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Seminar Archives

Mullen & Filippi Client Seminar 2016

Mullen & Filippi invites our clients to join us for lunch during an informative seminar from 11:30 a.m. – 1:30 p.m. During this series of seminars, we will give an update on the latest case law and discuss UR/IMR and Subrogation. DATES July 21, 2016 at the Hilton Concord July 22, 2016 at the Hyatt

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Defendants Utilization Review Obligation is Not Triggered Absent a Request for Authorization

Applicant sustained various injuries while working as an anesthesia technician. The injuries resulted in 100% permanent disability. In November 2013, the applicant had a walk-in bathtub installed because of stability issues which resulted in several falls. In addition, the tub had hydrotherapy jets which the applicant believed helped with her pain relief.

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Utilization Review Must Address the Treatment Specified in the Request for Authorization

In 2008, the Agreed Medical Evaluator was deposed and testified that it was medically reasonable for the applicant to use a motorized scooter. He reiterated that opinion in a report dated March 12, 2009. Based on those opinions, the defendant provided the applicant with a motorized scooter.

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Defendant Must Conduct Timely Retrospective Utilization Review Once Liability for Injury is Established

Applicant was an employee of United Parcel Service who claimed multiple injuries including intracranial hemorrhage, hypertension, sleep disorder, vision and psyche through August 2006. Defendant denied the claims. After several years of litigation, the case was tried and the injuries were found to be compensable on April 12, 2013. The defendant filed a Petition for Reconsideration which was denied on June 21, 2013.

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WCAB Clarifies When Applicant Sustains Successive Cumulative Traumas

Applicant was employed as a machine operator from 1998 through August 29, 2001. He alleged injury to his back as well as several internal medicine and a psych issues. The injuries were pled as both a specific injury (August 17, 2000) and cumulative trauma (through August 15, 2000). Following trial, the Workers Compensation Judge found cumulative trauma, but no specific injury. He awarded 72% permanent disability.

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Termination Of Employee Following Industrial Injury Results In Labor Code § 132a Sanctions

Applicant sustained injury while working at defendant dairy. In addition to his Application for workers compensation benefits, the applicant filed a Petition for Penalties under Labor Code § 132a, alleging discrimination. The employer did not appear at the trial of the Labor Code Section 132a claim.

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Applicant Must Treat Within the MPN when the Defendant Satisfies Access Standards

While the MPN included nine orthopedic doctors, only one would treat back injuries. Therefore, the applicant claimed the MPN did not meet the access standards in 8 CCR 9767.5 and selected a non-MPN physician approximately 70 miles away. The defendant refused to authorize the treatment. Applicant then agreed to select a neurosurgeon from within the MPN. However, that doctor would not accept the applicant as a patient.

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Applicant Entitled to Additional Period of Temporary Disability Following Self-Procured Medical Treatment

The applicant underwent shoulder surgery on August 11, 2011. However, the surgery did not alleviate her symptoms. Her treating physician referred her for a consultation with another surgeon who diagnosed the applicant with right shoulder rhomboid detachment. He recommended surgery to correct the detachment on December 15, 2014.

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Injury Occurring While at Public Transit Terminal Not Compensable

Applicant claimed injuries as a result of slipping and falling in Union Station as he was on his way home on the evening of September 25, 2014. Applicant was employed as a systems analyst for the Los Angeles County Metropolitan Transportation Authority (MTA). Union Station is owned by the MTA. Defendant denied the claim based on the “going and coming rule”.

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Defendants Not Required to Disclose Sub Rosa Video Prior to Mandatory Settlement Conference

The orthopedic QME reported that the injuries resulted in 11% Whole Person Impairment to the shoulder and 5% to the lumbar spine. The psychiatric QME report resulted in 61% Whole Person Impairment. Applicant’s attorney also retained a vocational expert who offered the opinion that the applicant’s injuries made him incapable of rehabilitation and that he had a 100% loss of future earning capacity. After receiving the vocational expert’s report, defense counsel noticed the expert’s deposition. The deposition notice was dated March 13, 2015 and scheduled the deposition for July 7, 2015.

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