The leader in workers’ compensation defense law.
Counseling employers and insurance carriers throughout California.
Subscribe to our email list to receive bulletins as well as invitations to our latest seminars and workshops.
Obtaining a zero MSA takes careful thought and consideration, just like all aspects of a workers compensation case. However, Defendants should be particularly prudent because an underfunded zero MSA account will ultimately be defendant’s medical treatment liability.
The Applied Materials case is a history of worker’s compensation theory and application since 1983 starting with Le Beof, then Western Growers and going through Hikida and resting with Fitzpatrick. The bottom line is that the system failed this injured worker by having an unprofessional physician handle the treatment for this applicant; the rest is left for history.
. . . an on-the-job injury, although caused by an idiopathic seizure of the employee, will be found to arise out of and in the course of employment and that the employment need not pose a unique danger to the worker in order for that injury to be compensable.
Perhaps all of us can take a step back from the crazy volume of paper, phone calls and email that we
receive each day and appreciate that we truly are part of a larger picture and that performing our roles
competently and accountably can positively touch individual lives as well as our shared society as a
An untimely UR decision does not require automatic authorization of the requested treatment.
While this case did accurately reflect the law, these types of problems can be negotiated with an Applicant’s attorney and should be so negotiated. Such negotiations deal with the extent of mileage reimbursement or for the number of treatments for the applicant.
The bottom line is that all settlements that effect the worker’s compensation case have must be approved by the Worker’s Compensation Appeals Board. The authoritarian power of the Board once again defeats and supersedes the power of the parties to settle a case.
Now, since settlement documents can be virtually walked through, make sure you upload in advance all supporting documentation including all QME/AME reports, denial letters, and any other documents to support the basis of your settlement.
Employers often surmise that an offer of modified work is not necessary or can be made informally. As the cases noted above show, the best defense is always to make a written offer, on the required forms if necessary, that outline the physical duties anticipated. Documentation of the employer’s efforts to accommodate an injured worker will assist the attorneys at Mullen & Filippi in defending against unreasonable demands for TD and vouchers and will result in an overall cost reduction in litigated cases.
Though Jimenez and Ochoa reach the same conclusion, the distinction is an important one. If Jimenez is correct and seasonal employees with no off-season earnings had a temporary disability rate of zero for the off-season, the entire off-season of temporary disability paid at the rate of zero would arguably count toward the 104-week temporary disability cap. On the other hand, under Ochoa that is not the case; during the off-season such employees are simply not entitled to temporary disability and the cap is not implicated.