Get documents about "Workers Compensation Matters
Shared by: jennyyingdi
-
Stats
- views:
- 13
- posted:
- 4/11/2012
- language:
- Latin
- pages:
- 2
Document Sample
Workers’ Compensation Matters
A Publication for the Members of the Association of Workers’ Compensation Professionals
A P R I L 2 0 0 6 A P R I L 2 0 0 6
President’s Message:The AWCP Progress Report
One Capitol Mall, Suite 320 2006 AWCP Board By JR Robles
Sacramento, CA 95814
President
JR Robles Stay Informed: News in our Biz
Apex Investigation
916-858-2999
JR@apexpi.com
In order to get the latest news in Workers’ Compensation, I turned to Eileen Gould, V.P.
Workers’ Compensation Client Services at G.B. Bragg & Associates, Roseville, CA. Eileen
Vice President
Amy Medina said, “Although the climate in workers’ compensation is constantly changing, we are
Gregory Bragg & Associates cautiously optimistic about the continuation of decreasing claims costs.” Bragg clients
916-412-0219
amy.medina@gbbragg.com have been seeing claim costs come down significantly compared to the 2003, 2004 and
Treasurer/ Recording Secretary
2005, which was echoed by the Division of Workers’ Compensation. The DWC reported
James Carmazzi that reform bills have saved $15 Billion in claims costs and as a result California is no
Carmazzi Interpreting longer the most expensive system in the country.
916-714-7848
james@carmazzi.com
The recent legislation (SB 899, AB 749, AB 227 & SB 228) has been extremely
Immediate Past President
Karen Preston effective in curbing the medical expenses, legal fees, benefits and awards which are the
RNS HealthCare Consultants main areas of savings. For example: the average number of chiropractic manipulations
916-929-6506
Legal Update RNSPreston@aol.com
recorded nine months post-injury declined from 28.5 visits in 2002 to 12.6 visits in 2004,
By Kyle R. Hansen a reduction of 55.8 percent. The average amount paid per claim for chiropractic ma-
Board Members
Applicant filed a Petition For Reconsideration on Joshua Bragg nipulation at nine months also declined significantly, from $1,139 in 2002 to just $445
the grounds that he never received a “prior award of Gregory Bragg & Associates in 2004 – a net reduction of 60.9 percent according to California Workers’ Compensation
An En Banc decision was recently issued by the 916-960-0952
permanent disability” within 4664(b). Joshua.bragg@gbbragg.com Institute. Another example comes from one of the most highly anticipated studies from
WCAB on the issue of apportionment under the Commission on Health and Safety and Workers’ Compensation. The commission
Marilyn Edwards
Labor Code Sections 4663 and 4664 and the The WCAB concluded that: Ca MENTOR Brain Injury Services looked at 3,500 workers’ comp cases and, according to preliminary results, found that
effect of a Compromise & Release in determining 916-791-7067 permanently disabled workers receive 50 percent less compensation than before the
marilyn.edwards@thementornetwork.com
apportionment. 1. An order approving a Compromise & Release reforms were enacted.
Kyle Hansen
agreement, without more, is not a “prior award of Hanna, Brophy, McAleer & Jensen
The case of Pasquotto v. Hayward Lumber & These savings are huge because they have been passed on to California employers
permanent disability” within 4664(b). The WCAB 916-929-9411
Connecticut Indemnity 8 WCAB Rptr. 10,086 khansen@hannabrophy.com in the form of rate reductions. The State Compensation Insurance Fund (State Fund)
indicated that while the Compromise & Release for
Richard Marconi (Alternate) which will provide an average 16% reduction for new or renewing policies as of January
involved an applicant who sustained an industrial the 1999 injury contemplated a preclusion from heavy St. Paul Travelers 1, 2006. Since 2003, State Fund’s cumulative rate reductions have totaled 38%. This is a
injury to his low back while employed as a carpet work such conclusion would be speculative due to the 916-638-6474
stark contrast to the rate increases we were experiencing just before the reforms when
rmarconi@stpaultravelers.com
layer. The matter was resolved by Compromise & fact that the Compromise & Release failed to contact insurance companies were filing bankruptcy and employers were leaving California or
Jamie Meyers
Release in October, 1999 based upon a preclusion any stipulation regarding the percentage of permanent State of California, going out of business.
