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

Originally published by WorkCompCentral as authored by Alan Gurvey

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.

There has been a lot of discussion in the media regarding Gov. Gavin Newsom’s COVID-19 executive order that creates a rebuttable presumption for all employees who contract coronavirus and claim it is due to work.   Alan Gurvey Labor interests would have you believe that this is an important and needed measure taken by the governor. And, it may be. Insurance companies, emplo...

Worker Advocates Push for COVID-19 Presumption in Golden State

Originally published by WorkCompCentral on April 17, 2020

“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

Originally published by WorkCompCentral.com  Authored by Greg Jones   As cases of COVID-19 increase among essential California workers who don’t have the luxury of sheltering in place during the pandemic, some advocates are pushing for changes that will make it easier to receive workers’ compensation benefits for the disease caused by the new coronavirus. California was th...

‘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

Originally Published in the Guardian on January 24, 2020 authored by Michael Sainato. Black lung disease is preventable – but high rates have emerged in recent years as workers inhale toxic dust, prompting calls for better protections ‘With black lung, even with supplemental oxygen, you suffocate to death.   “When you breathe in silica, it coats your lungs immediately,&...

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.”

Originally published by WorkCompCentral and authored by Mark Powell.  When Oklahoma claimants’ attorney Bob Burke woke up Wednesday, he wasn’t sure whether the state’s law firms were considered essential businesses under Gov. Kevin Stitt’s emergency declaration in response to the COVID-19 pandemic. By Wednesday afternoon, Burke got his answer, and his wish. One day...

"Carlos & Lisa" on KDOC Interview Alan Gurvey

Favorite Gurvey's Law Guests!

Join Alan Gurvey, Carlos and Lisa as they discuss some of the guests on Gurvey's Law! Alan shares the "behind the scenes" happenings of the substance and the shenanigans that is Gurvey's Law.  https://vimeo.com/beondtv/download/400846510/b1e06ec381

"Carlos & Lisa" on KDOC Interview Alan Gurvey

How to Select a Good Attorney. "The search for a lawyer needs to focus on the lawyer, one who has passsion for winning a case or defending a client.  Passion, persistence and patience are what you need to look for in a lawyer.  The lawyer should have that passion and believe in you so that they are going to advocate for your interests."  Alan Gurvey

Alan Gurvey was interviewed on KDOCTV "Carlos & Lisa". He spoke about how to choose the right lawyer and what qualities to look for in one before making a decision. Watch Alan's appearance below!

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.”

The California Victim Compensation Board on Tuesday said it would withdraw liens filed against the workers’ compensation claims of some victims of the Dec. 2, 2015, terrorist shooting at the San Bernardino County Inland Regional Center. The announcement comes one day after applicants’ attorney Alan Gurvey, managing partner of the Law Firm of Rowen, Gurvey & Win, sent a letter aski...

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?” 

Originally published by WorkCompCentral as authored by Tonika Reed In Rising Medical Solutions’ seventh annual Workers’ Compensation Benchmarking Study researchers exploring claims operational issues from the perspective of  claims processors uncovered matters regarding the ongoing threat of a talent shortage.  Rachel Fikes, chief experience officer and study program direct...

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.

Originally published by WorkCompCentral by Suzanna Speier The California Workers' Compensation Institute announced that the state’s effort to curb opioid addiction saved $6.5 billion over a 10-year period — a staggering, giant sequoia-scale achievement for the most populous state in the country to boast about, but also a source of concern for attorneys who say their clients strug...

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...” 

Originally published by WorkCompCentral authored by Tonika Reed Advocates for injured workers said a recommendation by the California Workers’ Compensation Institute to exempt treatment modifications from independent medical review is potentially unnecessary with the falling number of treatment disputes. Such a recommendation would also be unfair to injured workers who would be left with n...

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.”

By Greg Jones.  Originally published at WorkCompCentral.  The California Victim Compensation Board, which provided hundreds of thousands of dollars to victims of the December 2015 terrorist attack in San Bernardino, is trying to recoup by filing liens against county workers’ claims. Two liens filed Oct. 29 demand more than $180,000, of which more than $150,000 is for “...

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.

Originally published May 24, 2019 at WorkCompCentral.com authored by Eddie Curran An administrative judge in Southern California eschewed a long-standing but informal rule used to divide fees when more than one attorney or firm represents an injured worker, instead focusing assessment of the results litigators obtained following a record-setting $8.9 million workers’ compensation settl...

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. 

Originally published by WorkCompCentral.  Authored by Greg Jones  Although claim shops throughout California had the lowest amount of unpaid compensation since the Division of Workers’ Compensation started doing annual audits nearly two decades ago, penalty assessments still increased in 2017. The division fined four claims shops that failed the preliminary profile audit review a...

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

The latest California appellate court decision finding asymptomatic, pre-existing conditions are fair game for apportionment should shield employers from paying for disabilities arising from nonindustrial causes, according to workers’ compensation defense attorneys.   On the applicants’ side, Monday’s decision by the 1st District Court of Appeals is seen as anoth...

