Rowen, Gurvey & Win In The News

Injured Workers Waiting Years for Benefits Fight Back on Delays

"Meanwhile, delays will continue to harm the system, injured workers, and employers", Gurvey said.

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Employer Groups Argue Exclusive Remedy Precludes Negligence Claim for COVID Death

"Gurvey said there are dozens of cases like it with specific facts that do not apply to the general caseload that attorneys handle on a daily basis....If this case represents one exception to the general principle of exclusive jurisdiction, specifically based on contracting a disease or an infection at work that affects others, it has absolutely nothing to do with the grand bargain.”

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App-Based Companies Say They'll Appeal Ruling That Prop. 22 Is Unconstitutional

“It is a slippery slope to begin to define statewide employee benefits differently, subject to different industries and work practices, when it comes to workers' compensation benefits,” Gurvey said.

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Vaccine Side Effects Could Be Compensable, but Outcomes Hinge on Employers' Policies

“It seems reasonable to conclude that these measures are being put in place to protect employees. We use a lot of different safety measures to protect employees, and Cal/OSHA, in theory, anyways, enforces those measures. The burning question is, why would this be any different? If the answer is that it isn't different, then these mandates should stand the muster and withstand legal challenges. If there is a reason to differentiate vaccinations and other safety measures in the workplace, then that is where the controversy will continue.” Alan Gurvey 

 

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SB 1160 Data Unsurprising, but More Time Needed to Address Issues, Stakeholders Say

“The reality is to look at how limited the bill is, and you simply wouldn't expect major changes one way or another in terms of costs for medical services,” Gurvey said. “Sometimes bills are passed just to provide an appearance that workers' compensation issues are being addressed in the Legislature. More often than not, the real issues that cause the most concern for the system are too contentious for effective legislation to be passed.” 

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EXTRA EXTRA READ ALL ABOUT IT!

Alan Gurvey's Interview with WorkersCompensationExperts.Org

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As Grocer Plans to Replace Drivers, Observers Question Sufficiency of Prop. 22 Benefits.

“Yes, it is admirable that Prop. 22 is addressing these independent contractors' needs, but certainly the overall benefits for workers’ compensation purposes and other employment entitlements are not going to be what they are for employees.” Alan Gurvey

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Injured Workers' Relative Earnings Haven't Rebounded to Pre-Recession Levels

"SB 863 has been a failure. It has resulted in little access to medical treatment, no real substantial increases in permanent disability, especially given the limitations on the weekly rate, and apparently no real impact on the worker's ability to get back to work to earn reasonable earnings.” - Alan Gurvey

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WCIRB Study Links Treatment Delays to Higher Claim Costs

Alan Gurvey called laws related to medical provider networks, utilization review and independent medical review “draconian.” He said "the current system is not sustainable because injured workers are not recovering and getting back on the job as quickly as they should."

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Despite Reforms, Frictional Costs Remain High in Workers' Comp System

Originally published by WorkCompCentral on July 7, 2020.

Bringing California's expenses in line with those from other comp systems will require legislation "that simplifies all aspects of discovery and administration, from the filing of the claim to obtaining medical treatment to obtaining physician evaluations up to settlement or trial.” - Alan Gurvey

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Gurvey: All Injured Workers Getting the Shaft Because of Newsom's COVID-19 Executive Order

The more we sit back and listen to the whining about this presumption, the more harmful it is on injured workers’ lives throughout our state. It is just another slap in the face to injured workers at the hands of selfish and unsympathetic money interests that are focused only on cost-cutting strategies and public relations lies to color the thinking of those who are not suffering from work injuries.

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Worker Advocates Push for COVID-19 Presumption in Golden State

“Since California has been ahead of the game, at least relatively speaking, with respect to protecting the public in this state, it would be in everyone's best interests for emergency legislation to ensure that people exposed to COVID-19 are protected...Honestly speaking, it is not asking too much and will not be too costly to insurance companies, necessarily, to ensure workers’ compensation coverage, notwithstanding the possible argument that one cannot with medical certainty prove causation of the circumstances of contraction.” Alan Gurvey

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‘It’s really tragic’: why are coalminers still dying from black lung disease?

“Corporations are trading profits for people’s lives and their wellbeing. There are so many industries where employers are not taking responsibility for what they should and not treating their employees like human beings. That’s the fight we’re going to pursue in the court so this company will be held responsible under these very unfortunate circumstances.” - Alan Gurvey

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Essential Designation Allows Attorneys to Keep Serving Clients During COVID-19 Closures

“Clearly our services are needed to assist those who have filed claims and cannot necessarily get medical services or compensation without our services,” Gurvey said, “especially if we are the only person that the defendant will speak to, given the applicant’s legal representation.”

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"Carlos & Lisa" on KDOC Interview Alan Gurvey

Favorite Gurvey's Law Guests!

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Essential Designation Allows Attorneys to Keep Serving Clients During COVID-19 Closures

“Compensation issues have also been at the forefront of discussions we are having with defense representatives,” Gurvey said. “We are also finding many defendants engaging in overall case settlement discussions to secure the well-being of our clients, as well as of our firm. Defendants need their law firms up and running, as do applicants need theirs, so settling cases now instead of pursuing protracted litigation is always a worthwhile use of time.” 

