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Tag: 2017 News

Stakeholders Challenge TD Awarded After 5 Year Limit

Kyle Pike was employed by the County of San Diego as a Deputy Sheriff Detention on July 31, 2010. He sustained an industrial injury to his right shoulder and received a combination of Labor Code section 4850 salary continuation benefits and permanent disability benefits between October 27, 2010 and November 15, 2011 and April 30, 2015 through June 19, 2015.

Pike received a Stipulated Award of 12% permanent disability on May 31, 2011, and filed a timely Petition to Reopen on May 26, 2015 as he claimed an entitlement to Labor Code section 4850 benefits for the period September 15, 12 2015 through March 28, 2016, and temporary total disability benefits from March 29, 2016 through August 18,2016 which was beyond the five year time limit from the date of his injury.

The County paid all temporary disability and 4850 benefits through the period ending five years from the date of injury. The issue to be determined was whether applicant could receive additional benefits for periods of temporary disability that extended more than five years from his July 31, 2010 date of injury. The parties submitted the issue on the record without testimony.

The WCJ concluded that when acting upon a timely petition to reopen, the Appeals Board may award temporary disability benefits more than five years from the date of injury, provided that applicant is limited to an aggregate of 104 weeks of benefits. A split panel decision denied reconsideration in the case of Pike v County of San Diego.

Labor Code section 4656( c )(2) provides that “Aggregate disability payments for a single injury occurring on or after January 1, 2008, causing temporary disability shall not extend for more than 104 compensable weeks within a period of five years from the date of injury.”

The majority held that because “the statutory language does not provide that no temporary disability benefits may be paid more than five years from the date of injury, the WCJ concluded that the legislature did not intend to prohibit otherwise temporarily disabled injured workers from receiving the full 104 weeks of benefits where such temporary disability occurs within five years from the date of injury.” The majority cited some panel decisions that have agreed with this view.

Commissioner Razo dissented. “I believe our ability to award temporary disability indemnity is constrained by the statutory language in Labor Code section 4656( c )(2), which expressly limits such an award to five years from the date of injury for injuries on or after January 1, 2008.” He cited several panel decisions that agreed with his view and against the majority.

In August the County filed a Petition for Writ of Review with the Court of Appeal. At the end of September the Court issued a writ and agreed to hear the case. On October 23 the CWCI was grated permission to file an amicus brief in the case, and it is expected that the CAAA, and other stakeholders will soon weigh in as well.

Among the several theories presented by the County and CWCI, they claim “the decision below relies upon an improper use of Labor Code Section 3202. As noted by our Supreme Court in Nickelsberg v. Workers’ Comp. Appeals Bd. (1991) 54 Cal.3d 288, 298 the rule of liberal construction stated in section 3202 should not be used to defeat the overall statutory framework and fundamental rules of statutory construction.

En Banc WCAB Moves 1200 Lien Cases to Hearing

Numerous lien claimants by and through their sole representative Maximum Medical filed over 1,200 Petitions for Reconsideration,challenging an administrative action which prevented them from filing in their cases because they had allegedly failed to timely file required declarations.

Thereafter, to secure uniformity of decision in the future, the Chair of the Appeals Board, upon unanimous vote of its members, assigned these cases to the Appeals Board as a whole for an en banc decision. The cases at issue are defined as: “The Cases Involving a Labor Code section 4903.05(c) Declaration filed after 5:00 p.m. on Friday, June 30, 2017 through 5:00 p.m. on Monday, July 3, 2017 where a Petition for Reconsideration was filed on the issue of timeliness of the filing” and are designated as The Lien Cases.

The Lien Cases were consolidated on motion of the Appeals Board for the limited purpose of making the orders herein, including designating Rodriguez v. Garden Plating Co. (ADJ8588344) as the master case and designating service of this decision to lien claimants’ representative, Maximum Medical.

The providers in the Lien Cases contend that since July 1, 2017 fell on a Saturday, the required declarations were timely filed because the declarations were filed no later than the close of business on Monday, July 3, 2017 so that the notation placed in EAMS by DWC was improper.

However, on October 3, 2017, DWC issued a Newsline stating in pertinent part that: [DWC] will lift the notation in its Electronic Adjudication Management System (EAMS) that indicates all liens with Labor Code section 4903.05(c) declarations filed on July 2 and July 3 were dismissed.