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 

Originally published by WorkCompCentral as authored by Greg Jones. Expectations about the impact Jerry Brown would have on California’s workers’ compensation system at the start of his second stint as governor haven’t exactly matched reality. When Brown, who previously served as governor from 1975 to 1982, was elected to a third term in 2010, employers were warned to brace for...

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.”

Originally Published by WorkCompCentral on October 25, 2018 authored by Greg Jones  As the number of utilization review organizations complying with California's accreditation mandate slowly increases, attorneys who represent injured workers in California are eagerly awaiting rules they hope will offer some guidance for dealing with decisions that may not be valid. About 30% of utiliza...

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.”

California Gov. Jerry Brown’s call for a study of different versions of impairment ratings guidelines in a weekend veto message has some system users asking, “What’s the point?” A study of differences in the fifth and sixth editions of the American Medical Association’s Guides to the Evaluation of Permanent Impairment, which Brown directed while vetoin...

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.

Originally published by WorkCompCentral, authored by Greg Jones Passing Scores Save UROs From Paying Most Penalties for 2018 Audit Violations   Five utilization review organizations audited this year all scored passing grades, resulting in the Division of Workers’ Compensation waiving most of the penalties they faced for violations uncovered during the inspections. Although the vio...

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

Originally Published as WorkCompCentral authored by Greg Jones The number of treatment disputes in California’s workers’ compensation system that are being resolved through the independent medical review process increased in 2017 and is on pace to increase again this year. While there is disagreement over what the consistently high number of IMR decisions says about how treatmen...

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.

By Greg Jones.  Originally published at WorkCompCentral.com. California Gov. Jerry Brown tapped a high school classmate to fill one of three vacancies on the Workers’ Compensation Appeals Board, and to get a hefty raise in the process. The governor on Friday appointed 80-year-old Juan Pedro Gaffney of Sebastopol to the WCAB. The position pays $147,778 a year. Gaffney, a Democrat, bri...

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. 

Alan Gurvey and his panel provided insight as to the reality of a mass workplace violence claim.  The topic included: Unfortunately, mass workplace violence is becoming a recurring event in society. As employers are beginning to train employees how to handle such events, it is exceedingly important that attorneys train and understand the differences in handling claims involving victims of ma...

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

Published by WorkCompCentral as authored by Greg Jones California’s State Compensation Insurance Fund said it was able to cut in half the number of injured workers receiving opioids over the last four years, thanks in large part to efforts to educate providers about the risks associated with narcotic painkillers. Dr. Dinesh Govindarao, chief medical officer for State Fund, said W...

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.

Published by WorkCompCentral, authored by Greg Jones Rather than trying to clarify the Medical-Legal Fee Schedule, some observers are suggesting that the California Division of Workers’ Compensation undertake more of a soup-to-nuts review of the billing rules, or a broader reassessment of the nearly 14-year-old qualified medical evaluator process. The DWC in May posted to its online f...

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.

Originally published on WorkCompCentral by Greg Wilson  California’s Supreme Court on Monday laid down a simple, three-part test to determine whether a person is an employee of an independent contractor, in a ruling that could have implications for workers’ compensation and the gig economy. The three-part test the court created in Dynamex Operations West Inc. v. Super...

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,” 

California’s largest workers’ compensation carriers could launch a pilot project to evaluate the use of prepaid debit cards for temporary disability benefits, under recently introduced legislation. Another recently amended bill would hold customers jointly liable for future labor law violations when they contract with port trucking companies that have failed to make court-ordered...

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.”

Published by WorkCompCentral, by Greg Jones Attorneys hope Gov. Jerry Brown will act quickly to fill at least one vacancy on the Workers’ Compensation Appeals Board. The board has been short-staffed since at least 2014, and has had two vacancies since April 2016. With Frank Brass retiring in January, the board now has four commissioners and three open positions. Jason Marcus, a partner at...

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

Published by WorkCompCentral on March 7, 2018 by Greg Jones There is no wiggle room in the five-year statutory cap on the duration of temporary disability benefits, California’s 4th District Court of Appeals said in a decision published Tuesday. The appellate court found the Workers’ Compensation Appeals Board erred when it affirmed a decision by a workers’ compensati...

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.'”

Published by WorkCompCentral,by Emily Brill A window cleaner who fell off a roof may proceed with his negligence lawsuit against a Los Angeles County homeowner, the 2nd District Court of Appeal decided Wednesday. Independent contractors like Luis Gonzalez generally aren’t allowed to sue those who hire them. But California law recognizes two exceptions to the rule, and the 2nd DCA foun...

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

Published 12/7/17 on WorkCompCentral, by Greg Jones California employers will pay more in assessments for subsequent injury claims next year than they have in each of the three years combined, and the reason why isn’t exactly clear. Applicant’s attorneys say they haven’t seen notable increases in claims against the fund, which was created to encourage employers to hire wor...

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.  

The Montery Rating Seminar spanned two days on the topic of current permanent rating tecniques and current case law that affects PD rating.   

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

Published on 11/30/17 by WorkCompCentral by Greg Jones Some initial treatment requests for California workers injured after the start of the new year will be exempt from prospective utilization review when statutory changes made by Senate Bill 1160 take effect. Whether the Division of Workers’ Compensation plans to introduce rules to enact the changes — and if regulations are ev...

