACT)        .” Tony Hoy, Applicant v. Northrop Grumman Corporation, Insurance Company of the State of
Pennsylvania, AIG Claims, Defendants, 2006 Cal. Wrk. Comp. P.D. LEXIS 1, Opinion Filed February 7, 2006


PPO        Virginia Woodruff, Applicant v. Greenfield Trucking, State Compensation Insurance Fund, Defendants, 2007 Cal. Wrk. Comp. P.D. LEXIS
93, Opinion Filed September 4, 2007

PPO
PAYOR ISSUE
     Virginia Woodruff, Applicant v. Greenfield Trucking, State Compensation Insurance Fund, Defendants, 2007 Cal. Wrk. Comp. P.D. LEXIS 93,
Opinion Filed September 4, 2007

PPO
4609 ISSUE        Virginia Woodruff, Applicant v. Greenfield Trucking, State Compensation Insurance Fund, Defendants, 2007 Cal. Wrk. Comp. P.D.
LEXIS 93, Opinion Filed September 4, 2007

PPO
EXPRESS AGREEMENT ISSUE
     Virginia Woodruff, Applicant v. Greenfield Trucking, State Compensation Insurance Fund, Defendants, 2007 Cal. Wrk. Comp. P.D. LEXIS 93,
Opinion Filed September 4, 2007

PPO
DEEP DISCOUNT (PUBLIC POLICY)        Virginia Woodruff, Applicant v. Greenfield Trucking, State Compensation Insurance Fund, Defendants,
2007 Cal. Wrk. Comp. P.D. LEXIS 93, Opinion Filed September 4, 2007

PPO
ZUNIGA        Zuniga, Applicant v. Herb Stewart, State Compensation Insurance Fund, Defendants, 2002 Cal. Wrk. Comp. P.D. LEXIS 104, Opinion
Filed June 13, 2002in which the court held as follows:

PPO ISSUE        Tri-City Medical Center v. Workers' Compensation Appeals Board, (2010) 75 Cal. Comp. Cases 790 (writ denied)
.
PRE-EXISTING DISEASE / INJURY        Spillane v. Workers' Comp. Appeals Bd., (1969) 269 Cal. App. 2d 346;348, 74 Cal. Rptr. 671; 673
PRE-EXISTING DISEASE / INJURY        Hart v. Workers' Comp. Appeals Bd.,(1978)  82 Cal. App. 3d 619; 626, 147 Cal. Rptr. 384; 389:

PRE-TRIAL CONFERENCE STATEMENT        

County of Sacramento v. Worker's Comp. Appeals Bd., (1999) 64 Cal. Comp. Cas. 26,

PRE-TRIAL CONFERENCE STATEMENT        Cal Lab Code  § 5502  (e)(3)
PSYCHE        Labor Code §4660.1. (c) (1)
PSYCHE        Labor Code § 4660.1

PSYCHE
COMPENSABLE CONSEQUENCE        Pirelli Armstrong Tire Co. v. Workers' Compensation Appeals Bd., (2003) 68 Cal. Comp. Cas. 970, 973

PSYCHE        Grom v. Workers' Comp. Appeals Bd.,(2004) 69 Cal. Comp. Cas.  1567; 1572
PSYCHE        Regents of the University of California v. Workers' Compensation Appeals Bd., (2005) 70 Cal. Comp. Cas. 1733; 1735 (writ denied)

PSYCHE
     Ernestina Molina, Applicant v. Den-Mat, Zenith Insurance Company, Defendants (2004)32 Cal. Workers Comp Rptr 293;  W.C.A.B. No. GRO
0028061; WCAB Panel Decision 2004 Cal. Wrk. Comp. P.D. LEXIS 80

PSYCHE ACOEM
     ACOEM Guidelines (at page 114)
Psyche injury        MICAELA LLAMAS, VS. GUILD, INC.; STATE COMPENSATION INSURANCE FUND; EMPLOYERS COMP GLENDALE,
ADJ2994393 (Oxnard District Office) April 11, 2014, OPINION AND ORDER DENYING PETITION FOR RECONSIDERATION :

