MICHAEL SULLIVAN & ASSOCIATES BLOG

Your Resource for the Latest Legal News, Combined with Insights and Recommendations from Our Attorneys

WCAB Clarifies Roles of Physicians and Vocational Experts Under Ogilvie

WCAB Clarifies Roles of Physicians and Vocational Experts Under Ogilvie

It has long been recognized that an applicant's ability to participate in vocational retraining is a significant factor in assessing the worker's permanent disability. (LeBoeuf v. WCAB (1983) 48 CCC 587, 597.) In 2004, the Legislature enacted Senate Bill (SB) 899, and among the provisions was a requirement that permanent disability give consideration to an applicant's "diminished future earnings capacity," rather than the "ability to compete in the open labor market" (Labor Code § 4660(a).) The Labor Code was amended to require permanent disability to incorporate the "impairments published in the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment (5th Edition)" (LC 4660(b)). Prior to SB 899, permanent disability generally was rated based on work restrictions reported by doctors, but now, it is generally rated using impairments assigned by doctors under the AMA guides.

Highlights from PIHRA's CELU24 Conference in Irvine

Highlights from PIHRA's CELU24 Conference in Irvine

What an inspiring time at PIHRA's CELU 2024 Conference in Orange County!

Check out the highlights! MS&A’s Eric De Wames and PIHRA President Tara Fournier teamed up for the latest “Building Airplanes in Flight” session, where they explored the cutting-edge intersection of AI technology and employment law. MS&A and Lockton sponsored the post-conference happy hour, creating the perfect atmosphere to connect, unwind, and discuss the day's insights.

Thank you to everyone who attended, joined the discussion, and made this event so impactful. Here’s to more innovation and collaboration in the world of employment law!

WCAB Provides Guidance on New Time Limits for Reconsideration Under LC 5909

WCAB Provides Guidance on New Time Limits for Reconsideration Under LC 5909

Under former Labor Code § 5909, a petition for reconsideration was deemed denied by operation of law unless the Workers' Compensation Appeals Board (WCAB) acted on it within 60 days from the date of filing. Effective July 2, 2024, LC 5909 states:

  • "(a) A petition for reconsideration is deemed to have been denied by the appeals board unless it is acted upon within 60 days from the date a trial judge transmits a case to the appeals board.
  • "(b)(1) When a trial judge transmits a case to the appeals board, the trial judge shall provide notice to the parties of the case and the appeals board.
  • "(2) For purposes of paragraph (1), service of the accompanying report, pursuant to subdivision (b) of Section 5900, shall constitute providing notice."

LC 5909(c) specifies that the statute will be repealed as of July 1, 2026. The Court of Appeal has explained that LC 5909 was amended as a short-term fix to the WCAB's need for resources, and gives it the additional time to act on petitions it needs to resolve normal human errors or administrative irregularities. (Mayor v. WCAB (2024) 104 Cal. App. 5th 1297.)[1]

On Nov. 5, 2024, the WCAB issued a significant panel decision, Reed v. County of San Bernardino, applying the time limits to act on a petition for reconsideration and explaining when a petition for reconsideration is appropriate.

October 2024 Rhino Round-Up

October 2024 Rhino Round-Up

It’s the October Rhino Round-Up!

October was packed with team-building events, industry conferences, and giving back at the Olive Crest fundraiser! From strengthening bonds to supporting children and families, it was a rewarding month for MS&A.

If you'd like to join MS&A at one of our upcoming events, just follow us on one of our social media channels--we're on LinkedIn, Instagram, and Facebook. We'd love to have you attend one of our events!

Photos from PIHRA's CELU24 Conference in L.A.

Photos from PIHRA's CELU24 Conference in L.A.

MS&A had an amazing time at PIHRA's CELU 2024 Conference in Los Angeles last week! It was a fantastic opportunity to connect with so many industry professionals and exchange valuable insights.

Check out the highlights! 📸 Eric De Wames and Tara Fournier led the latest installment of their ongoing “Building Airplanes in Flight” session, where they explored the intersection of AI technology and employment law. The energy at the conference happy hour was incredible, and our MS&A booth was buzzing with engaging conversations.

Thanks to everyone who stopped by, attended our session, and joined us in celebrating this outstanding event!

If you'd like to join MS&A at one of our upcoming events, just follow us on one of our social media channels--we're on LinkedIn, Instagram, and Facebook. We'd love to have you attend one of our events!

Liability for Medicare Conditional Payments

Liability for Medicare Conditional Payments

Medicare is a secondary payor. That is, it does not have primary payment responsibility for its beneficiaries when another entity is responsible for paying for medical care before Medicare. Workers' compensation is a primary payor for work-related illnesses or injuries. Medicare will not pay for a beneficiary's medical expenses when payment has been made or can reasonably be expected to be made by a workers' compensation insurer.

Medicare, however, may pay for medical services when the primary payor has not made or cannot reasonably be expected to make payment for them promptly. Those Medicare payments are referred to as “conditional payments,” because Medicare pays under the condition that it is reimbursed when the beneficiary gets a workers' compensation settlement, judgment, award or other payment. Medicare is required by statute to seek reimbursement for conditional payments related to the settlement.

Special Report: 2024 California Workers' Compensation Bills

Special Report: 2024 California Workers' Compensation Bills

The 2024 California legislative season is over. The Legislature had until Aug. 31, 2024, to pass bills, and Gov. Gavin Newsom had until Sept. 30, 2024, to sign or veto them. The bills signed by the governor take effect Jan. 1, 2025.

The 2024 legislative session was fairly quiet as it relates to the California workers' compensation process. Aside from the electronic signature provision, it is probably more notable for the bills that were vetoed than those signed into law.

September 2024 Rhino Round-Up

September 2024 Rhino Round-Up

It’s the September Rhino Round-Up!

September was a month to remember at MS&A! From an inspiring attorney retreat to celebrating excellence at the CLA Workers’ Compensation Awards Ceremony, we made unforgettable memories together. We also took time out for some fun at an Angel's baseball game, showcased our insights at industry conferences, and strengthened our bonds through exciting team-building events.

If you'd like to join MS&A at one of our upcoming events, just follow us on one of our social media channels--we're on LinkedIn, Instagram, and Facebook. We'd love to have you attend one of our events!