RGW Firm Members Attend WCAB Judge Swearing-In

 

RGW firm members are pictured with former firm members Judge Steve Carbone, Judge Clint Feddersen and Judge M. Victor Bushin. 

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 

Published on 918/17 by WorkCompCentral , Author Greg Jones After increasing for each of the last two years, the California Workers’ Compensation Institute is projecting the number of independent medical review determinations will drop this year. Maximus Federal Services, the contractor responsible for IMR decisions, issued 86,066 decisions in the first half of 2017, CWCI said in a Spotligh...

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

Published 9/11/2017 on WorkComp Central, Authored by Greg Jones A key legislative committee passed a measure intended to close possible loopholes in last year’s fraud-fighting bills while California lawmakers sent to the governor bills addressing apportionment discrimination and the makeup of State Compensation Insurance Fund’s board of directors. At the same time, an assemblywo...

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

Published 8/10/2017 by WorkComp Central, authored by Emily Brill A California appellate court panel ruled that an employee may pursue a tort claim against her supervisor for intentional infliction of emotional distress, creating a conflict with another panel's reading of a 2008 state Supreme Court opinion. The 1st Division of the 4th District court decided Tuesday that Miklosy v....

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

Published on 7/5/2017 by WorkComp Central, authored by Greg Jones California Assemblywoman Eloise Reyes is making a renewed push to relax utilization review and independent medical review rules for victims of domestic terrorism. The San Bernardino Democrat last week amended AB 44 to propose a presumption that care and services requested by a physician treating a victim of domestic terr...

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  

Published on June 26, 2017 by WorkCompCentral The Frances Stevens case, which resulted in a ruling that restricted the California Workers' Compensation Appeals Board's ability to overturn independent medical review decisions, has re-emerged as a challenge to the WCAB's ability to overrule medical treatment guidelines. Two years ago, former magazine editor Frances Stevens was unable to persuade t...

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

ROWEN, GURVEY & WIN PREVAIL FOR INJURED WORKERS' RIGHTS

  Published on June 25, 2017 by WorkCompCentral, authored by Sherri Okamoto The 2nd District Court of Appeal on Thursday ruled that an employer with a legal obligation to provide medical treatment to an injured worker is responsible for any disability arising directly from an unsuccessful medical intervention, without apportionment to any non-industrial causes for the underlying inj...

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 

 

Published on 4/17/17 by WorkCompCentral, authored by Greg Jones Survivors of the December 2015 terrorist shooting in San Bernardino who tap into the $4 million the Department of Justice last year allocated to provide mental health treatment, crisis counseling and other services could be forced to repay that money out of their workers’ compensation awards. The California Victim Compensation...

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

Published on 4/05/2017 by WorkCompCentral The California 2nd District Court of Appeal will be weighing in on the appropriate standard for addressing the causation of a worker's disability. Twelve years ago, the Workers' Compensation Appeals Board put out an en banc decision in Escobedo v. CNA Insurance that established a rule that apportionment must be based on the causation of the worker's...

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

 Published on 03/23/2017 by WorkCompCentral An administrative law judge on Monday signed off on $10 million settlement for a worker's comp claim in what may be a record recovery for the state. Los Angeles attorney Chris Asvar of Asvar Law on Tuesday said the settlement he attained for Boram Teresa Choi certainly beats his personal best, which was an $8.9 million payment from the State...

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

Published on 03/038/2017 Ninety percent of treatment requests submitted by survivors of the 2015 terrorist attack in San Bernardino have been approved, the California Division of Workers' Compensation found in a review of how the county has handled those claims. George Parisotto, the DWC's acting administrative director, wrote a letter to Department of Industrial Relations Directo...

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

Publsihed 02/28/2017 on WorkCompCentral, authored by Greg Jones  Depending on whom you ask, utilization review may be called a righteous tool to ensure California’s workers’ compensation system provides appropriate medical care, or a dangerous weapon that withholds from workers treatments their physicians think are necessary. The California Workers’ Compensation Institute...

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

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

Alan Gurvey Super Lawyers Magazine profile – “Diagnosis: Life”

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

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

Published on 02/06/2017 by WorkCompCentral, authored by Sherri Okamoto Applicants' attorneys have been fighting for years to get treatment for their clients from doctors outside of the employer's medical provider network, but now a group of practitioners is suggesting a new tactic: demanding treatment from within the network.  Charles Rondeau, a panelist for a discussion on MPNs last mont...

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.

Published on January 30, 2017 by WorkCompCentral, authored by Sherri Okamoto SAN DIEGO — Tensions ran high at the California Applicants' Attorneys Association 2017 winter convention on Friday when the administrators of the state comp system faced a packed ballroom to discuss their efforts at implementing the latest round of statutory directives from the Legislature. The audience becam...

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

Alan Gurvey was honored to introduce the inaugural panel for the 2016 50th Anniversary CAAA Winter Convention in Rancho Mirage, California, for which he served as the Education Chairperson. Since 1966, the California Applicants’ Attorneys Association (CAAA) has dedicated itself to helping Californians that get hurt on the job heal and get back to work. As a Teamsters affiliate, we proudly r...

