June 25, 2024 The WCAB has issued a rare en banc decision providing guidance on the applicant’s burden of proof in rebutting the use of the “Combined Values Chart” (CVC) when combining impairments pursuant to the Kite decision. The WCAB found that the use of the phrase “synergistic effect” frequently used by QMEs when invoking the Kite decisions to justify addition of the impairments was insufficient to justify rebutting the use of the CVC without further analysis of whether the applicant’s impairments had overlapping […]
News & Knowledge
Category: Flash Bulletins
June 13, 2024 The Workers’ Compensation Appeals Board has designated its March 27, 2024, opinion in Sandra Ja’Chim Scheuing v. Livermore National Laboratory, permissibly self-insured, administered by Gallagher Bassett, as a significant panel decision. The decision tackles the issue of when a petition for reconsideration is timely filed, but is not received by the Appeals Board within the statutory time limit to act upon the petition by no fault of the parties. In Ja’Chim, Applicant sought a finding of permanent and total […]
June 13, 2024 It is well-established that the purpose of the workers’ compensation system is to provide benefits to employees who suffer on-the-job injuries or certain work-related illnesses. To adhere to the purpose of the workers’ compensation system, California Code of Regulations §10109(a) requires a claims administrator to “conduct a reasonable and timely investigation upon receiving notice or knowledge of an injury or claim for a workers’ compensation benefit.” This has been interpreted by courts as a “duty to investigate.” […]
February 14, 2024 For more than three years, virtually everyone in the California workers’ compensation community had become familiar with the Covid-19 presumptions. Labor Code sections 3212.86, 3212.87, and 3212.88 were passed as emergency legislation in response to the unprecedented pandemic that changed life as we knew it, beginning in the Spring of 2020. Understandably, the legislature sought to protect those who were still working on site and were unfortunate enough to contract Covid-19. All three Labor Code sections provided […]
February 14, 2024 There continues to be a steady increase in subpoenas seeking claims files and human resources or personnel files from applicant’s counsel. Receiving and responding to subpoenas can be burdensome and costly, especially for long-term employees or voluminous claims files. Laughlin Falbo Levy & Moresi provides a streamlined process for subpoena response, to ensure only relevant, discoverable information is produced, as well as to protect privileged documents and information, which in turn, protects the interests of the carrier, […]
August 31, 2023 The WCAB offered clarity on the complex topic of “vocational apportionment” in an en banc decision issued on June 22, 2023: Grace Nunes v. State of California, Dept. of Motor Vehicles, legally uninsured; State Compensation Insurance Fund (ADJ8210063; ADJ8621818). In that decision, the WCAB held that “vocational evidence must address apportionment and may not substitute impermissible ‘vocational apportionment’ in place of otherwise valid medical apportionment.” In other words, the WCAB found that the concept of “vocational apportionment” […]
August 3, 2023 The California Court of Appeal for the Second District issued a writ of mandate on August 1, 2023, ending the WCAB’s longstanding procedure of granting Petitions for Reconsideration for Further Study. Unfortunately, however, do not expect the WCAB to start issuing final decisions at a blistering pace just yet. There has been a significant uptick in the number of “grant-for-study” orders in recent years, especially since the start of the pandemic in 2020. If you have petitioned […]
August 3, 2023 A carefully crafted advocacy letter will make an impactful first impression. Often, an advocacy letter is one of the first communications between an attorney or adjuster and the medical expert. Many advocacy letters submitted to medical experts are “form letters” lacking specific details and information from a medical standpoint. As a result, medical experts are left to submit reports that do not address specific details of the claim and pertinent medical information. This leads to delays, supplemental […]
August 3, 2023 Twice a year, the California Applicants’ Attorneys Association has a conference to discuss everything from changes in Workers’ Compensation Law, to developing new strategies to increase recoveries for their clients. The 2023 Winter CAAA and Summer conferences were no exception; this year’s conferences covered a range of topics including expediting medical treatment, strategies to obtain QME panel lists in their preferred specialties, increasing permanent disability, and pursuing penalties. 1) Medical Discovery – Securing Authorization for Treating Physicians, […]
July 6, 2023 In a unanimous opinion, the California Supreme Court answered two questions posed to it by the Ninth Circuit Court of Appeal, finding that an employer is not liable for a COVID-19 injury sustained by an employee’s household member, even if that household member contracted COVID-19 because of the employer’s negligence, and that the household member’s negligence claim is not barred by the exclusive remedy doctrine. The Court held that while the workers’ compensation exclusive remedy doctrine does […]