eNews - August 1, 2008
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| California
Supreme Court Rules for Injured Workers |
On July 7, 2008, the California Supreme Court
in Sandhagen v. WCAB sided with injured workers in an important
case concerning insurance company authorization for medical
treatment for an industrial injury. In Sandhagen, the Supreme
Court confirmed the overriding interest that injured workers
receive prompt and proper medical care.
One of the effects of the "reform" of the Workers'
Compensation Laws has been the growing frustration by injured
workers and their doctors regarding their inability to obtain
authorization for recommended treatment. Often a lengthy litigation
process has been required to resolve such issues. The Sandhagen
ruling limits an insurance company's ability to dispute treatment
requests.
The "utilization review" process is the process
in which an insurance company refers a treating doctor's medical
treatment request to another physician to review and authorize,
reject, or delay (for more information) the treatment request.
The insurance companies must now complete utilization review
within 14 days.
The Supreme Court rejected the insurance company's argument
that even if utilization review was not timely provided under
Labor Code Section 4610, they still had additional time to
dispute the treatment under Labor Code Section 4062. The Court
ruled that there is no other medical basis to dispute a request
if the review was not timely under Section 4610. Therefore,
if there is no timely denial, the insurance company should
authorize the requested care, or risk being penalized for
unreasonably delaying the treatment. It is hoped that this
decision will help injured workers receive the timely treatment
that is needed for their injuries.
If you would like to talk with an attorney about your case, please contact us at (213) 739-7000 or click here to learn more about your legal options.
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| Law
Firm Atorneys Awarded for Going "Above and Beyond" |
Monterey - Three of the firm's workers' compensation partners - Sherry E. Grant, Adam Dombchik, and Richard Felton - were recognized by the California Applicants Attorneys Association (CAAA) at the June 2008 Conference with the "Above and Beyond Award." The attorneys were recognized for their efforts on CAAA's AMA Guides Committee. All three partners are active participants on the Committee, which serves to educate attorneys and doctors throughout the state of California on application of the AMA Guides, which must be used in determining an injured worker's level of permanent disability.
The California Applicants' Attorneys Association (CAAA) is the most powerful, and most knowledgeable legal voice for the injured workers of California. Serving California's injured workers since 1966, CAAA has been built with the support of its members who recognized the necessity of an active voice for injured workers. |
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