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

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

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

Published on 12/08/2016 by WorkCompCentral, authored by Greg Jones The San Bernardino County, California, Board of Supervisors earmarked $100,000 to hire an outside firm to ensure survivors of the Dec. 2, 2015, terrorist attack receive necessary medical treatments as quickly as possible. Survivors of last year’s shooting at the Inland Regional Center that killed 14 and injured 22 others re...

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 

Published on 12/05/2016 by WorkCompCentral, authored by Greg Jones Survivors of the 2015 terrorist attack in San Bernardino say the county tried to — and in some cases did — persuade them to apply for medical leave under a federal program that offers workers up to 12 weeks of unpaid time off for serious medical conditions. The U.S. Department of Labor says employers ca...

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

Published on 12/01/2016 by WorkCompCentral, authored by Greg Jones Survivors of the 2015 terrorist attack in San Bernardino are fighting with the county to get approval for medications and treatments their doctors say are necessary — and in the process exposing California’s workers’ compensation system to a new round of national scrutiny. Eighteen county workers who were a...

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."

Published 11/11/2016 by WorkComp Central, authored by Sherri Okamoto  The 4th District Court of Appeal is being asked to decide whether an employer is able to refer treatment recommendation from a doctor within its own medical provider network through utilization review and independent medical review. In Parrent v. WCAB (Pacific Bell Telephone Co.), No. D071162, applicants' attorney Robert...

Live from WorkComp Central Comp Laude! Gurvey's Law

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

The Comp Laude® Awards recognize Integrity, Excellence and Success in the Workers' Compensation industry. Each year, nominations are received and reviewed by a panel of industry judges. Comp Laude® awards are presented by WorkCompCentral at the annual Comp Laude® Gala. Alan Gurvey was honored ot win a Comp Laude Award in 2014.  Alan Gurvey  was honored to bring the Gurvey's...

Dozens of Injured San Jose Firefighters Denied Workers' Comp Treatment

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

NBC Bay Area, authored by by Liz Wagner, Michael Bott and Jeremy Carroll Part I: The City of San Jose was forced to reexamine cases after firefighters complained that the workers' compensation system denied necessary treatment for their on the job injuries. A San Jose fire captain nearly died after a building collapsed on him, but the workers’ compensation system denied the medical t...

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

 Published on 08/04/2016 by WorkCompCentral, authored by Greg Jones California employers would not be liable for medical treatment provided before they accept or deny a cumulative trauma or occupational disease claim unless the injured worker was treated by a doctor in the employer’s network or his or her personal physician, under recent amendments to a bill that could also be a vehicl...

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

Published on 08/03/2016 by WorkCompCentral, authored by Greg Jones A draft of proposed legislation by the California Department of Industrial Relations shows that the department might put the brakes on utilization review for network doctors in the first 30 days after injury and is considering adding another layer of review for medical treatment disputes. DIR Director Christine Baker an...

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

   Published on 07/08/2016 by WorkCompCentral, authored by Greg Jones Department of Industrial Relations Director Christine Baker rejected claims that gender discrimination is rampant in California’s workers’ compensation system and said a lawsuit alleging widespread bias against women could be part of an effort to undo successful reforms. Baker said a group of lawyers who...

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

  Published on 05/19/2016 by WorkCompCentral, authored by Greg Jones The retirement of Ronnie Caplane as chairwoman of the Workers’ Compensation Appeals Board created a second vacancy and a growing desire among some attorneys to have a fully staffed panel of seven commissioners. Vacancies on the appeals board were long a concern of Caplane, who retired on April 29 and took a vice pre...

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.”

Publsihed on 04/08/2016 by WorkCompCentral, authored by Greg Jones Bills in the California Legislature that would extend salary-continuation benefits for police and firefighters recovering from catastrophic injuries, and reinstate the qualified medical evaluator designation for neuropsychologists, were unanimously passed out of committee, along with three other workers' comp measures. At the sam...

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

Published on 03/28/2016 by WorkCompCentral, authored by Sherri Okamoto California applicants' attorneys say they are outraged with the news that some medical provider networks are using economic profiling to determine the top-performing doctors within their networks, and at least one is promising to reward the best performers with extra compensation. The Labor Code expressly allow...

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

Published on 03/09/2016 by WorkCompCentral, authored by Greg Jones Eight California claims administrators face a total of $8.25 million in administrative penalties for not submitting medical records to Maximus Federal Services within the time period allowed by law. Documents provided in response to a public records request reveal the Division of Workers' Compensation started the process of asses...

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

Published on 02/29/2016 by WorkCompCentral  More than a year after warning claims administrators that it would start assessing penalties for untimely submission of records for independent medical review, the Division of Workers' Compensation has started a process that could lead to fines against 10 firms. The division has issued orders to show cause to 10 claims administrators that have cons...

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."

  Published on 02/16/2016 by WorkCompCentral, Authored by Greg Jones The most vocal critics of utilization review reacted to the Division of Workers' Compensation's announcement that it will ramp up audits this year with a range of opinions, from "it's about time" to "so what." The division last week said its Audit and Enforcement Unit will be noticing more target audits in 2016 to ad...