The DWC has now removed the notation as to dismissal. Accordingly, lien claimants are not aggrieved (Lab. Code, §§ 5900, 5903) and their Petitions for Reconsideration are moot. Thus, the WCAB ruled that the Petitions must be dismissed. As set forth above in the Newsline and as discussed below, the issue of timeliness must be adjudicated in each case in the first instance at the trial level. Accordingly, the WCAB made no opinion on the merits of the issue of whether the declarations were timely filed.

Given that the Petitions for Reconsideration are nearly identical and given the limited resources of the Appeals Board, consolidation of the cases for the narrow purpose of addressing the Petitions for Reconsideration was appropriate. The en banc decision shall apply to any case in which a Labor Code section 4903.05(c) Declaration was filed by a lien claimant after the close of business at 5:00 p.m. on Friday, June 30, 2017 through the close of business at 5:00 p.m. on Monday, July 3, 2017, whether or not the case number is identified in this decision.

Whether declarations filed after the close of business at 5:00 p.m. on Friday, June 30, 2017 through the close of business at 5:00 p.m. on Monday July 3, 2017 were timely filed is not presently at issue, and we make no determination as to the timeliness of filing of such declarations. Once such a determination has been made, any aggrieved person may seek review of such determination. (Lab. Code, §§ 5900, 5903.)

Purdue Pharma Faces Criminal OxyContin Probe

Purdue Pharma confirmed on Wednesday that it has become the subject of a U.S. criminal investigation related to its painkiller OxyContin as the drugmaker battles a series lawsuits seeking to hold it responsible for its role in the nation’s opioid epidemic.

U.S. Attorney Deirdre Daly is gathering documents about Purdue’s claim that OxyContin provides 12 hours of pain relief. A Los Angeles Times investigation, published last year, found that Purdue ignored evidence showing the drug’s effects failed to last that long in some patients, increasing the risk of withdrawal, abuse and addiction.

“Purdue is committed to being part of the solution to our nation’s opioid crisis and has been cooperating with the U.S. Attorney’s investigation,” company spokesman Robert Josephson said in an email. “We will continue to do so until this matter is resolved.”

Purdue is cast as the main villain in a wave of government lawsuits seeking to hold opioid makers and distributors responsible for an epidemic now killing thousands of people and costing the U.S. economy billions of dollars annually. Ten states and dozens of cities and counties have sued companies including Purdue, Endo International Plc, and Johnson & Johnson’s Janssen Pharmaceuticals, alleging that they triggered the epidemic by minimizing the addiction and overdose risks of painkillers such as OxyContin and Percocet.

Stamford, Connecticut-based Purdue invented many of the aggressive marketing techniques that made OxyContin a blockbuster drug and which government lawsuits now seek to frame as unlawful.

Purdue resolved a federal criminal prosecution in 2007. The company and three of its top executives pleaded guilty to “misbranding” OxyContin and collectively agreed to pay more than $630 million in civil and criminal penalties in one of the largest pharmaceutical settlements in U.S. history. The company specifically acknowledged that it trained its sales representatives to mislead physicians about opioid risks.

Purdue promoted the synthetic morphine substitute as a low-risk painkiller, according to court papers, although the drug is a habit-forming narcotic derived from the opium poppy.

The executives, former CEO Michael Friedman, General Counsel Howard Udell and Chief Medical Officer Paul Goldenheim, served no prison time and were sentenced to community service in drug rehabilitation centers.

Purdue has faced a wave of lawsuits by Louisiana, Washington, New Mexico, Oklahoma, Mississippi, Ohio, Missouri, New Hampshire and South Carolina, as well as several cities and counties. Many of those cases target other drugmakers as well.

The lawsuits have generally accused Stamford, Connecticut Purdue of deceptive marketing of OxyContin and convincing doctors and the public that its drugs had a low-risk of addiction and were effective for treating chronic pain.

Purdue is closely held and doesn’t release financial information, but the brokerage Sanford C. Bernstein & Co. estimates OxyContin alone generated sales of $1.3 billion in 2016. Purdue is also the focus of a Congressional investigation led by Senator Claire McCaskill, a Missouri Democrat, who’s demanding documents and information related to the sales, marketing and education strategies that opioid manufacturers used to promote their painkillers.

DEA’s Prescription Drug Take-Back Day Is Saturday

Unused or expired prescription medications are a public safety issue, leading to potential accidental poisoning, misuse, and overdose. Proper disposal of unused drugs saves lives and protects the environment.

The Drug Enforcement Administration first launched its “Take-Back” day more than six years ago and since then has collected more than 8.1 million pounds of prescription drugs from the public.