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"Carlos & Lisa" on KDOC Interview Alan Gurvey

How to Select a Good Attorney

"Lawyers should have the passion and believe in you, so that they will advocate for your interest." - Alan Gurvey

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Attorneys Identify Usability, Efficiency as Areas for Improving EAMS

"In a better system, there would be less paper and more direct communication with the users. The separator sheets and the cover sheets create more paper and more separation of documents that typically result in more friction costs and less efficiency at court."

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CalVCB to Drop Liens Filed Against Victims of San Bernardino Terrorist Attack

"Fast forward two and a half years, and after several terrorist shooting victims’ workers’ compensation claims were resolved without any indication of liens being pursued against the compensation, CalVCB began filing liens in cases that had not previously been resolved,” Gurvey wrote in his letter to the governor. “That, in and of itself, creates an issue of equal protection under the law.”

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Study Highlights Talent Shortage and Need for Advocacy Based Training

“Alan Gurvey states claims adjusters and their executives must consider the interests of everyone involved. “The bottom line is, ‘What is your goal?’ Is your goal simply to save money for the insurance companies at anyone’s expense, or is it to be effective professional, benefit-delivery personnel?”

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Attorneys Say Workers Need Alternative Treatments as Opioids Continue to Decline

Alan Gurvey, managing partner of Rowen, Gurvey & Win, also questioned the premise of the CWCI report on grounds that the beneficiaries of the study are the insurance corporations, not the patients.

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Worker Advocates Critical of Suggestion to Exempt Modifications from IMR

Alan Gurvey, an applicants’ attorney and managing partner at the law firm of Rowen, Gurvey & Win, said the recommendation to disallow modifications from IMR is not “fair.” “When a doctor makes a recommendation for treatment, he or she obviously does it because he or she believes that it’s in the best interest from a medical perspective for his or her patient...”

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Victim Compensation Board Files Liens to Recoup Benefits Paid to Survivors of Terrorist Attack

Alan Gurvey...said he was surprised by the liens in part because a person with CalVCB in 2017 said the only time the agency seeks reimbursement is to prevent double recovery. “Apparently, all the correspondence with them in April 2017 has been swept under the table and they are starting over”...“I don’t think this will go over big with the (San Bernardino) Assembly members or the administrative director, for that matter, especially if we remind everyone what representations were made two-and-a-half years ago.”

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Judge Eschews 'Khan Rule,' Focuses on Results in Attorney Fee Dispute

"There may still be some precedential value because “there are now guidelines to use for fee splits, discouraging simple focus on time on the file...the Legislature should consider increasing the percentage of fees awarded in certain complex cases to discourage volume businesses and inappropriate behaviors such as those Dobrin judge talked about in the decision.

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Audit Penalties Increase, Unpaid Benefits Fall to All-Time Low

"Applicants’ attorney Alan Gurvey said the statutory maximum 25% penalty on the delayed benefit amount that employers face appears inconsequential. “In my view, this has undermined the whole system, as there is absolutely no motivation to get things right,” he said. “In fact, there’s probably an argument that it is more cost-effective to get things wrong than right.”

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Attorneys See Significant Ramifications From Lindh Decision

"Being predisposed to something doesn’t mean that it will become a reality, unless medical science can show that, notwithstanding the industrial injury, Mr. Lindh still would have had this disability at that time and at that place, then, in my opinion, this is just another unfair knock against injured workers in favor of cost containment.” Alan Gurvey

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Brown Administration Had Unexpected Impact on Comp

“...it was rather shocking and it was a blow to my idealistic political perspective to see that the money interests and ‘cost containment’ drove the legislation under Gov. Brown. It seems that he was very responsive to cutting costs while not being cognizant and aware of how these cost-cutting measures detrimentally impacted those who were legitimately injured. There are so many fixes that are necessary, and only time will tell whether Gov. Newsom will focus on these fixes or will simply throw injured workers under the bus, as Gov. Brown did. Alan Gurvey

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Number of Accredited UR Firms Grows; Attorneys Eager to See Enabling Regs

Alan Gurvey, managing partner of applicants’ firm Rowen, Gurvey & Win, in Sherman Oaks, said it would be nice to see the accreditation requirement and deadlines be taken seriously, “thereby eliminating utilization review organizations who were not compliant and accredited.” He called it a “blemish on the system as a whole” that people handling claims can operate “without scrutiny and without penalty.”

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Users Question Gov's Call for Study of 6th Edition of AMA Guides

Alan Gurvey said he thinks a study comparing the two guidelines would be a waste of time and money. “Bottom line, we have heard enough about how the sixth edition for the most part will cause lower impairment ratings, so clearly it’s not something that I can support, being an applicant attorney,” he said. “Whether it occurs or not, I would hope that the Legislature is mindful of that fact in making its decision.”

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Passing Scores Save UROs From Paying Most Penalties for 2018 Audit Violations

“... litigating late UR decisions can be burdensome. There are sometimes disputes over date stamps and when the reviewing agency received a request for authorization, Gurvey said. Applicants’ attorneys don’t always have evidence needed to address timeliness. Gurvey said he thinks treatment should be authorized if a UR decision isn’t communicated in time. In contrast to penalties that might be waived, he said, forcing employers to pay for treatment if they blow deadlines for UR would be more effective at changing behavior.