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

Published on 01/27/2016 by WorkCompCentral, authored by Sherri Okamoto Getting a second go-round through the independent medical review process is not as simple as asking for it, even if there is no dispute that the initial IMR decision was invalid, according to a letter by the California Division of Workers' Compensation issued last week. Labor Code 4610.6 provides that the remedy for an invalid...

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

Published on 01/15/2016 by WorkCompCentral, authored by Elaine Goodman Differences in workers’ compensation claims in the Los Angeles area are again in the spotlight, as a new report says the five-county Southland is responsible for driving up indemnity claim frequency for the state as a whole. The report, from the California Workers’ Compensation Insurance Rating Bureau, i...

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."

Published on 01/07/2016 by WorkComp Central, authored by Greg Jones California employers and carriers would be prohibited from offering financial incentives to physicians performing utilization review based on the number of treatment requests that are delayed, modified or denied, under a bill that could be called for a committee hearing as early as Jan. 13. New language in SB 563 that...

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

Published on October 30, 2015 by WorkCompCentral, authored by Sherri Okamoto The California 1st District Court of Appeal has declared that the state's independent medical review process passes constitutional muster, but attorneys are saying the ruling still leaves them plenty to fight over. In Stevens v. WCAB, a unanimous panel determined that California’s scheme for evaluating workers&rsq...

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. "  

 Published on WorkCompCentral on 10/23/15, authored  by Greg Jones Independent medical review final determination letters are supposed to list all records that were considered when deciding if a treatment is appropriate, but applicants' attorneys say Maximus Federal Services is not doing that in all cases. Instead, Maximus is identifying the range of dates of the medical records review...

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

Published on 10/08/2015 by WorkCompCentral, authored by Greg Jones Workers' compensation attorneys say the online process for requesting qualified medical evaluator panels that went live Oct. 1 isn't perfect, but they're generally pleased with how it's working and the immediate turnaround in getting a list of doctors to determine an injured worker's eligibility for benefits. "I went online, fill...

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

Published on 09/03/2015 by WorkCompCentral, authored by Greg Jones  State Farm Fire and Casualty Co. negotiated a good deal on copy service rates in California, but its request for applicants' attorneys to help it control costs by using its vendor has some copy shops and attorneys scratching their heads. The Division of Workers' Compensation's copy service fee schedule, which was mandated b...

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."

Published on 08/31/2015 by WorkCompCentral, authored by Sherri Okamoto The 5th District Court of Appeal has agreed to weigh in on the question of whether the Workers' Compensation Appeals Board should have adjusted the amount of a truck driver's award of benefits after the parties discovered they had mistakenly stipulated to his earnings being lower than they actually were. Attorney Michael Burg...

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

Published by WorkCompCentral on 06/30/2015, authored by Greg Jones The California Department of Industrial Relations paid more than $1 million to injured workers from the Return-to-Work Supplement Program in June alone, about 50% more than it did during the first seven weeks after the program went live in April. And while department officials say they're happy with how the program is working and...

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."

Published on 06/10/2015 by WorkCompCentral, authored by Greg Jones The California Department of Industrial Relations has made $865,000 in supplemental payments to injured workers since it launched the return-to-work program created by Senate Bill 863 in April. As of June 1, the DIR had received 233 applications for the one-time payment of $5,000, of which 37 were denied either because the person...

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

Published on May 19, 2015 by WorkCompCentral, authored by Sherri Okamoto State Compensation Insurance Fund's May 11 letter to a doctor within its medical provider network has applicants' attorneys up in arms over what they perceive as a dissemination of misinformation and bullying.  Defense attorneys, however, say the applicants' bar is making much ado about nothing, suggesting th...

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

Published on May 18, 2015 by WorkCompCentral, by Sherri Okamoto The California 3rd District Court of Appeals has agreed to hear a constitutional challenge to the independent medical-review process mandated by Senate Bill 863. Ramirez v. WCAB (SCIF), No. C078440, joins a case already pending at the 1st DCA called Stevens v. WCAB (Outspoken Entertainment), No. A143043, which also seeks to hav...

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.

Published by WorkCompCentral on 05/08/2015, authored by David DePaolo Access to medical care is usually debated in terms of geography or process approval - injured workers in more rural areas have greater difficulty getting to a physician because of geographical limitations, or a particular treatment request has to go through the approval/denial process before a physician will execute a treatment...

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

 

Published on 05/07/2015 by WorkCompCentral, authored by Alan Gurvey Recently I was interviewing a candidate for a vacant attorney position at our firm. I asked the attorney, who had spent most of his career as a defense attorney, what he thought the three most difficult challenges would be as an applicant attorney in today’s post-SB 863 environment. He first said, “Dealing with the ap...

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.”

  Published on 03/24/2015 by WorkCompCentral Applicants’ attorneys say that a statement last week by the California Division of Workers' Compensation – spurred by national coverage of an insurer's decision to cut off home health care – gives them more ammunition in a long-standing dispute over whether the 2012 reforms give employers and carriers an opportunity to challenge...

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

  Published on March 4, 2015 by WorkCompCentral, authored by Sherri Okamoto The California Workers' Compensation Appeals Board has been allowing attorneys to literally "phone in" appearances using a program known as "Court Call" for well over two years. The program is in place at 15 boards, and the department is in the process of setting it up in another six. But the program doesn't seem...