from heavy work. Attached to the Compromise & disability or the nature of the back disability. The Office of Self-Insurance
916-483-3392
Release was an addendum but it failed to include any WCAB indicated that in looking at the addendum jlmeyer@dir.ca.gov
Despite the positive
effects, critics are
reference to the percentage of permanent disability. there was no way to determine how much money was Debra Real
County of Sacramento lining up to rollback 2006 Event Calendar
for the permanent disability to the back. The WCAB 916-834-7887 the reforms and the
Shortly thereafter Mr. Pasquotto was hired as a truck also ruled that intrinsic evidence outside of the reald@saccounty.net
debate is heating up.
driver. in 2001 and 2002 the applicant sustained Compromise & Release should not be allowed. Ted Richards Get ready for another April 20 . . . . . . . . . . . . . . . . . . . . . . . . . Monthly Luncheon
injuries to his back. The applicant was evaluated by Grancell, Lebovitz, Stander,
Barnes & Reubens round and Good
both applicant and defense QME’s who precluded The WCAB held that where there is “no permanent 916-922-7390 Luck. May 18. . . . . . . . . . . . . . . . . . . . . . . . . . Monthly Luncheon
trichards@glsbr.net
the applicant from heavy work. One of the QME’s disability: within 4664 (b) the medical reports and
other evidence relating to a prior industrial injury KC Schuft
indicated that 50% of the disability would be related Frasco Investigative Services June 16 . . . . . . Golf Tournament, Whitney Oaks Golf Club
to non-industrial conditions whereas the applicant’s could be relevant in determining 4663 apportionment. 916-856-5788
kschuft@aol.com
QME found no apportionment. Finally the WCAB held that the concept of medical August 11 . . . . . .Boat Cruise Friday, Spirit Of Sacramento
Staff
rehabilitation was a viable option under 4663 however Connie Conley
The WCJ issued a decision finding no permanent even if the injured worker has medically rehabilitated cconley@amgroup.us October 23 . . . . . . 2006 AWCP Seminar, Raddison Hotel
disability due to the fact that Mr. Pasquotto previous from an industrial injury a prior industrial injury is Connie Payne JR Robles,
award was 30% and this disability also was precluded not precluded from being “another factor” causing the
cpayne@amgroup.us AWCP President December 14 . . Holiday Party, Arden Hills Country Club
from heavy work the net result was 0%. employee’s permanent disability.
awcp • one capitol mall, suite 320 • sacramento, ca 95814 • phone: 916-669-5335 • fax: 916-444-7462 • awcp@amgroup.us • www.awcp.org awcp • one capitol mall, suite 320 • sacramento, ca 95814 • phone: 916-669-5335 • fax: 916-444-7462 • awcp@amgroup.us • www.awcp.org
Platinum Sponsor Perez Investigations
Al Perez
McDonald Law Corporation
Mike & Sue Mc Donald
Medical/Pharmacy/MRI
3I Interpreting, Inc. P. O. 1764 1900 Point West Way Suite 141 PMSI Clinical Update - Knee and Hip Replacement Surgeries Predicted to Increase
Sal Diego Alvarez Martinez, CA 94553 Sacramento, CA 95815 Keri Chapman
338 S. Melrose Drive Phone: (925) 934-5543 Phone: (916) 201-2450 701 Gibson Drive #1927
Vista, CA 92081 aperez@perezinvestigations.com Fax: (916) 914-2159 Roseville, CA 95678 Submitted By: Karen Preston, RNS HealthCare Consultants
Phone: (800) 311-6289 mike@mcdonaldlawcorp.com Phone: (916) 704-2027
Fax: (866) 903-4329 Probe Information Services, Inc Fax: (916) 723-3599
sdalvarez@3icorp.net Rebecca Hughes Mullen & Filippi keri.chapman@pmsionline.com
6375 Auburn Blvd Wesley Liv In a recent article posted on Work Comp Central, a recent study predicts that knee
Citrus Heights, CA 95621 1601 Response Road, Suite 300 Professional Diagnostics
Phone: (800)397-6517 Sacramento, CA 95815 Management replacement surgeries will increase 6-fold by 2030, which translates to nearly 3.5 million
Phone: (916) 442-4503
Diamond Sponsors Fax: (800)373-6547
rebecca@probeinfo.com Fax: (916) 442-1028
Elizabeth Prillwitz
2241 Lava Ridge Court knee replacements per year. While most are for Medicare beneficiaries, about 1/3 are
wliu@mulfil.com Roseville, CA 95661 paid by other insurers including worker’s compensation. Replacement of previous knee
Insurance Shadow Company
Pursley, Rush, & Wesley, Llp
Phone: (916) 782-2200
Gregory B. Bragg & Associates
Laura Barrett P. O. Box 254476
Sacramento, CA 95865 Bill Pursley
Fax: (916) 782-2211 replacement is also expected. Hip replacement surgeries are also expected to dramati-
elizabeth@PDM-Nationwide.com
Eileen Gould Phone: (916)487-1688 1760 Creekside Oaks Drive, Suite190
Sacramento, CA 95833
cally arise.