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High Volume of IMR Cases Expected to Continue

“Apparently, the system was set up to do exactly what it is doing and we now have enough data to show that the numbers are not flukes,” he said. “Whatever is behind IMR, which many believe to be cursory reviews of complex and serious medical conditions without requisite information and without the proper medical specialists, will not change until the system changes.” Alan Gurvey

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Governor Taps High School Classmate to Fill WCAB Vacancy

While it may be a lot to try to learn the comp system on the fly, Gurvey said the community needs to “give him a chance” to show that he can do it. He also said he doesn’t know anything about Gaffney and wasn’t going to comment on the appointment until he has some evidence upon which to base his opinion.

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California Lawyers Association~Advanced Litigation Boot Camp

The California Lawyers Association (CLA) is a member-driven, mission-focused organization dedicated to the professional advancement of attorneys practicing in the state of California. They presented the Advanced Litigation Boot Camp on June 9, 2018 - June 10, 2018. Alan Gurvey spoke on the realities of a Mass Workplace Violence Claim.

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State Fund Says Opioid Focus Cut Prescriptions by Half

“...the treating doctors are reluctant to provide...for multidisciplinary programs that truly can help, especially chronic pain patients with their functional restoration and decreasing pain, since their collective experience has been an automatic denial of all of those modalities of treatment, which, by the way, are typically less expensive approaches to treatment... “It is one thing to look like a hero by saying that the carrier recognizes the need for the replacement of opioid use with alternatives that help patients, and it it’s another thing to actively promote it and authorize these treatments so that the doctors can feel comfortable in referring patients to these treatment programs.” Alan Gurvey

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QME Fee Schedule Proposal Prompts Call for Reassessment of Med-Legal System

"The system will “implode” if the Medical-Legal Fee Schedule interferes with the ability of QMEs to write reports that constitute substantial medical evidence. If doctors aren’t getting paid for the work they do, especially when it comes to complex cases, they might not write the kind of quality reports that are admissible as evidence", Alan Gurvey said.

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High Court IDs Test to Distinguish Employees From Contractors

Alan Gurvey, managing partner of Rowen, Gurvey & Win in Sherman Oaks, on Monday afternoon said that the Dynamex decision will put more pressure on employers to follow the new test when deciding whether people are entitled to employment rights, including workers’ compensation coverage.

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Lawmakers Propose Prepaid Debit Cards for TD, Crackdown on Drayage Misclassification

Alan Gurvey said he’s “not dead set” against the idea of using prepaid cards to get TD benefits to injured workers...he doesn’t think creating a new way to pay benefits should be a priority now, especially if State Fund has something to gain from pursuing the project. “I may be jaded, but it seems to me that insurance companies aren’t bending over backwards to help injured workers in this sort of way unless there is something in it for them.”

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Attorneys Hopeful for Quick Filling of Latest WCAB Vacancy

“It has been particularly frustrating waiting for a decision in this case, since the injured worker lives by himself and is in need of the home care and indemnity payments,” Gurvey said. “He doesn’t have family members who live with him to help him. We also argued that the (workers’ compensation judge) erred in the disability rating, which has resulted in a far lower compensation than he should be entitled to under prevailing law.”

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4th DCA: WCAB Erred in Awarding TD More Than Five Years After Injury

".. the 104-week limit on TD is the harsher law of the benefit limits, saying the 'arbitrary cost-cutting limitation' is 'one of the greatest injustices in our system.' The Pike case would then just be a rarer injustice affecting far less injured workers than the 104-week TTD cap. So many of my clients remain TTD after 104 weeks and are being starved out unceremoniously, which is indeed a sad commentary on our provision of benefits system.” Alan Gurvey

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Privette Doctrine Doesn't Bar Contractor's Suit Over 'Dilapidated' Roof

“Independent contractors take the risk of getting injured under normal circumstances. But when we’re talking about exceptions, I think it just goes to the facts,” Gurvey said. “If there are dangerous conditions on the property, you’d hope the landowner would be responsible.”

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Little Explanation for Large Increase in SIF Costs

“There is certainly nothing that I have seen to suggest that SIF business is booming versus in the past...In fact, we continuously hear that attorneys find SIF somewhat burdensome and at times confusing, notwithstanding it provides valuable benefits to those seriously injured.” Alan Gurvey

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Alan Gurvey Panelist at California Applicant Attorney PD Rating Seminar

The California Applicant Attorney  Association (CAAA) offered its annual rating seminar in Monterey, California.  Alan Gurvey joined other industry expert panelists who covered current permanent disablity rating techniques.  