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

Published on December 19, 2014 by WorkCompCentral, authored by Greg Jones The California Division of Workers' Compensation says a report detailing independent medical review statistics from 2013 shows the program is on the right track in reducing delays and delivering timely medical care, but attorneys who represent injured workers say they're not seeing those improvements. In some cases, IMR ha...

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

  Published on 12/18/14 by WorkCompCentral Medical providers say Tuesday's ruling by the California 4th District Court of Appeal that the Workers' Compensation Appeals Board has the authority to decide medical billing disputes that were pending prior to the passage of SB 863 averted a catastrophe for doctors who treat injured workers. Insurers, on the other hand, are disappointed. They had...

Alan Gurvey Featured in Valley Lawyer December 2014 Issue

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

Alan Gurvey was featured in the Valley Lawyer December 2014 Issue , page 28 and continuing, in the article titled “An Unconventional Journey: Alan Gurvey and a Commitment to Service.”  

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

Published 12/11/14 on WorkCompCentral, authored by Greg Jones Editor's Note: Three WorkCompCentral reporters devoted at least one week each in the past several months to tell the story behind the story about the dysfunction of California's workers' compensation system. This is the fourth of six stories in our special report, which was distributed in print form at the Third Annual Comp Laude Award...

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." 

  Published on 12/9/2014 by WorkCompCentral, authored by Sherri Okamoto Editor's note: Three WorkCompCentral reporters devoted at least one week each in the past several months to tell the story behind the story about the dysfunction of California's workers' compensation system. This is the second of six stories in our special report, which was distributed in print form at the Third Annual...

WorkCompCentral Recognizes Individuals, Organizations with Comp Laude Awards

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

An injured worker who lost both legs in separate workplace accidents, an applicants' attorney who filed some of the first appeals of independent medical-review decisions and a claims administrator who was praised by an applicant for his compassion and kindness were among the winners of WorkCompCentral's Comp Laude awards. WorkCompCentral selected Dwight Johnson as a Comp Laude recipient in the in...

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

Published on 12/1/2014 by WorkCompCentral, authored by Sherri Okamoto Applicant and defense attorneys across the state have mixed views on the direction that the Workers' Compensation Appeals Board has indicated it is heading with its recent significant panel decision, Bodam v. San Bernardino County. Without question, the issue of when and how the board can decide medical necessity for a wo...

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

Published on 11/26/2014 by WorkCompCentral, authored by Greg Jones   The California Division of Workers' Compensation announced that next Monday it will begin the process of assessing penalties against claims administrators that fail to submit relevant medical records for independent medical review. The DWC said in a notice issued Tuesday that it will pursue administrative penalti...

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

Published by WorkCompCentral on 10/28/2014, authored by Greg Jones The California Applicants' Attorneys Association said it supports rules proposed by the Department of Industrial Relations that would make receipt of the Supplemental Job Displacement Benefit voucher the sole factor in determining an injured worker's eligibility for payments from the $120 million fund created by Senate Bill 863....

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.

  Published on October 7, 2014 by WorkCompCentral, authored by Sherri Okamoto The California Workers' Compensation Appeals Board, sitting en banc, ruled Monday that a utilization-review decision will be deemed invalid and ineligible for the independent medical review process created by Senate Bill 863 only if it is untimely. If a UR decision is untimely, the WCAB said it can make the deter...

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

Published 09/30/2014 by WorkCompCentral, authored by Greg Jones Expectations are high that a proposed electronic application process will allow the California Division of Workers’ Compensation to quickly issue qualified medical evaluator panels in represented cases, but system users want some testing to ensure the system works before it becomes mandatory. Employers and carriers who comment...

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

Published on 08/29/2014 by WorkCompCentral, authored by Greg Jones The sharp spike in applications for independent medical review observed in the second quarter of this year is likely the result of duplicate and ineligible requests, according to the California Division of Workers’ Compensation. IMR requests jumped 70% from 11,571 in March to 19,663 in April. That was the largest number of...

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.

Published on 08/07/2014 by WorkCompCentral, authored by Sherri Okamoto The California Workers' Compensation Appeals Board hasn't had a court administrator for three years. This week, the Division of Workers' Compensation started the process of repealing all of the rules that went with the job. The WCAB on Monday issued notice that it is accepting public comment on a proposal to repeal the Rules...

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

Published on 07/18/14 by WorkCompCentral, authored by Greg Jones   The California Department of Industrial Relations so far has not imposed penalties − allowed by contract − against Maximus Federal Services for not issuing independent medical review decisions within regulatory timeframes, but that could change in September. DIR Director Christine Baker said Thursday, during...

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?” 

 

Published on 07/16/2014 by WorkCompCentral, authored by Greg Jones A Southern California judge, in striking down an independent medical review decision and ordering the injured worker to receive the denied treatment, joined the chorus of detractors who say the new administrative process for resolving treatment disputes is creating delays and improperly denying care. Although the decision doesn't...