P. O. Box 619058 Fax: (916)486-3522
Roseville, CA 95661-9058 Phone: (916) 922-9801 Medical Service/
Phone: (916) 960-0955 Sterling Investigative Services, Inc. Fax: (916) 922-9061
Fax: (916) 783-0338 Jeremiah Scott wjp@prwattorneys.com Functional Capacity This study was presented at a meeting of the American Academy of Orthopaedic Sur-
eileen.gould@gbbragg.com P. O. Box 418203
Sacramento, CA 95841-8203 Rahn, Holbrook, Murphy Law Ca MENTOR Brain Injury Services geons. The study’s author, Steven M. Kurtz, PhD, stated:
LWP Claims Solutions Michael Rahn Marilyn Edwards
Angela Livingston
Phone: (916) 972-0989
Fax: (916) 972-0987 1300 Ethan Way, Suite 500 7150 Sierra Ponds Lane “Among the reasons for the expected increased demand is that total joint re
Granite Bay, CA 95668
3835 N. Freeway Blvd
Suite 210 Sacramento, CA 95834
sterlinginvestigations@comcat.net Sacramento, CA 95825
Phone: (916) 569-1700
placement is gaining in acceptance. “There are few procedures that return as much qual-
Pringle Consulting
Phone: (916) 609-3616
Job Placement
mrahn@rhmlaw.com Dave Pringle ity of life as joint replacement,” he explained.
Fax: (916) 609-3645 2007 Opportunity Drive #1
a_livingston@lwpclaims.com The Law Offices of Richard J.
International Insurance Institute Yrulegui Roseville, CA 95678
Janell Fisher Karen Yrulegui Phone: (916) 789-1979 Other reasons include an aging population with arthritis requiring joint replacement;
Interpreting 4641 Freeport Boulevard 5088 North Fruit Fax: (916) 789-1254
Carmazzi Interpreting
Sacramento, CA 95822 Fresno, CA 93711 ptdave@inreach.com the increasing prevalence of obesity, which puts undue stress on the knee and hip joints;
Phone: (866) 356-0395 Phone: (559) 222-0660
Jim Carmazzi Fax: (209) 370-2089 Fax: (559) 222-2880 Miscellaneous and the trend toward baby boomers remaining physically active later in life, which also
8698 Elk Grove Blvd, Ste 3, Pmb 331
Elk Grove, CA 95624-3300
janellfisher@insuranceinstitute.com KYrulegui@RJYLaw.com
Camellia Memorial Lawn
places demands on the joints.”
Phone: (916) 714-7848 Lynda Baxter
Fax: (916) 714-4232 Law Firms Medical Legal 10221 Jackson Road
sales@carmazzi.com
Cuneo, Black, Ward & Missler MEDLink Sacramento, CA 95827 Knee and hip injuries are common workers’ compensation injuries, so it is likely that
David Converse Janice Haris Phone: (916) 363-3850
Investigation Services 8880 Cal Center Drive #300 1613 Montgomery Street
there will be increasing requests for these procedures, both during the original course of
Stress Management Institute
Alpine Investigations
Sacramento, CA 95826 San Francisco, CA 94111
Phone: (415) 399-9769
Martin Shaffer treatment, or under future medical care coverage.