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UR Changes Coming in 2018; Need for Rules an Open Question

“And, if the doctors are aware of what is not subject to UR in the first 30 days, this too will help the injured workers get the initial treatment without roadblocks and politics.” Alan Gurvey

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RGW Firm Members Attend WCAB Judge Swearing-In

 

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CWCI Reports First Signs of Decline in IMR Volume

"...perhaps UR is getting called to the mat on their more vacuous opinions, that can't stand up to the medical guidelines."   Alan Gurvey 

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Fraud Cleanup Starts Moving; Other Bills Heading to Governor's Desk

"if the goal of the comp system is to provide medically necessary treatment, there needs to be an “objective arbiter” who makes the decision of what is appropriate...“It is putting all of the power in the hands of the employer/defendant who can dictate who it is that reviews medical necessity,."   Alan Gurvey

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Appellate Panel Challenges Peers' Ruling in Exclusive Remedy Decision

"when employers' behavior constitutes 'egregious and unwarranted treatment,' courts have traditionally found that applicants have the grounds to pursue a remedy outside the workers' compensation system..."   Alan Gurvey

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Lawmaker Proposes Special UR Rules for Victims of Terrorism

“This is a nuance that a lot of people probably don’t understand, but I have to say it is seemingly not coincidental when I receive on multiple cases at the same time [as] objections to the treatment”    Alan Gurvey

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WCAB Asked to Revisit Decision Invalidating 2009 MTUS Provision on Home Care

"The court notes there is evidence of an 'overwhelming need for the home care, but apparently that's not something that they were willing to order based on the invalidity of the MTUS at that time,' leaving the injured worker 'in limbo,'"   Alan Gurvey  

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Employer Can't Apportion Liability for Disability From Poor Surgical Outcome

ROWEN, GURVEY & WIN PREVAIL FOR INJURED WORKERS' RIGHTS

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San Bernardino Survivors Would Have to Repay Federal Funds Used for Treatment

“...what is truly bothersome is that the victims have no idea that they are being duped and that they have to pay back the money without really knowing how much and whether it was the right price for the treatment”   Alan Gurvey 

 

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2nd DCA to Clarify Apportionment of Worker's Permanent Disability

"(I)... was pleased the court has agreed to hear the case and that it recognized the important legal issues that need to be clarified."  Alan Gurvey

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Worker Recovers $10 Million Settlement for Brain Injury From Car Accident by Sherri Okamoto

"Over the course of the past 10 years...settlements have been rising for serious injury claims because of the ever-increasing costs of medical and home care."   Alan Gurvey

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Report: 90% of San Bernardino Attack Victims' Treatment Requests Approved

"There are problems we see every day that need to be addressed for the victims and for other workers that may not have been subject to terrorist shootings."   Alan Gurvey

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DWC to Start Gathering Data On UR Decisions

"there are an extraordinary number of denials on legitimate and appropriate treatment requests. In fact, we are seeing more and more denials on long-standing authorized treatment post-permanent disability award with an award of future medical treatment.”   Alan Gurvey

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Alan Gurvey featured in Super Lawyers Magazine Profile: “Diagnosis: Life”

Once given a second chance, it's been carpe diem ever since

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Applicants' Attorneys' New Strategy: Push for Treatment Within MPNs

Sylvia Joo of Rowen, Gurvey & Win presented the results of an informal statistical research project

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Baker and Parisotto Seek Collaboration to Carry Out Reforms Options

The CAAA convention drew an estimated 1,200 attendees, according to organizer Alan Gurvey. The four-day event at the San Diego Sheraton Hotel & Marina wrapped up Sunday.

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Alan Gurvey and Sylvia Joo, Speakers at the 2017 CAAA Winter Convention in San Diego

Alan Gurvey, Education Chariperson for the 2016 50th Anniversary CAAA Winter Convention

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Called ‘hogwash,’ a gene test for addiction risk exploits opioid fears

"(he)... was troubled by the use of unverified genetic tests. He said via email that employers and insurers often describe cost containment justified by unproven diagnostics, such as some genetic tests, as in 'the best interests of the injured worker.'”   Alan Gurvey

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San Bernardino Approves $100,000 to Hire 'Claim Expediter'

"If the latest media propaganda move by the county had any substance to it, and was not simply a smokescreen and an attempt to manipulate the bad press that has recently come to light in this situation, then apparently every workers’ compensation defendant would require a $100,000 firm to expedite treatment requests”   Alan Gurvey

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Survivors of San Bernardino Attack Question Use of FMLA Leave

 I don't..."agree with the practice of using FMLA for workplace injuries, because that’s not the intended use of the program. “Workers’ comp benefits are for workers’ comp, not FMLA, as FMLA is simply to maintain a job while the person is off for approximately 12 weeks, without pay.”   Alan Gurvey 

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San Bernardino Terrorist Attack Victims Fight for Comp Benefits

"the bureaucratic nightmare of utilization review is a hindrance to the recovery of all injured workers."   Alan Gurvey

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4th DCA Asked to Decide if Treatment by MPN Doctor Goes Through UR/IMR

"The denial of treatment through UR and IMR has been 'rampant' ever since the systems came into existence, Alan Gurvey said, so the MPN process may provide 'another pick at the hand' and "more opportunity to have communication between the doctor and the injured worker, which may yield a more favorable result for workers in a system that many have seen as becoming increasingly unfair."

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Live from WorkComp Central Comp Laude! Gurvey's Law

Alan Gurvey and Kerri Kasem of Gurvey's Law - Movers and Shakers, they are everywhere!