After collecting and destroying 900,000 pounds – 450 tons – of unused prescription drugs last April, the U.S. Drug Enforcement Administration is continuing its efforts to take back unused, unwanted and expired prescription medications.

The DEA invites the public to bring their potentially dangerous, unwanted medicines to one of nearly 5,000 collection sites around the country that are manned by more than 4,000 of DEA’s tribal and local law enforcement partners.

The public can find a nearby collection site by visiting or by calling 800-882-9539. This service is free of charge, with no questions asked.

“The abuse of opioids and prescription drugs is at an all-time high in our country, and the effect is devastating, not only on the users, but on their families, friends, and communities,” U.S. Attorney Talbert stated. “Young people are particularly at risk, as they can gain easy access to unused and addictive prescription drugs inside the home. I strongly encourage everyone to take advantage of this safe and easy way to dispose of unused prescription drugs.”

“America is in the midst of a prescription drug crisis and the home medicine cabinet is a major source. Let’s work together to help put an end to this epidemic by cleaning out that cabinet and disposing of unwanted medication at a take back location,” stated DEA Special Agent in Charge John J. Martin.

Overdoses from prescription opioids are the driving factor in the 15-year increase in opioid overdose deaths. The removal from homes of unwanted prescription pills that can be abused, stolen or resold is an easy way to help fight the epidemic of substance abuse and addiction.

More Controversy Over Vegas Shooting Comp Claims

Orange County rejected workers’ compensation claims from four sheriff’s deputies injured in the shooting, paving the way for a court battle that could force appellate judges to eventually decide an untested issue touching several counties and cities in Southern California.

Los Angeles County is considering whether to grant claims from two of its deputies shot Oct. 1 at the Route 91 Harvest festival. Officials acknowledged they have no policy on how to handle such requests and said they expect the issue will result in litigation.

Several other officers from Southern California law enforcement departments also plan to file claims in the near future, according to police unions, potentially forcing as many seven other municipalities – including San Bernardino and Riverside counties  -to soon consider similar questions.

If the claims are approved, it could put taxpayers on the hook for years of medical expenses, allow officers to retire early on disability and guarantee injured officers paid time off in the short term. If officers begin to claim injuries related to PTSD suffered during the shooting – as two deputies in Orange County did – it also could open the door for scores of additional filings.

In San Bernardino County, which employs 11 deputies who attended the festival, including Sgt. Brad Powers, who was shot in the leg in Las Vegas, the deputies’ union has initiated talks with the sheriff’s department to advocate that Powers be treated as an on-duty injury.

Steve Nyblom, a manager in Los Angeles County’s risk management branch, which is weighing claims from local two deputies shot in Las Vegas, said legislative intervention may be needed to clarify the labor code in light of the looming disputes. “There is that vague issue, subject to interpretation, and issues relating to legislative intent should be clarified by the legislature,” Nyblom said.

Had all those officers been shot and injured while responding to a mass-killing in California, they likely would be taken care of without dispute. But because they were shot in Nevada instead, their life-saving efforts could cost them dearly.

California’s labor code states that public agencies are required to pay benefits to off-duty police officers injured while engaging in “protection or preservation of life or property, or the preservation of the peace anywhere in this state,” even if the officer “is not at the time acting under the immediate direction of his employer.” Out-of-state events are not mentioned, spurring multiple interpretations of the law.

“The statute does not allow counties to cover off-duty conduct outside of states,” Orange County Supervisor Todd Spitzer said, expressing a view shared by county lawyers. “These police officers went into their instinctive training mode – and I don’t think they should be punished because they trusted their instincts. But it requires a legislative fix to the statute to extend workers’ benefits for out-of-state conduct.”

However, local workers’ compensation attorneys disagree with Orange County’s interpretation of state law. And the union representing Orange County’s sheriff’s deputies has said that if the county denied its members’ claims, the agency would be abandoning officers who were acting in accordance with their department’s training.

“The sheriff’s department has an expectation of its sworn members to take whatever actions are necessary to preserve life wherever they’re at,” said Tom Dominguez, president of the Association of Orange County Deputy Sheriffs. “If they deny the claims, then the message that they’re sending to their peace officers is not to take action when it is certainly warranted.” “Everybody’s watching what happens with these cases,” Dominguez added.

