Sierra Pacific v Chattham – 3 rd DCA Opinion, 6.30.06
ACOEM applies to all dates of treatment. (Go To Decision)
This case discusses the application of apportionment pursuant to the workers’ compensation reforms of 2004 and 2005. (Go To Decision)
Sandhagen v SCIF 7.03.08 (Go To Decision)
We conclude the Legislature intended to require employers to conduct utilization review when considering requests for medical treatment, and not to permit employers to use section 4062 to dispute employees' treatment requests.
Macari v Lawrence Livermore Labs, 11.03.05 (Go To Decision)
Patients with future medical awards may be entitled to 30 visits of chiropractic care per year.
Metoyer v Wilshire West Dental, 12.05.05 (Go To Decision)
Employee may be entitled to treatment “out of network” if the employer does not follow all applicable laws when attempting to transfer a patient into their Medical Provider Network.
Raley v Fremont Unified School District , 11.22.05 (Go To Decision)
Future chiropractic care was allowed pursuant to a future medical award and Utilization Review reports that were not provided timely pursuant to LC4610 were not allowed.
Sandhagen v Cox, 2.07.05 (Go To Decision)
Utilization Review must be performed in compliance with LC 4610, including the stated timelines.
Casillas v San Luis, 8.12.05 (Go To Decision)
Chiropractic care is appropriate for flare-ups of industrial conditions pursuant to future medical awards and is consistent with the ACOEM guidelines.
Willette v WCAB, 5.17.04 (Go To Decision)
The Qualified Medical Evaluator is to resolve all disputes, including those related to Utilization Review and LC 4610.
Kelly v South Lake Tahoe School District 12.14.06
WCAB held that applicant with 04/22/1996 industrial neck and back injuries was entitled to chiropractic treatment under Chapter 6 of the ACOEM Guidelines even though treatments did not cure her condition, when chiropractic treatment temporarily relieved applicants pain and restored her functional capacities; WCAB found that, even if chiropractic treatment was not recommended under the ACOEM Guidelines, guidelines were rebutted by preponderance of evidence, including applicants testimony and Qualified Medical Examiner's opinion that established that variance.