Miguel Pena claimed injury to the head, neck, back, shoulders and psyche. The employer disputed injury to his psyche, but not to the other body parts pied. An award found applicant needed future medical care, but did not decide AOE-COE to the psyche.

Later a psychological PQME diagnosed major depression, pain disorder and cognitive disorder that was 100% industrially-based. Future treatment recommendations were made for treatment.

Pena requested authorization for treatment with Dr. Lorant,.a secondary treater for psyche. Defendant responded asking “if there has been an RFA for sessions with Dr. Lorant..”

In response, applicant filed a Declaration of Readiness to Proceed on the issue of treatment for his psyche, as well as a Petition for Penalties under section 5814 and attorney’s fees under section 5814.5.

The issues at trial included injury AOE/COE to the psyche, a penalty for failure to promptly provide or authorize medical care to the psyche and fees under section 5814;5 if a penalty is assessed.

The WCJ found an unreasonable delay in authorizing medical care, and assessed a penalty of 25% of the first visit with Dr. Lorant, and found that applicant’s attorney was entitled to fees under section 5814.5 in an amount to be adjusted between the parties. The F&A did not contain a finding of fact regarding injury AOE/COE to applicant’s psyche. After reconsideration, a WCAB panel agreed with the penalty, and a split panel disagreed with the attorney fee award in the case of Pena v Agua Systems. Commissioner Sweeney wrote a dissenting Opinion.

Applicant’s psychiatric condition was found to be industrially caused by the PQME and treatment was recommended. The record does not reflect that defendant raised any issues with the PQME conclusions or attempted to conduct discovery to challenge those conclusions prior to or during the trial.

The record therefore does not support genuine doubt by defendant from a medical or legal standpoint for liability for benefits in relation to applicant’s psychiatric condition. Once applicant requested treatment for his psychiatric condition per his July 6, 2018 request, defendant was obligated to provide it.

Defendant fails to cite any authority for its contention that the mere selection of a physician to provide medical treatment itself constitutes a RF A for a “specific course of proposed medical treatment” subject to UR. There is no specific course of treatment being proposed by applicant’s selection of Dr. Lorant as a secondary treater; this is simply a request for an opportunity to be seen by a psychiatrist who can then report to applicant’s primary treating physician (PTP) on what treatment, if any, is necessary to cure or relieve from the effects of applicant’s psychiatric condition.

But fees under 5814.5 are only permissible where applicant has incurred fees in specifically enforcing a prior award. That did not occur here. There was no prior award for treatment to applicant’s psyche at the time of the trial.

In other words, the second trial was not conducted to enforce a prior award so there can be no award for attorney’s fees under section 5814.5.

A Madera pharmacist and two others were arrested in connection with a conspiracy to distribute oxycodone and hydrocodone.

On April 11, a federal grand jury returned a 42-count indictment, charging Ifeanyi Vincent Ntukogu, 44, of Fresno, a pharmacist, with one count of conspiracy to distribute and possess with intent to distribute controlled substances and 17 counts of distribution of controlled substances.

Kelo White, 38, of Fresno, was charged with one count of conspiracy to distribute and possess with intent to distribute controlled substances and 12 counts of possession with intent to distribute controlled substances.

Donald Ray Pierre, 50, of Fresno, was charged with one count of conspiracy to distribute controlled substances, 10 counts of possession with intent to distribute controlled substances, and two counts of identity theft.

According to court documents, Ntukogu owned and operated New Life Pharmacy in Madera. Between December 2014 and November 2018, Ntukogu filled fraudulent prescriptions for oxycodone and hydrocodone, Schedule II controlled substances, then dispensed the controlled substances to White and Pierre.

Ntukogu was arrested at the New Life Pharmacy in Madera and White and Pierre were arrested at their homes in Fresno.

If convicted, Ntukogu, White and Pierre each face a maximum statutory penalty of 20 years in prison and a $1 million fine in connection with the drug charges. Additionally, Pierre faces a maximum statutory penalty of 20 years in prison and a $250,000 fine in connection with the identity theft charges. Any sentence, however, would be determined at the discretion of the court after consideration of any applicable statutory factors and the Federal Sentencing Guidelines, which take into account a number of variables.

This case is the product of an investigation by the Federal Bureau of Investigation, the Drug Enforcement Administration, and the California Department of Health Care Services. Assistant U.S. Attorney Melanie L. Alsworth is prosecuting the case.

An employer’s experience modification rating, also called E-mods or EMR, is determined by dividing a company’s actual workers’ comp claim losses by the expected losses for the company’s specific occupations. The EMR plays a vital role in determining the premium a company pays.