FDA Supports Substitution Over Abstinence for Opioid Addiction

The U.S. Food and Drug Administration plans to encourage opioid addicts to use less harmful opioid drugs such as methadone and buprenorphine, a radical shift in policy that could agitate those in the addiction field who believe abstinence is the only effective treatment.

Speaking before the House Committee on Energy and Commerce on Wednesday, Reuters reports that FDA Commissioner Scott Gottlieb outlined a proposal under which every addict who suffers a non-fatal overdose would be treated with an opioid substitute, for long periods if necessary, or even for life.

“I know this may make some people uncomfortable,” Gottlieb said of his proposal. Even so, he added, “FDA will join efforts to break the stigma associated with medications used for addiction treatment.”

Gottlieb’s plan mirrors his recent proposal to reduce nicotine in cigarettes while expanding access to potentially less harmful nicotine delivery devices such as e-cigarettes. Both proposals embrace an approach to substance abuse that aims to reduce harm rather than insist on complete abstinence.

The stigma around opioid alternatives, Gottlieb said, “reflects a view some have, that a patient is still suffering from addiction even when they’re in full recovery, just because they require medication to treat their illness.”

Drugs such as methadone and buprenorphine reduce pain in the same way that opioids do, but without delivering the “high” that leads to addiction. They are used to help addicts taper off opioids, but insurers are not always willing to pay for the treatment.

Gottlieb cited data from the Commonwealth of Massachusetts which found a greater than 50 percent reduction in the risk of death from overdose among those treated with methadone or buprenorphine after an overdose.

This kind of data “has immense implications for insurers and policymakers in deciding how to adopt these treatments,” he said. The FDA also plans to examine expanding the labels for existing medication-assisted treatment for everyone who presents with an overdose, based on data showing a reduction in deaths.

“Such an effort would be a first for FDA,” Gottlieb said. “We believe that granting such an indication in labeling can help promote more widespread use of, and coverage for, these treatments.” The FDA, he said, will issue guidance for drugmakers to promote the development of new addiction treatments and lay out the agency’s interest in “novel, non-abstinence-based” products.

New QME Study Shows Less Evaluator “Bias”

Frank Neuhauser from the University of California, Berkeley published a new study on Qualified Medical Evaluators discussing trends in evaluations, availability to meet panel requests, and other issues. He used extensive electronic administrative data made available by the DWC Medical Unit and Disability Evaluation Unit (DEU), supplemented with summary data from several sources.

The study covers the period from 2007 through 2017. This period covers much of the evolution after the 2004 reforms which introduced utilization and treatment guidelines, a new permanent disability rating schedule based on the AMA Guides, and changes to the manner parties in represented cases can select QMEs. The key findings in this study included the following general observations:

– The number of providers registered as QMEs continues to decline (17% since 2007), but less rapidly than it did prior to 2007.
– The number of requests for QME panels has increased rapidly, 87% since 2007.
– The decline in QMEs and increase in panel requests means that the number of requests per QME has doubled (+101%).
– Coupled with a continuing increase in the average paid amount for QME reports, the average QME earns 240% more from panel reports now than in 2007.
– All the increase in panel requests is from represented track cases, up 400% despite the elimination of panels for most medical treatment issues (replaced by the IMR process). This increase was equally driven by requests from both parties, applicant and defense.
– Panel requests for unrepresented cases declined 55%, entirely driven by a decline in requests from injured workers. The number of requests by claims administrators in unrepresented cases changed little.
– The DWC began collecting the reasons for panel requests on represented cases in 2015. Those data show that the primary reasons for panels are: (1) Compensability (42.5%), Permanent disability (21.4%), and Permanent & Stationary (P&S) status (11.4%).

In response to the earlier study, SB 863 placed limits on the number of locations (10) at which QMEs can be registered. This has had the effect of distributing QME panels more evenly and widely among registered providers.

– Very-high-volume QMEs (with 11-100+ registered locations) have been eliminated.
– However, a high proportion of panel assignments (55%-60%) are still assigned to the busiest 10% of QMEs, nearly all of whom have exactly 10 offices and are in orthopedic specialties.
– Unlike the very-high-volume QMEs studied earlier, the top 10% and 5% of QMEs by number of panels in the current system produce reports that show less bias. Even the top 5% of QMEs by volume rate only slightly more conservatively than average.

Access to QMEs does not appear to be an important current problem, but there are signs that delays in getting an evaluation may be developing.