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Dozens of Injured San Jose Firefighters Denied Workers' Comp Treatment

NBC Bay Area 3-part Investigation into the California’s Workers’ Compensation System

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Bill Would Limit Employer Liability for CT and Disease Claims

"...said he thinks there could be equal-protection issues or other constitutional concerns relating to the proposal to limit liability for cumulative trauma and occupational disease to treatment provided by MPN doctors. He said the proposal would effectively allow employers to control liability without the intervention of a court."   Alan Gurvey

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DIR Working on Legislative Fixes for UR and Lien

"...he found a lot of the proposals to be confusing, and said they are likely to lead to more litigation and disputes.  Prohibiting UR for most services within the first 30 days is really just a band-aid."   Alan Gurvey

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DIR Rejects Claims of Rampant Gender Discrimination

"...the law is “murky” when it comes to what constitutes “valid apportionment.This means that the real question, in a technical sense, is, ‘What caused the actual disability?’” he said. “In its purest form, one cannot make a determination of true cause of a disability if you simply blame it on risk factors, or what the medical literature states generally.”   Alan Gurvey

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Attorneys Anxious to See WCAB Vacancies Filled

"...said he doesn’t know why it appears so hard to appoint new commissioners. But the effect of an understaffed WCAB, in some cases at least, is a long wait until cases are resolved, he said. One case has been pending before the WCAB for almost a year since commissioners agreed to hear an appeal, he added."   Alan Gurvey

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Bills on UR, WCIS Reporting, QMEs Move Forward in Legislature

“The naysayers will say that moving away from the MTUS, and easing the limitations on chiropractic treatment as well as physical therapy, will create more fraud in the system, both with the doctors and applicants,” Alan Gurvey said. “However, obviously people are understanding that legitimately injured workers need better medical attention and that the doctors have to be doctors, and not simply slaves to the insurance companies and employers.”

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Applicants' Attorneys Alarmed by Incentive Program for MPNs

"Although he said he would like to believe most doctors would not allow their medical opinion on the extent of a worker's disability to be influenced by Harbor's performance evaluation, he said the plan was basically 'dangling a carrot' to tempt doctors to do just that."   Alan Gurvey

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DWC Proposes Penalties of $8.25 Million for Untimely Submission of IMR Records

"...said any penalties the DWC might ultimately collect mean little to injured workers. What injured workers care about is that their treatment is denied, and it sometimes takes 'forever and a day to hear about the denial'"   Alan Gurvey

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DWC to Penalize Claims Administrators over IMR Medical Records

"There should be a listing of the records, and a review so we know that they were actually reviewed...Just because an insurance organization is fined for not providing all of the records does not guarantee that the injured worker is going to get a fair shake."   Alan Gurvey

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Expectations for DWC's UR Audit Ramp Up Mixed

"Anyone who understands the gravity of the problems with UR knows that these audits are simply window dressing done to look like something is being done to police the system, but, in actuality, it does little to simplify the process and make it more efficient," Alan Gurvey said. "What is actually behind the windows is a seriously dysfunctional system that window dressings can't possible have any appreciable impact on."

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DWC Provides Guidance on Requirements for Workers to Get 2nd IMR by

 "...he believed Overpeck was saying the order needed to contain language about the IMR being invalid because of a "plainly erroneous express or implied finding of fact," and that there was "clear and convincing evidence" of this mistake. If the WCJ "had written these magic words...I'm sure there wouldn't have been a problem."   Alan Gurvey

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Study Finds L.A. Area Accounts for California's Increased Claim Frequency

 “...'bad apple' attorneys who try to take advantage of the workers’ compensation system are one factor in the higher claim frequency in Southern California. Problems have resulted from reform measures in SB 863...which have allowed some to exploit the system."   Alan Gurvey

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Bill Amendments Would Prohibit Financial Incentives for UR Physicians

"The real issue is that UR doctors, I believe, maintain a very conservative posture with respect to certifying treatment by treating doctors because they are trained to do so, and definitely want to continue to get the business from the carrier," Alan Gurvey said. "Just like (medical provider network) doctors live in fear every day of being kicked off the MPN and losing significant compensation, the UR doctors, perhaps in their own limited way, rely on this business as well to pay their bills."

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Attorneys Say Stevens Decision May Lead to more Litigation

"court apparently didn't care much about the word 'shall'" being used in the Labor Code, and he thought "it would really help the system if Southard and Saunders were the law." That way, "if there has to be challenges, at least we'd know things would move"   Alan Gurvey

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Attorneys Say Maximus Not Listing Medical Records in IMR Letters

"The underlying theory behind the mistake of fact is that the IMR decision cannot be valid where it has not considered the evidence necessary to arrive at a medically sound conclusion," Alan Gurvey said. "That would mean that the reviewer did not review relevant records or reports that would potentially allow for the decisions to be medically supportable."  

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Attorneys Generally Satisfied with New QME Process

"...he expects to see an increase in discovery litigation pertaining to panels issued through the new website. He said he anticipates that many of the problems that existed with the Medical Unit before will now move to the Workers' Compensation Appeals Board for adjudication."   Alan Gurvey

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Attorneys, Copy Shops Question Carrier's Request

"Are these people serious? They want us to bypass the regulations in order to save them money? We should be ignoring the administration so we can save the insurance companies money?"   Alan Gurvey

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5th DCA Grants Review to Dispute over Worker's Earnings

"A scrivener's error as to how much a worker made is different from the failure to state an affirmative defense or request penalties, Alan Gurvey opined, since the question of earnings is simply a factual issue."