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

 Published 06/19/14 by WorkCompCentral, authored by Sherri Okamoto The 1st District Court of Appeal on Tuesday summarily denied review of a lawsuit that challenges the constitutionality of the independent medical review process, but applicant attorneys say this doesn't mean the controversial system with limited judicial oversight for treatment decisions actually comports with principles of d...

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

Published on June 13, 2014 by WorkCompCentral, authored by Sherri Okamoto The California Workers' Compensation Appeals Board, in an en banc ruling Thursday, unanimously rescinded an award to a worker with a severe injury to his dominant hand for the home health care assistance he was receiving from his wife. Even though Roque Neri-Hernandez got hurt before the California Legislature passed Senat...

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

Published on 06/05/2014 by WorkCompCentral, authored by Sherri Okamoto California attorneys say the Division of Workers' Compensation has largely cleared a backlog that delayed the issuance of qualified medical evaluator panels for six months, but now they have a new problem. When applicants do get a panel, they have trouble making a timely appointment with the QME or discover that the doctor se...

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

Published on 04/30/2014 by WorkCompCentral, authored by Sherri Okamoto While California attorneys are busy battling out their differing interpretations of Senate Bill 863 at the Workers' Compensation Appeals Board, disputes about the meaning of the statutes that existed before passage of the 2012 reform are on their way to the Court of Appeals.  So far, 13 workers' compensation cases have b...

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

Published 04/28/2016 by WorkCompCentral A former workers' compensation judge is cautioning that she thinks a California Workers' Compensation Appeals Board decision from earlier this month on what should happen when a doctor fails to sign a utilization review decision doesn't mean that the decision is necessarily invalid.  Pamela Faust, now with the Zenith Insurance Co.'s legal te...

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.

Published on 04/18/2014 by WorkCompCentral, authored by Sherri Okamoto The California applicants' attorneys say a Workers' Compensation Appeals Board panel decision issued last week gives them a new avenue to invalidate an adverse utilization-review decision.  In Weilmann v. United Temporary Service, a board panel ruled that UR decisions issued by doctors who had not signed their decisions,...

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

 Published on April 15, 2014 by WorkCompCentral, authored by Greg Jones An injured worker adjudged 100% permanently and totally disabled filed a petition with the California 1st District Court of Appeal seeking a declaration that the independent medical review process that denied her home health services violates the state constitution.   Such a challenge was clearly envisioned by th...

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. "

Published on April 16, 2014 by WorkCompCentral, authored by Sherri Okamoto A qualified medical evaluator is not limited to commenting solely on impairments that fall within the scope of treatment for his medical specialty, according to a panel decision by the California Workers' Compensation Appeals Board.  A WCAB panel last month accepted and adopted a decision by Workers' Compensation Jud...

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

 Published on 03/26/2014 by WorkCompCentral, authored by Sherri Okamoto The California State Compensation Insurance Fund on Monday filed a petition seeking reconsideration of the en banc Workers' Compensation Appeals Board decision last month in Dubon v. World Restoration. In the Dubon case, the WCAB ruled that medical necessity is not subject to the independent medical-revie...

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

Published on 03/04/2014 by WorkCompCentral, authored by Sherry Okamoto Attorneys up and down the state are voicing strong reactions to the en banc Workers' Compensation Appeals Board decision last week in Dubon v. World Restoration, with some on the defense side decrying the decision as making it virtually impossible for the utilization-review process to work, and those on the applicant side...

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 !  

The Law Firm of Rowen, Gurvey & Win participated in the Santa Clarita 5K Color Run.  The Santa Clarita 5K Color Run was held on February 15, 2014 in Santa Clarita, CA.  The Rowen, Gurvey & Win team had a great time showing off their bright colors and high energized spirits while working on their health and fitness.  The Color Run is also known as the Happiest 5K on the plane...

CAAA 2014 Women’s Symposium

Rowen, Gurvey & Win's Women Represent!

A few of the women from the Law Firm of Rowen, Gurvey & Win attended the CAAA 2014 Women’s Symposium.  The CAAA 2014 Women’s Symposium was held on February 12, 2014 in Sacramento discussing a symposium on working women’s on-the-job injuries, and how they might be better prevented, addressed and cured.  The program was built upon research to generate policies and pra...

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

Published January 29, 2014 on WorkCompCentral, authored by Sherri Okamoto In the past year, the California Supreme Court has handed down only one decision dealing directly with workers' compensation, and naturally the panelists at the California Applicant Attorneys Association winter convention last weekend discussed that ruling as part of a session on the most important cases of 2013. However,...

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

California Applicants' Attorney Association Winter Convention 2014

Alan Gurvey was a featured speaker at the California Applicants’ Attorney Association Convention in Palm Springs on Friday, January 24th, 2014.  Alan’s panel was titled “Mental Conditions That Impair Professional Competence” and the panel members were two other well respected attorneys, Saul Allweiss, Esq. and Terri Cheney, Esq., as well as psychiatrist doctor, Dr. Gab...

Los Angeles Valley Applicants’ Attorneys Association November 2013

Featuring Alan Gurvey as a panel member

Alan Gurvey spoke at the Los Angeles Valley Applicants’ Attorneys Association (also know as LAVAAA) monthly meeting on November 13, 2013 with vocational expert Enrique Vega.  The discussion was “Using the Vocational Expert For An Accurate Permanent Disability Rating.”  This was a very informative discussion that could be very helpful when dealing with permanent disabili...