Rod Christopher Phone: (916) 363-8822 5 Third Street, Suite 412
Fax: (916) 363-8821 Fax: (415) 399-9439
5050 Laguna Blvd #112-368 San Francisco, CA 94103
dconverse@cbwmlaw.com jharis@camedlink.com
Elk Grove, CA 95758
Phone: (916) 691-0200
Phone: (415) 543-3283
Fax: (415) 543-3741
Further information from the American Academy of Orthopaedic Surgeons is available
Grancell, Lebovitz, Stander, Barnes,
Fax: (916) 244-2662 Reubens Medical/Managed Care martin@aboutstress.com at http://www3.aaos.org/anmeet2006/podium/podium.cfm?Pevent=403 . This site gives
rod@alpineinvestigations.com Ted Richards
1451 River Park Drive #230
Choices Case Managemant Inc a synopsis of this presentation, as well as other papers presented at the 3-day meeting in
APEX Investigation Connie Rominger
J.R. Robles Sacramento, CA 95815
Phone: (916) 922-7390
1145 Second Street Ste. A #315 March 2006. There were many presentations on injuries and treatment that are relevant
2934 Gold Pan Court, Suite 12 Brentwood, CA 94513
Rancho Cordova, CA 95670 Fax: (916) 922-7392 Phone: (925) 516-3901 to workers’ compensation.
Phone: (916) 858-2999 trichards@glsbr.net Fax: (925) 516-3905
Fax: (916) 858-2227 Hanna, Brophy, MacLean, McAleer, crominger@choicescm.com
jr@apexpi.com & Jensen Excel Managed Care
Capitol Legal Investigations, Inc. Kyle Hansen Bill Spaller
Luke Patterson 99 Scripps Drive 8300 Fair Oaks Blvd
102 Lincoln Street Sacramento, CA 95825 Carmichael, CA 95608-1969
Roseville, CA 95678 Phone: (916) 929-9411 Phone: (916) 944-7185
Phone: (916)784-3920 Fax: (916) 929-0549 Fax: (916) 944-0211
pitollegal@yahoo.com khansen@hannabrophy.com spallerb@excelmanagedcare.com
Frasco Inc. Haworth,Bradshaw, Stallknecht, & RNS Healthcare Consultants
K.C. Schuft Barber Karen Preston
9960 Business Park Drive, Suite 170 Ruth Stallknecht 4811 Chippendale Drive
Sacramento, CA 95827 4420 Auburn Blvd #100 Suite 704 Sacramento, CA 95841
Phone: (916) 856-5788 Sacramento, CA 95841 Phone: (916) 929-6506
Fax: (916) 368-7611 Phone: (916) 484-4354 Fax: (916) 929-6013
Kschuft@aol.com Fax: (916) 487-4348 RNSpreston@aol.com
Hoy & Associates Insurance Investi- Laughlin, Falbo, Levy & Moresi MedFocus Radiology Network
gations Terri McFarland Brandon Beaver
Russell Hoy 106 K Street, 2nd Floor 2811 Wilshire Blvd Suite 900
705-2 E. Bidwell Street #268 Sacramento, CA 95814 Santa Monica, CA 90403
Folsom, CA 95630-3315 Phone: (916) 441-6045 Phone: (800) 398-8999
Phone: (916) 983-9800 Fax: (916) 441-7067 Fax: (310) 264-4729
Fax: (916) 983-1057 tmcfarland@lflm.com blbeaver@medfocus.net
awcp • one capitol mall, suite 320 • sacramento, ca 95814 • phone: 916-669-5335 • fax: 916-444-7462 • awcp@amgroup.us • www.awcp.org awcp • one capitol mall, suite 320 • sacramento, ca 95814 • phone: 916-669-5335 • fax: 916-444-7462 • awcp@amgroup.us • www.awcp.org