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Payments from RTW Fund Increase in June

"...his assessment on the $120 million fund is deteriorating quickly since July, when he called it an 'unadulterated failure.' Just because checks are going out doesn't mean the program is a success." Alan Gurvey

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DIR Paid $865,000 since Return-to-Work Fund Launched in April

"The limitations on the fund have made this notion a total joke," Alan Gurvey said. "In fact, the people who may take advantage of it are most likely not the ones where it will make any difference."

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Attorneys Argue whether SCIF Letter Shows MPN 'Bullying' Doctor or 'Self-Policing' Billing Rules

"...It's not at all unusual" for doctors to get letters such as the one State Fund wrote. He said he sees such letters as warnings to the doctors that "you will not be able to earn your livelihood if you do not do what we tell you to do."   Alan Gurvey

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3rd DCA Accepts Review of Constitutional Challenge to IMR

"(I am) .....a vocal opponent to IMR – last week heralded the 3rd DCA's decision to hear the Ramirez matter and all cases involving IMR decisions ought to be appealed 'until there is transparency' in the decision-making process."   Alan Gurvey

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DePaolo's World: Claim Commodit

Applicant attorney and radio talk show host Alan Gurvey, in a recent WorkCompCentral opinion piece, points out a much more sinister and debilitating access issue: California Medical Provider Networks in accepted cases are themselves an access to care issue.

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The Fiasco Starts Here: MPNs and Workers' Compensation in Califonrnia

"An assistant in our office called 55 doctors on one MPN. Out of the 55, only two were willing to consider treating the injured worker. Most of the doctors were not familiar with workers’ compensation, nor did they even know that they were on the MPN. Other doctors had moved. Others were no longer on the MPN, but their names remained on the website. There were at least six doctors who had died."   Alan Gurvey

 

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DWC, Judges Push against Denial of Care without Change in Medical Circumstances

“(Judges) are all taking this very seriously that based on the Patterson v. The Oaks Farm case that they believe that this line of thinking is proper,” Gurvey said. “And it's coming before the administration, so it’s putting a monkey wrench in all of these situations where the defendant is unilaterally attempting to stop treatment through the utilization-review process.”

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WCAB Expanding Telephonic Appearances, but some Attorneys Skeptical

"...his firm's belief is that 'we should be present at appearances so we get the full impact of the event,' no matter what it is. 'Court was meant to be a place where everyone sees each other eye to eye'"   Alan Gurvey

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Applicants' Attorneys Pan DWC's Rosy View of Independent Medical Review

"the suggestion that the high volume of applications prevented Maximus from issuing timely decisions is not a valid excuse. 'How does that help an injured worker who needs treatment? And if he or she is not going to receive the treatment, will need to seek a different source in some cases'...the DWC seems to be unapologetic of this massive oversight, causing long delays in determining whether treatment denials were overturned or upheld."   Alan Gurvey

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4th DCA Ruling Removes Ambiguity about which Disputes are Subject to IBR By Sherri Okamoto

"..he sees all this litigation as an example of why 'changing the rules in the middle of the game' is never a good idea, 'in sports or in law.'"    Alan Gurvey

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Alan Gurvey Featured in Valley Lawyer December 2014 Issue

"An Unconventional Journey:  Alan Gurvey and a Commitment to Service"

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Employer Wish List Led to Grand Bargain with Labor

"...those involved with the negotiations approached the reform efforts with only cost reduction in mind and that the permanent disability increases didn’t justify the other changes the bill included – things like eliminating the compensability of sexual dysfunction and adding the independent medical-review process."   Alan Gurvey

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Courts Have Their own Take on Legislative Reform

"Back then, the workers' comp system was far different than it is today. A new client would came in and you'd send him to a doctor, and that was all there was to be done,” recalls Alan Gurvey...it was so easy to represent workers that many lawyers with general practices would "dabble" in workers' compensation – something that rarely happens anymore." 

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WorkCompCentral Recognizes Individuals, Organizations with Comp Laude Awards

Congrats to Alan Gurvey for winning a WorkCompCentral 2014 Comp Laude Award!

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Attorneys Have Mixed Views on whether Bodam Brings Clarity or Confusion

"...he remains adamant that treatment decisions "should depend on the medicine, on need and on the patient," and he was having a hard time coming to terms with the idea that "we're in a situation where we're deciding medical need based on timing." So, even though he's grateful to have the opportunity Bodam has opened up for a judge to look at the medical evidence and decide the need for treatment, Gurvey said he thought the decision has "muddied the waters more," paving the way for 2015 to be "a crazy litigated year."   Alan Gurvey

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DWC to Fine Administrators for Not Submitting Medical Records for IMR

"...the announcement is a "step in the right direction.""Perhaps there is an underlying understanding that the administration and the WCAB cannot turn a blind eye to the flaws of the UR/IMR review process"   Alan Gurvey

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Rules for $120 Million Fund Earn Mixed Reviews

"...the program should be structured in a way such that eligibility is determined by a minimum disability rating. Payments should start at $100,000 and be calculated using a sliding scale that takes into account medical evidence showing the injured worker's needs. "This is a meaningless provision of 863, and the administration of the $5,000 per worker provision will be a nightmare, costing more money than the benefit..."   Alan Gurvey

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WCAB Issues New En Banc Decision Limiting Review of UR to Timeliness Issues

Under the new en banc decision, Alan Gurvey said there is "no incentive for UR to be done properly." As long as the decision is issued within five days, "that's a valid UR," or so it seems, he reflected. And then the decision goes through IMR, which upholds the UR denial 85% of the time.