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

Published on 11/07/2013 by WorkCompCentral, authored by Sherri Okamoto Applicants' attorneys do not have the right to select the interpreter who will translate his or her client's words into English at a deposition for his or her comp claim, according to a recent panel decision from the California Workers' Compensation Appeals Board. In a ruling last month, the WCAB panel upheld a ruling by Work...

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

Published on 09/16/13 by WorkCompCentral, authored by Sherri Okamoto The regulators who control California's workers' compensation system and the attorneys who practice within it agree on one thing: The process for getting a qualified medical evaluator panel isn't working the way it's supposed to. But that's about as far as any meeting of minds goes.  The California Division of Workers'...

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

Published on 08/02/2013 by WorkCompCentral Pennsylvania became the ninth state in the country to certify attorneys as specialists in workers' compensation this March, joining Arizona, California, Connecticut, Florida, New Jersey, New Mexico, North Carolina, Ohio and Texas. A total of 176 attorneys applied to take the exam, but only 171 of them qualified to sit. Of the 155 people who took the tes...

California Applicants’ Attorneys Association Summer Convention 2013

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

 Alan Gurvey was a featured speaker at the California Applicants’ Attorney Association Convention in Las Vegas on June 28th, 2013.  The exciting panel included three well respected workers’ compensation judges.  The panel focused on where the line is drawn between advocacy on behalf of a client and bad faith unethical tactics.  Mr. Gurvey’s background as an et...

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

Published on 06/17/13 by WorkCompCentral, authored by Sherri Okamoto The California 1st District Court of Appeal on Tuesday ruled in favor of an employer that argued a worker's hearing loss should be apportioned for nonindustrial factors, handing business interests a small consolation prize after the state Supreme Court ruled against them last week in a case that touched on similar apportionment...

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

Published on 05/24/2013 by WorkCompCentral, authored by Sherri Okamoto The California 1st District Court of Appeals will hear oral arguments next month in a case where an administrative law judge found a worker was permanently and totally disabled from a cumulative trauma injury causing hearing loss, without apportionment for his previously established permanent disability from hearing loss, base...

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 

Published on 05/07/2013 by WorkCompCentral, authored by Greg Jones  Allegations that Sedgwick CMS repeatedly denied care to an injured worker who suffered from a fatal infection contracted during surgery illustrates that California workers' compensation carriers have no incentive to authorize treatment or pay benefits or bills on a timely basis because the penalties for violations amount to...

State Bar Workers’ Compensation 2013 Spring Conference

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

 Alan Gurvey is seen here as a featured presenter at the State Bar of California Workers’ Compensation 2013 Spring Conference at the Sheraton Gateway Los Angeles Hotel.  Mr. Gurvey is also a featured speaker for the same conference in Shell Beach, California.  He and panelists, Robert Rassp, Esq. and Saul Alweiss, Esq. provide an informative presentation on the ...

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

Published on February 25, 2013 by WorkCompCentral, authored by Sherri Okamoto  The California 2nd District Court of Appeal is considering whether an employer can apportion liability for a permanent and total disability caused by a worker's loss of earning capacity if the worker also has limitations caused by non-industrial medical conditions. The defense in Pacific Compensation Insurance Co...

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 

Clint Feddersen was a featured panelist at the California Applicants’ Attorney Association Convention in January 2013 in San Diego.  Mr. Feddersen joined three other erudite panelists to talk about the impact of the new laws under SB 863 on the Expedited Hearing process.  Approximately 1400 people were there to listen to the presentation.

California Applicants’ Attorneys Association Summer Convention 2012

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

Attorney Alan Gurvey spoke at the California Applicants’ Attorneys Association (CAAA)  Summer Convention 2012 in San Francisco.  Mr. Gurvey explained to the attorneys and doctors in the audience that potential apportionment of causation of a workers’ compensation injury to a prior non-industrial or industrial injury does not necessarily diminish the value of a case....

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

Published on April 16, 2012 by WorkCompCentral, authored by Sherri Okamoto The California Workers' Compensation Appeals Board ordered $16,510 in sanctions against TIG Specialty Insurance, its claims administrator and its defense attorney for engaging in bad-faith and frivolous actions in a benefits dispute. The panel concluded that the monetary penalty against the carrier, Risk Enterprise Manage...

Applicant Law Firm Announces Name Change

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

Published on 12/13/2010 by WorkCompCentral   A Van Nuys law practice that specializes in representing injured workers will change its name at the first of the year. The Law Firm of Kenneth H. Rowen, in operation for more than three decades, announced Thursday it will become the Law Firm of Rowen, Gurvey & Win effective Jan. 1. Alan Gurvey, managing partner, and Michael Win each have b...

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

Published on June 5, 2007 by WorkCompCentral, authored by Rob McCarthy Los Angeles applicants' attorney Ken Rowen, who was known for his fierce negotiating skills, expertise on chronic pain syndrome and generosity to charities died over the weekend and will be buried today.  Rowen, 65, died after a short illness, according to his law partner Alan Gurvey. Funeral services are at 10 a.m. at M...