MICHAEL SULLIVAN & ASSOCIATES BLOG

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Receipt of a Request for Authorization by a Defense Attorney

Receipt of a Request for Authorization by a Defense Attorney

Labor Code § 4600(g)(2)(A) states, "Unless otherwise indicated in this section, a physician providing treatment under Section 4600 shall send any request for authorization for medical treatment, with supporting documentation, to the claims administrator for the employer, insurer, or other entity according to rules adopted by the administrative director." The statute directs that a request for authorization for medical treatment (RFA) must be sent to a claims administrator, rather than somewhere else, although the claims administrator may designate where the RFA is sent (CCR 9792.6.1(t)(3)).

Liability for Cumulative Trauma Injury Under LC 5500.5

Liability for Cumulative Trauma Injury Under LC 5500.5

Multiple employers or insurers can be liable for a cumulative trauma (CT) injury, and it's common for employers or insurers to dispute whether and how much liability they have for such an injury. Pursuant to Labor Code 5500.5(a), liability for a CT injury is limited to employers who employed the worker during the one-year period immediately preceding the date of injury (LC 5412), or the last date of injurious exposure, whichever occurs first.

Time Extensions for Petitions for Reconsideration

Time Extensions for Petitions for Reconsideration

Per Labor Code § 5903, a petition for reconsideration may be filed "[a]t any time within 20 days after the service of any final order, decision, or award made and filed by the appeals board or a workers' compensation judge." Although LC 5903 establishes a basic 20-day time period for filing a petition for reconsideration, most parties are given longer.

Special Employment and Union Workers

Special Employment and Union Workers

When an employer lends an employee to another employer and both have the right to exercise certain powers of control over the worker, a "special employment" relationship arises. The employee can be held to have two employers — the original "general employer" and the second "special employer." If a special employment relationship is found to exist, both employers are jointly and severally liable for any injuries to the employee.

Settling Cumulative Trauma Claims Involving Multiple Defendants

Settling Cumulative Trauma Claims Involving Multiple Defendants

Pursuant to Labor Code 5500.5(a) , liability for a cumulative trauma injury is limited to employers who employed the worker during the one-year period immediately preceding the date of injury (LC 5412), or the last exposure to the occupational hazard, whichever occurs first. Multiple employers or insurers can be liable for a cumulative trauma (CT) injury. An employee can choose to obtain an award for her or his entire CT injury from one or more employers for whom they have worked within the preceding year (LC 5500.5(c)).

An Analysis of  Death Claims’ Statute of Limitations

An Analysis of  Death Claims’ Statute of Limitations

The statute of limitations for pursuing death benefits is established in LC 5406. Except for LC 5406.5 and LC 5406.6 (which cover deaths from asbestos and HIV-related disease), proceedings for the collection of death benefits, per LC 5406(a), may be commenced one year from:

  1. the date of death when it occurs within one year from date of injury;
  2. the date of last furnishing of any compensation benefits, when death occurs more than one year from the date of injury; or
  3. the date of death, when death occurs more than one year after the date of injury and compensation benefits have been furnished.

Designating Address, Fax Number or Email Address for Utilization Review

Designating Address, Fax Number or Email Address for Utilization Review

Effective Jan. 1, 2022, the Workers' Compensation Appeals Board (WCAB) amended its Rules of Practice and Procedure to permit electronic service, including via email. The Labor Code, however, previously recognized electronic service of a request for authorization (RFA) for medical treatment. Specifically, LC 4610(i)(1) states: "The request for authorization and supporting documentation may be submitted electronically under rules adopted by the administrative director."

Urgent Report: DWC Announces In-Person Trials Starting March 21, 2022

Urgent Report: DWC Announces In-Person Trials Starting March 21, 2022

On March 9, 2022, the Division of Workers’ Compensation (DWC) announced that in-person hearings will resume starting March 21, 2022, at almost all of the DWC district offices. The only exceptions are Eureka, which is now a completely virtual office, and satellite locations Bishop, Marysville, Chico and Ukiah, which also will remain virtual.