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Comments Request Testing before Online QME Application Goes Live

"...it’s a 'must' for the DWC to develop and implement an electronic system for requesting QME panels so the process is more efficient.....he also supports the proposal to allow judges to resolve QME panel disputes. It is a “miscarriage of justice” to have the Medical Unit making quasi-judicial decisions."   Alan Gurvey

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IMR Spike Likely Caused by Duplicate Applications, DWC Says

“I don’t buy it one bit....he has noticed in his office that the number of IMR denials has increased in the past two months, which would coincide with the notion that there has been an increasing number of applications. What’s happening...is that carriers are sending all treatment requests to utilization review, especially on older claims where treatment is being provided but there was no valid UR performed."   Alan Gurvey

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WCAB Repealing Court Administrator Rules after 3-Year Vacancy

"I'm more interested in substantive changes," said applicants' attorney Alan Gurvey. For the most part, the WCAB is looking to adopt the existing court administrator rules and simply renumber them as WCAB rules, without making any changes.

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DIR to Ratchet Up Pressure on Maximus

"...(we) are seeing an increase in the number of treatment disputes stemming from carriers using utilization review and IMR to deny care on cases that have already been settled...he suggested that it’s financially advantageous for carriers to use UR and IMR to try to get out of paying for medical care."   Alan Gurvey

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Judge Delivers Scathing Rebuke of IMR

Gutierrez initially said he wasn’t sure he could render a decision in the case because IMR decisions, although issued by physician reviewers under contract with Maximus Federal Services, are technically an order by the administrative director.  Alan Gurvey said “What we asked of the judge is, if UR is invalid, doesn’t that necessarily make IMR invalid?” 

 

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1st DCA Denies Review of Constitutional Challenge to IMR Optio

"...the Labor Code allows an applicant to get judicial review of an IMR decision if there is a mistake of fact or law...one of his cases may still need to make its way through the appeals court, but if it stands, "then there is still hope to litigate some instances where applicants have been railroaded."  Alan Gurvey

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En Banc Board Rescinds Award to Wife of Worker for Care Services

"....the board's decision also potentially has opened up 'a whole new can of worms,' and could lead to 'a lot more litigation' over every step of the process that the WCAB has laid out for obtaining payment for home health care."   Alan Gurvey

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Elimination of QME Backlog Didn't End Attorney Woes

"I think this can be fixed...but if someone doesn't speak up, it won't get fixed...it seems like most attorneys have 'just thrown their hands up,'" but "if they're not complaining about the situation, they're not practicing workers' compensation law." Alan Gurvey

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Appellate Court Review Sought for Issues Affected by SB 863

"...disputes about the impact of SB 863 seem to be mostly at the hearing level for now. The situation...is a 'quagmire.'" Expedited hearing requests are on the rise and 'issues in accepted claims are being litigated more than ever' .....it (is) "unfortunate that all of the changes and ambiguities in the law have resulted in often mean-spirited and win-at-all-cost behaviors by certain players that have caused costs to rise and tempers to flare." Alan Gurvey

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Former WCJ Questions Exact Parameters of Weilmann Decision By Sherri Okamoto

"...Faust's reasoning still gets her to the point of saying the unsigned UR is 'of no probative value.' So 'if you want to say that it is a valid UR denial that is useless, fine" ...but the fact remains, it's still "useless."   Alan Gurvey

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WCAB Panel Says Unsigned UR Decisions Are Invalid

Alan Gurvey predicted that litigation will "chip away at UR as we know it until there will be more transparency and more accountability." He said that it "will be a long, drawn-out process" but eventually decisions from these cases will form a "step-by-step guide" on reshaping the UR system. As a practical matter, Michael Win added that requiring UR decisions to be signed by the reviewing doctor gives reassurance that the decision was the reviewer's and not a "cut and paste" job.

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Petition Challenges Constitutionality of IMR

"...shares the widespread concern among his fellow applicants' attorneys over the limited nature of the appeal process for IMR decisions, so he was happy to see someone has finally taken the issue up on a writ." Michael Win

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WCAB Says QMEs Can Comment on Conditions outside Specialty

"Michael Win said that the comp scheme allows any QME to assign impairments ratings to any condition, as long as the QME consulted with specialists who would treat those conditions and incorporated their opinions. This, he said, is 'one of the duties of a QME.'  His firm colleague, Alan Gurvey, suggested that 'common sense' dictates that when a condition is within the scope of the QME's practice, the QME ought to be able to comment on it."