The DWC has made an effort to eliminate from the workers’ compensation system providers who are accused or convicted of fraudulent activity or violations of professional standards. This study examined the activity of these doctors in the QME process and how their suspension may impact QME evaluations. The study found:

– Of providers suspended or restricted under Labor Code sections 139.21 & 4615, 41 were registered as QMEs at least one year between 2007 and 2016.
– They represented a small minority of all QMEs (1.6%) and were assigned to a minority of all 3-doctor panels (4.6%).
– While these percentages are small overall, there were some areas where problem providers appear to be concentrated and represent a special issue. The “Pain” specialties (PAP, MAA, & MPP), stood out, with 40% -50% of QME panels including at least one restricted or suspended provider.
– The more general “pain” category (MPA) that is more commonly used now, as well as the Physical Medicine and Rehabilitation (MPR) and Internal Medicine–Hematology (MMH) had 15% – 17% of panels include a restricted or suspended provider.
– Overall, the restricted and suspended doctors gave much more generous evaluations to injured workers than the average QME: higher ratings, less frequent use of apportionment and more frequent “Almaraz” ratings.

Hartford to Acquire Aetna’s Life, Disability Businesses

The Hartford said Monday it has agreed to purchase Aetna’s life and disability insurance business. The deal, valued at $1.45 billion, is expected to close early next month. The move will make The Hartford the second largest U.S. carrier of group life and disability insurance after MetLife.

“The transaction provides a unique and accretive opportunity for The Hartford to become the second largest group life and disability insurer, an important business for The Hartford with a stable risk profile, attractive returns and strong long-term growth prospects,” said The Hartford’s Chairman and CEO Christopher Swift. “The combination of these two businesses strengthens our position as a leader in the large employer market and increases our presence among midsize employer clients.”

Swift says the acquisition will be positive because of the complimentary nature between Aetna and The Hartford models, noting that the synergies around its claim systems as well as Aetna’s digital capabilities making the integration “natural.”

“Our claims organization continues to use data and advanced analytics across workers’ compensation and disability to drive better outcomes for customers in both business lines,” added Doug Elliot, The Hartford’s president. “As the nation’s second largest workers’ compensation insurer, and now, the second largest group disability insurer, this transaction increases our competitive differentiation and potential for future product offerings for absence management.”

With the expanded data and advanced analytical capabilities, The Hartford’s claims organization will also be able to drive better recovery outcomes for customers in both workers’ compensation and group disability businesses.

The Hartford says it will integrate the absences and disability administration platforms with robust web portal and mobile capabilities with text message integration.

The Hartford will also acquire a majority of Aetna’s approximately 1,800 Group Insurance employees as part of the deal, as well as its digital assets and integrated absence-management platform. In addition, the deal includes an exclusive collaboration under which Aetna will offer The Hartford’s group life and disability products through Aetna’s sales team.

Earlier this year, Aetna abandoned its attempt to acquire fellow insurer Humana after a federal judge blocked the transaction on antitrust grounds.

Judge Issues “Partial” Injunction Against Lien Stay Law

The federal courtroom battle over the survival of the new automatic stay law governing liens filed by indicted medical providers reached a milestone last week as Judge Wu issued his decision, one that is unlikely to provide the plaintiffs any substantial benefit for their efforts.

The lien claimants argued that the new law violated due process requirements among other complaints. The DIR sought to demonstrate ample opportunities for due process mostly articulated by a declaration by Chief Judge Paige Levy. Her declaration did not completely convince the federal court.

Judge Wu commented that “nothing in Judge Levy’s declaration demonstrates that WCALJs are uniformly adjudicating challenges to Section 4615 in the manner she endorses, or that any Court precedent requires them to do so. Nonetheless, Defendants argue that Judge Levy’s testimony proves the merit of Defendants’ initial legal argument in opposition to Plaintiffs’ procedural due process claim: pre-existing regulations afford claimants sufficient due process.”

“That being said, Judge Levy’s testimony still informs the Court’s interpretation of Section 4615 as well as the constitutionality of its current implementation. This is because established principles of interpretation permit the Court to look to extrinsic evidence to further discern the meaning of the statute if the statute is ambiguous on its face, including the statute’s legislative history, and its administrative implementation.”

Judge Wu then concluded “this Court finds that Section 4615, as currently implemented, does not provide the sufficient procedural due process before or after it deprives certain  lien claimants of a protectable interest. Because the 14th Amendment requires basic notice and hearing rights that Defendants are currently denying certain Plaintiffs, the Court would GRANT Plaintiffs’ Motion for a Preliminary Injunction, but only to a limited extent.”