PSYCHE TREATMENT
6 MONTH EMPLOYMENT
     Sharon Hammerly vs. Carrow Restaurant  and Mitsui Sumitomo Marine Management (2011) ADJ6990558 Appeals Board Decision Denying
Reconsideration Decided June 22, 2011
PSYCHE TREATMENT
6 MONTHS EMPLOYMENT
     Matea v. Workers' Comp. Appeals. Bd. (2006) 144 Cal.App.4th 1435 [71 Cal.Comp.Cases 1522, 1522].
.
PSYCHE TREATMENT
NOT PLED        Divjakinja v. Workers' Compensation Appeals Bd., (2007) 73 Cal. Comp. Cas. 142 144
.


PSYCHE TREATMENT FOR TREATMENT OF PHYSICAL INJURY        Sharon Hammerly vs. Carrow Restaurant  and Mitsui Sumitomo Marine
Management (2011) ADJ6990558 Appeals Board Decision Denying Reconsideration Decided June 22, 2011
Psychiatric Injuries/Good Faith Personnel Actions
     County of San Bernardino v. WCAB (McCoy) (2011) 77 CCC 219, Court of
Appeal, Fourth Appellate District, Division Two
Psychiatric Injuries/Six Month Exclusion
     State Compensation Insurance Fund v. WCAB (Garcia) (2012) 77 CCC 307,
Court of Appeal, Second Appellate District, Division Three.

PSYCHIATRIC INJURY        Cal Lab Code § 3208.1
PTP / MPN        
REASONABLENESS OF MEDICAL BILLS        Giroux Glass, Inc. v. Workers' Compensation Appeals Bd., 70 Cal. Comp. Cas. (MB) 490 (Cal. App.
4th Dist. 2005)

REFERRAL BY PTP        Mears Group v. Workers' Compensation Appeals Bd., (2004) 69 Cal. Comp. Cas. (MB) 1601

REFERRALS        Cal Lab Code § 139.31
RESTITUTION        American Psychometric Consultants Inc. v. Workers' Compensation Appeals Bd., (1995) 36 Cal. App. 4th 1626, 43 Cal. Rptr.  
2d 254, 60 Cal. Comp. Cas. (MB) 559
RESTITUTION        American Psychometric Consultants Inc. v. Workers' Compensation Appeals Bd., (1995) 36 Cal. App. 4th 1626, 43 Cal. Rptr.
2d 254, 1995 60 Cal. Comp. Cas. (MB) 559, 1995
SANCTIONS        Labor Code § 5813

SANCTIONS        
Labor Code § 5813 and 8 Cal. Code Reg. § 10561(a)

SANCTIONS
8 CCR § 10561. SANCTIONS        8 CCR § 10561. Sanctions
SIGNIFICANT PANEL DECISIONS        Kenneth Grom vs. Shasta Wood December 8, 2004(WCAB No. RDG 0091839) 69 Cal.Comp.Cases 1567

SIX MONTH EMPLOYMENT        

Wal-Mart Stores v. Workers' Comp. Appeals Board  (Garcia) (2003) 112 Cal.App.4th 1435 [68 Cal.Comp.Cases 1575
SPECIFIC INJURY        Cal Lab Code § 3208.1. "Specific" and "cumulative" injuries
SPINAL SURGERY        California Insurance Guarantee Association; and Broadspire (Servicing Facility), September 19, 2009 A DJ3675309 (SAL
0081669) ADJ2967795 (SAL 0101259) ADJ3517685 (SAL 0077391)ADJ1962561 (SAL 0077392
STIPULATIONS        Mary Gillett, Applicant v. Los Angeles Unified School District, Sedgwick Pasadena, Defendants (2010) W.C.A.B. Nos.
ADJ1601344 (MON 0275791), ADJ2934340 (MON 0275793), ADJ2221693 (MON 0275795)- Workers' Compensation Appeals Board (Panel
Decision)2010 Cal. Wrk. Comp. P.D. LEXIS 44 Opinion Filed February 4, 2010

STIPULATIONS AND ISSUES        Cal Lab Code  § 5502  (e)(3)
STIPULATIONS AND ISSUES        Stelling Robinson, Petitioner v. Workers Compensation Appeals Board of the State of California and Republic
Indemnity Company of America, Respondents. F008164 Court of Appeal, Fifth Appellate District 52 Cal. Comp. Cas 419:

