Job stress is an unfortunate reality of being part of today’s workforce. The capacity for being able to deal with such stress varies from worker to worker, but whether that stress is the cause of someone’s psychological...more
The Centers for Medicare and Medicaid Services (CMS) recently announced that it intends to resume both prepayment and postpayment medical reviews conducted by the Medicare Administrative Contractors, Supplemental Medical...more
KEYSTONE RX, LLC v. AMERIHEALTH - A recent opinion from the Commonwealth Court of Pennsylvania has changed the rules for Utilization Review and thrown open the doors to a new class of litigants....more
Employers of drivers who hold commercial driver’s licenses (CDL) have been subject to U.S. Department of Transportation drug and alcohol testing requirements for over twenty-five years....more
In Josef K. v. California Physicians’ Service, No. 18-cv-06385-YGR (U.S. District Court for the Northern District of California, June 3, 2019), Judge Yvonne Gonzalez Rogers concluded that an independent medical review (IMR)...more
Zuniga v. WCAB (Interactive Trucking, Inc.), 2018 A143290 confirms that Labor Code Section 4610.6(f) prevents the Workers’ Compensation Appeals Board from ordering an Independent Medical Review (IMR) organization from...more
On its face the decision of the Wisconsin Supreme Court in Flug v. LIRC, 2017 WI 72 (decided on June 30, 2017), is a clear, important win for the employer side in common injuries that involve pre-existing degenerative...more
A second district of the California Court of Appeal has now upheld utilization review (UR) and independent medical review (IMR) as constitutional means to manage medical treatment in California's workers' compensation system....more
Aberrant workplace behavior caused by stress or a psychological condition is not uncommon. However, such behavior can also cause employers to become anxious regarding how to lawfully deal with the disruption and its effect on...more
In 2004 and 2012 the California Legislature enacted reforms to streamline the medical treatment approval process for workers' compensation claims. The most significant of the 2012 reforms was California Senate Bill 863, which...more
The Audit and Enforcement Unit of the California Division of Workers’ Compensation (DWC) issued a press release recently indicating it will be conducting more target audits in 2016 to address utilization review (UR)...more
While it seems the members of our state legislature have been busy doing nothing but arguing about the budget for the past year – one young state rep has proposed a bill that may have a positive effect on employers seeking...more
In Frances Stevens v. Workers’ Compensation Appeals Board, Outspoken Enterprises, Case: A143043 1st District, Division 1, the California Court of Appeal upheld the constitutionality of California Labor Code Section 4610.6...more