“After reviewing both parties’ second and third round of supplemental briefing, considering the relevant portions of AB 1422, and for the reasons stated below, the Court finds that Section 4615, even as amended, does not provide all affected lien claimants with a meaningful opportunity to be heard to challenge an erroneous application of Section 4615. See T.R. at 25-26. As such, the Court would find that Section 4615 as currently implemented fails to provide a specific group of affected claimants, namely those not listed on the DWC website, with the fair process the Constitution requires. The Court would also find that this deficiency is not solved even if it assumes what Defendants claim AB 1422 confirms, that the text of Section 4615 implicitly provides those lien holders the opportunity to utilize pre-existing procedures.”

But, Judge Wu also said the “relief granted would be narrow and targeted to solve the specific procedural due process defects identified above.”

“As to notice, the Court would require Defendants to include the name of any lien holder affected by Section 4615 on the “division’s [public] Internet Web site” as directed by statute. The Court would also prohibit Defendants from staying the processing of any lien pursuant to Section 4615 unless the lien holder is provided notice via the DWC Site, and given the opportunity to be heard as to whether that lienholder falls within the statute at a lien conference and/or lien trial. As stated above, the sole purpose of such hearing is to prevent the erroneous application of Section 4615, by its own terms, not the propriety of the underlying criminal charges, or whether or not a given lien arises from fraud.”

The Court has asked Plaintiffs to submit a proposed order that comports with the scope of relief the Court has described. It would seem that the plaintiffs, Vanguard Medical Management Billing, Inc., and Eduardo Anguizola M.D. would not ultimately be removed from the automatic stay requirements as they had hoped. The DIR need only provide them proper notice on its website, if they have not already, and once this is accomplished there are no other limits to the new law imposed by this ruling. One might say their effort was more or less like trying to eat soup with a fork.

Transcripts of the public hearings in this case have been requested, signalling that this case is headed to the 9th Circuit Court of Appeals. One can assume we have not heard the last of the arguments in this case.

DWC Proposes New Notices for Denied Claims

The DWC has posted a draft amendment to the Benefit Notice regulations regarding required notices for denied claims to the DWC online forum for public comment.

Labor Code section 138.4 requires the Administrative Director, in consultation with the Commission on Health and Safety and Workers’ Compensation (CHSWC), to prescribe reasonable rules and regulations for service on the employee (or employee’s dependents, in the case of death) notices dealing with the payment, nonpayment or delay in payment of temporary disability, permanent disability and death benefits; notices of any change in the amount or type of benefits being provided, the termination of benefits, the rejection of any liability for compensation; and an accounting of benefits paid.

Labor Code section 138.4 was amended, effective January 1, 2017, by section 1 of SB 1160 to require the AD to adopt regulations, on or before January 1, 2018, “to provide employees with notice that they may access medical treatment outside of the workers’ compensation system following the denial of their claim.”

Section 9812 of the regulations prescribes the required timeframes for sending benefit notices and the content for notices dealing with each type of benefit to which an injured worker might be entitled. The proposed amendment to section 9812(i) will require the Notice Denying Liability for All Compensation Benefits to contain the following statement:

– Although your claim has been denied, if you believe that you still need medical treatment for your injury or illness, you have the right to obtain treatment outside the workers’ compensation system.
– If you have your own health insurance, or are eligible to be treated by someone else’s health insurance, you can use that insurance to get medical care. You should advise your physician that you believe that your injury or illness is work related, so the health insurer can seek reimbursement from the claims administrator.
– If you do not have health insurance available, there are doctors, clinics, or hospitals that will treat you without immediate payment. You should advise any doctor, clinic, or hospital that agrees to treat you that you believe that your injury or illness is work related so they can seek payment from the claims administrator through the workers’ compensation system.”

The “safe harbor” provision of Title 8, California Code of Regulations, section 9810(f) provides that: “Benefit notices using the sample notices devised by the Administrative Director and available on the Division’s website are presumed to be adequate notice to the employee and, unless modified, shall not be subject to audit penalties.”

DWC welcomes suggestions from the workers’ compensation community to improve the quality and clarity of the proposed amendment. The division will accept comments on the proposed amendment to section 9812 until close of business on October 31, 2017. Please note that this comment period does not concern any other provision of the benefit notice regulations.

The proposed amendment to the existing regulation is shown in underlined format. In addition, due to the length of section 9812, the proposed amendment is highlighted in yellow.