SUPPLEMENTAL PETITIONS        8 CCR § 10848.
TREATING FOR NON-INDUSTRIAL BODY PART        Granado v. Workmen’s Comp. App. Bd. (1968) 69 Cal. 2d 399, 404 [71 Cal. Rptr. 678,
445 P.2d 294 “

TREATMENT 4600        
UEF
EN BANC        Daniel Milbauer vs. Erez Boostan December 18, 2003 Case No. (WCAB No. LAO 722567) 68 Cal.Comp.Cases 1834

UR: UTIMELY / DEFECTIVE URS        En Banc Decision / Defective and Untimely Utilization Review   Jose Dubon v.World Restoration, Inc.; and
State Compensation Insurance Fund Oct. 6, 2014 Case No: ADJ4274323 (ANA 0387677) - ADJ1601669 (ANA 0388466) 79 Cal. Comp. Cases
USAUL AND CUSTOMARY FEES        ILIA JAROSTCHUK vs SAN FRANCISCO 49ERS Case No. ADJ7865722 ORDER DENYING PETITION
FORECONSIDERATION

USUAL AND CUSTOMARY        CNA Ins. Cos. v. Workers' Compensation Appeals Bd. (Valdez), ( 1997) 62 Cal. Comp. Cas. (MB) 1145, 1146:
USUAL AND CUSTOMARY
TAPIA CASE        Tapia v. Workers' Comp. Appeals Bd., (2008) 73 Cal. Comp. Cas. (MB) 1338, 1340; held

USUAL AND CUSTOMARY FEES        Luis Gonzalez (Luis Gonzalez Valladeres), Applicant v. San Cristobal Distributing, State Compensation
Insurance Fund, Defendants No. ADJ6448504 (Panel Decision)Opinion Filed November 12, 2010
UTILIZATION REVIEW        8 CCR § 9792.7(b)(3))
UTILIZATION REVIEW        Carl Dixon, Applicant v. Phillips Buick, Pontiac & Mazda, Clarendon National Insurance Company, Administered By
LWP Claims Solutions, Defendants, 2010 Cal. Wrk. Comp. P.D. LEXIS 343, Opinion Filed August 23, 2010

UTILIZATION REVIEW        Labor Code § 4610 (g) (3)(A)
UTILIZATION REVIEW
LABOR CODE SECTION 4610(A)        Labor Code section 4610(a)'
UTILIZATION REVIEW
EN BANC        En Banc Decision of Lisa Simmons vs. State of California, Dept of Mental Health (Metropolitan State Hospital), Legally Uninsured; and
State Compensation Insurance Fund (Adjusting Agent), June 17, 2005 Case No. (WCAB No. LBO 0340807) 70 Cal. Comp. Cases 866, 869, 870

UTILIZATION REVIEW        Labor Code section 4610(g)(1)
UTILIZATION REVIEW
SANDHAGEN        State Comp. Ins. Fund v. Workers’ Comp. Appeals Bd. (Sandhagen) (2008) 44 Cal.4th 230 [73 Cal.Comp.Cases 981] (Sandhagen
UTILIZATION REVIEW SB 863  LABOR CODE § 4604.5.
     Labor Code § 4604.5.(a)

UTILIZATION REVIEW SB 863  LABOR CODE § 4604.5.
     Labor Code § 4604.5.  (b)
Utilization Review/ Home health care        Salguero v. ins. Company of the West (BPD) 41 CWCR 246

Verification        Lucena v. Diablo Auto Body (2000) 65 Cal.Comp.Cases 1425 (Significant Panel Decision),
WRIT DENIED CASES        Farmers Ins. Group of Companies v. Workers’ Comp. Appeals Bd. (Sanchez) (2002) 104 Cal.App.4th 684, 689, fn. 4
[67 Cal.Comp.Cases 1545]; Bowen v. Workers’ Comp. Appeals Bd. (1999) 73 Cal.App.4th 15, 21, fn. 10 [64 Cal.Comp.Cases 745].)