The State of California and other public authorities, major utilities, private project owners and prime contractors for years have used the rating as a one-size-fits-all way to gauge a contractor’s safety record. Three consecutive years of EMR are usually considered, excluding the most recent year. Some treat a company with one EMR blip as a contracting untouchable.

EMRs are sometimes treated as vital to prequalification of a contractor to bid on a project. One sign of that trend occurred this year when the National Council on Compensation Insurance (NCCI) – the insurer-owned workers’ comp rate-making entity covering most states – added to its published material a boilerplate disclaimer against using EMRs to prequalify employers.

This new language is designed to raise awareness on this important topic and to reinforce the intended purpose of an experience rating worksheet for using the rate only to adjust the premium, according to Kathy Antonello, NCCI’s chief actuary. “This is consistent with the information we have provided to the public and the industry that it’s not appropriate to use E-mods to compare the relative safety of employers. The E-mod should be used for its intended purpose.”

A more comprehensive evaluation of safety performance usually includes other data and information – such as the reason for the higher EMR, style of the safety program, qualifications of the safety managers or U.S. Occupational Safety and Health Administration (OSHA) data used to calculate rate of injuries per hours worked – a different type of statistic.

Changing the deeply entrenched practice of using EMRs to prequalify contractors may not be as simple as writing a few articles and publishing a disclaimer, however. Companies that understand the value placed by owners and prime contractors on safety know that a low EMR impresses them as much as do held-down costs. “It will take a generation” to get out of the habit of using EMRs as a quick take on a company’s safety record, says one industrial construction contractor’s safety director. “There are union shop stewards who talk about EMRs on a regular basis.”

At a recent construction conference of the International Risk Management Institute, where Antonello, in a presentation, repeated cautions against using EMRs to prequalify, an insurance director at a large construction firm turned to someone sitting near him and said, “We use our EMR to compete all the time.”

Smaller contractors are the biggest losers in the “EMR equals safety” mindset, insurance brokers report. Fewer hours worked maximizes the effect of a single claim.

“Setting these strict experience mod-factor thresholds can discriminate against smaller or midsized companies, disqualifying them from bidding on projects, despite their having an excellent safety and injury history,” wrote Sonja Guenther, a workers’ compensation specialist at Denver financial consultant IMA Financial Group, in a recent report on the issue. Larger contractors, with the help of consultants, can find ways to drive down their EMR that have little if anything to do with their actual safety record, critics add.

The National Prescription Drug Take Back Day aims to provide a safe, convenient, and responsible means of disposing of prescription drugs, while also educating the general public about the potential for abuse of medications.

This year the National Prescription Drug Take-Back Day will be Saturday, April 27, 2019 from 10:00 a.m. – 2:00 p.m.  The DEA has an online site locator which quickly identifies a disposal site near your location.

The last Take-Back Day brought in more than 900,000 pounds of unused or expired prescription medication. This brings the total amount of prescription drugs collected by DEA since the fall of 2010 to 10,878,950 pounds.

Too often, unused prescription drugs find their way into the wrong hands. That’s dangerous and often tragic. That’s why it was great to see thousands of folks from across the country clean out their medicine cabinets and turn in – safely and anonymously – a record amount of prescription drugs.

The U.S. Drug Enforcement Administration (DEA) hosts a no-questions asked National Prescription Drug Take-Back event twice per year where temporary collection sites are set up in local cities throughout the nation for safe disposal of prescription drugs, including opioids.

DEA began hosting National Prescription Drug Take-Back events in 2010. At the last Take-Back Day in October 2018 over 5,800 sites across the nation collected unwanted or expired medications totaling 914,236 pounds (457.12 tons). The total amount of prescription drugs collected by DEA since the fall of 2010 is 10,878,950 pounds (5,439.5 tons).

Keep in mind that these items generally are not accepted at the drop box. Check with the collector ahead of time to determine what items are specifically not accepted.

–  Needles or other sharps
–  Asthma inhalers
–  Mercury thermometers
–  Iodine-containing medications
–  Illicit drugs or substances (including marijuana which is still a schedule 1 drug under federal law), and any prescription medications obtained illegally.

Opioid abuse is at epidemic levels in the U.S., and remains a top public health concern. Consumers should dispose of expired, unwanted, or unused medicines as quickly as possible to help reduce accidental or intentional overdoses or illegal abuse. The DEA’s “Take-Back” initiative is one of several strategies to reduce prescription drug abuse and diversion in the nation.