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State Fund Seeks Reconsideration of WCAB's Dubon Decision

"....(he) was even less impressed with the State Fund's arguments. Upon reviewing the petition Tuesday, he derided its contents as 'unadulterated nonsense.' ....(he) posited that "basically what (the State Fund) is saying is that if people break the rules, regardless of what they do, the Appeals Board has no authority to deal with it."   Alan  Gurvey

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Attorneys Predict Upswing in Litigation on UR Denials, Post-Dubon

"....(he) insists that litigation and uncertainty are part of the growing pains of the comp system, and it's the price participants have to pay to provide injured workers with just outcomes for their cases. "The system is absolutely inequitable...it feels like every UR decision he gets is a denial of authorization for a treatment, and many are "ridiculous."   Alan Gurvey

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The Santa Clarita Color Run 5K

The Team Members of Rowen, Gurvey & Win join the Happiest 5K on Earth, moving together to make the world a happier, healthier place!  

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CAAA 2014 Women’s Symposium

Rowen, Gurvey & Win's Women Represent!

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Valdez Decision Reopened Debate over Non-Network Doctor Reports

"...it remains to be seen how the WCAB and courts will interpret the 'sole basis,' language, as it could arguably mean that the non-MPN report cannot be the sole basis for establishing the compensability of one condition among many, or if it just cannot be the sole basis for establishing the compensability of the worker's overall condition.....he is inclined to think it is the latter."   Alan Gurvey

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Alan Gurvey, Panel Speaker on "Mental Conditions That Impair Professional Competence"

California Applicants' Attorney Association Winter Convention 2014

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Los Angeles Valley Applicants’ Attorneys Association November 2013

Featuring Alan Gurvey as a panel member

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WCAB Says Applicant Attorney Can't Choose Interpreter for Depos

"...Section 5811 was ambiguous though, and if the law really is that the defense has the right to choose the translator for an applicant's deposition, 'then it should be made clear either by regulation or in the statutory language.' He has had problems with interpreters who have been hired by defense firms who are not paying attention during depositions...he has seen interpreters talking on their cell phones or sending text messages during depositions or failing to provide the applicant with a translation when other people in the room are talking to each other, and not to the applicant."   Alan Gurvey

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Attorneys, Administration Dispute Cause of QME Process Woes

"...he has been seeing form letters from the DWC rejecting panel requests based on noncompliance with Regulation 30(b), and he suggested that if the DWC wants the information called for in Form 106-a included in all requests for a QME panel, then it should change Form 106 to say so."   Alan Gurvey

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Attorneys Question Value of Workers’ Compensation Specialization Programs

"...certification is a good thing to have, especially with the constant influx of new attorneys each year."   Alan Gurvey

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California Applicants’ Attorneys Association Summer Convention 2013

Alan Gurvey was a panel member with 3 WCAB Judges speaking on discussing attorney ethics

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Employers Lose on Apportionment at High Ct., but Win at 1st DCA

"....counsel for Nilsen, filed a response to the letters with the Supreme Court attacking the amici's arguments as a 'strawman' fallacy.' ....there was never any finding that any nonindustrial factors contributed to Nilsen's loss-of-earning capacity after his industrial injury, so Nilsen's employer was not being held liable for a disability that was not attributable to his workplace accident. "   Alan Gurvey

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1st DCA Sets Oral Argument in Dispute about Worker's PTD Award

"...he understood the Labor Code as only allowing for apportionment if there is 'an overlap' between the prior injury and a later injury. Alan Gurvey represented the injured worker in the Pacific Compensation Insurance Co. case. He said that case had turned on the fact that his client's inability to work was entirely due to 'symptoms that were separate from the nonindustrial injuries.'"   Alan Gurvey

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Stakeholders Say Low Penalties Encourage Carrier Delays

“…had a similar experience with the same Sedgwick adjuster named in the WCAB decision...the case does not have the 'evidence necessary for publication' ...but when something smells fishy, many times it is. This is, however, an important topic as there are other adjusters who seemingly take it upon themselves to inject their own intransigence into cases without legal justification”    Alan Gurvey 

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State Bar Workers’ Compensation 2013 Spring Conference

Alan Gurvey joined other panel members discussing the realties of opiod use

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2nd DCA Asked to Rule on Apportionment for PTD, LC 139.48

"...saw no need for the 2nd DCA to hear the substantive issue in the case since there was no dispute that Nilsen was permanently and totally disabled, and "it is so clear that...but for this injury, he would not have been out of the labor market."   Alan Gurvey

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California Applicants’ Attorney Association Winter Convention 2013

Rowen, Gurvey & Win Attorney Clint Fedderson featured as a CAAA panelist sharing his insights the new laws passed under SB 863 

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California Applicants’ Attorneys Association Summer Convention 2012

Alan Gurvey was featured on the panel "Using Apportionment as Swords" with WCAB Judge Honorable Lilla Rados

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WCAB Imposes Sanctions on Carrier, Adjuster and Defense Attorney

"the WCAB's decision was consistent with the statutes, which provide that a party generally can only be deposed once.  "You can't expect to have continuing depositions once the record is closed," he said, and "you can't do it just because you want to."   Michael Win

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Applicant Law Firm Announces Name Change

The Law Firm of Kenneth H. Rowen changes name to the Law Firm of Rowen, Gurvey & Win

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Services Today for Applicants' Attorney Ken Rowen

"The reason that I consider him a legend is because of the way he practiced law....The word bulldog is used many times. There's hardly anyone in the state who can negotiate and argue a case the way he can" Alan Gurvey

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