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Workers Compensation Matters

VIEWS: 13 PAGES: 2

									                                                                                                                                                                               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

                                                                                                                                                                                                                            

								
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