Public Hearing Set for Medical Provider Network (MPN) Rules

Adelson, Testan, Brundo, Novell & Jimenez (ATB Law) would like to make its audience aware that the California Division of Workers’ Compensation (DWC) will be holding a public hearing to discuss issues and changes connected with the Medical Provider Networks, or MPNs, following the passage of SB 863 last year. The term MPN was coined in 2005 as a way to describe health care providers and groups maintained by insurers and self-insured employers and approved by the DWC for workers’ compensation cases. SB 863 will bring significant changes to the way that MPNs operate in workers’ compensation claims. The DWC hearing will be the first occasion for members of the public to supply recommendations on these MPN changes as part of the state rulemaking process.

The details for this hearing are as follows:

January 31, 2013

10 AM to 12 noon

Elihu Harris State Office Building Auditorium

1515 Clay Street

Oakland, CA 94612

All Employers Should Have a Voice in the Rule making Process

It is hoped that the pending reforms will reduce costs to employers while developing a more navigable workers’ compensation system for all. The DWC is seeking public input on a variety of issues, including new MPN applicants, MPN audits and investigations, and the Independent Medical Review process. Employers will have the opportunity to participate in the formation of regulations for these new processes on January 31, and will also be able to share input on other facets of the law.

Adelson, Testan, Brundo, Novell & Jimenez believes it is important for employers to have a voice in workers’ compensation legislation, and encourages all employers potentially impacted by the coming changes to send a representative to this hearing and voice any suggestions or concerns they may have.

 

Diversity Is Valued Through Inclusiveness at Adelson, Testan, Brundo & Jimenez

Adelson, Testan, Brundo & Jimenez (ATB Law) believes in and supports diversity, not only by recognizing the value of differences between individuals, but also by supporting a culture of inclusiveness within the firm and with our clients.

We believe that any form of diversity helps strengthen an organization and community, but at ATB we take our commitment to diversity a step further and it’s reflected in our wonderful staff. Adelson, Testan, Brundo & Jimenez attorneys, associates and support staff represent a huge variety of different backgrounds and can offer services in all of the following languages:

Afrikaans

French

Korean

Spanish

Arabic

German

Mandarin

Swedish

Armenian

Greek

Marathi

Taiwanese

English

Hindi

Punjabi

Urdu

Farsi

Italian

Russian

Vietnamese

Adelson, Testan et al. also believes that diversity is more than language and culture. Diversity encompasses all backgrounds, beliefs, experiences, and worldviews. We recognize and value all different types of diversity, including that of race, sex, age, sexual orientation, and even personal interests.

One of the ways that we encourage inclusiveness for all groups is through community outreach programs and support. The organizations our firm supports are as diverse as Adopt a Fire Station, Cerritos College Women’s Soccer, and the Southern California Latvian School, just to name three of among over 100 programs to which Adelson, Testan, Brundo & Jimenez has contributed.

Adelson, Testan, Brundo & Jimenez actively supports diversity throughout our firm with our recruitment efforts and by offering internal mentoring programs and diversity trainings. This not only enhances our ability to serve clients but also enables us to connect more closely with them and with the communities in which we live and work.

Our firm embraces diversity in all of its many forms, in our office and in our communities. Adelson, Testan, Brundo & Jimenez believes that on a macro level, diversity makes the world a more enriching place for all. On a more local level, diversity strengthens the community by incorporating different ideas, viewpoints, and backgrounds. And at Adelson, Testan, Brundo & Jimenez, diversity makes us a stronger firm.

 

 

What is Valley Fever? Workers’ Compensation Attorney Explains the Basics

As part of Adelson, Testan, Brundo and Jimenez’ ongoing educational seminar series, presented on ATB Law’s YouTube Channel, David Tew, managing partner at our Fresno office, covers workers’ compensation issues and defense strategies related to Valley Fever.

Valley Fever is also known as coccidiomycosis, an infection in the lungs and respiratory system caused by inhalation of Coccidioides immitis, a fungus that grows in soil in areas of the US and Central and South America. Valley Fever generally causes a temporary disability, and in its most common forms is not a cause to be unable to work. In cases where permanent disability does arise from Valley Fever, impairment can range from 0% to 100% disability, and in rarer cases may involve a death benefit.

Avenues of Workers’ Compensation Defense against Valley Fever

Valley Fever must be diagnosed through lab tests to create substantial medical evidence for a workers’ compensation claim. When deposing a worker claiming a Valley Fever injury, it’s also important to determine the symptoms, as Valley Fever’s various forms present with classic symptoms.  In addition, employees who live or visit endemic areas on a non-industrial basis will have difficulty proving industrial exposure, as will those who do not have a greater exposure than that of the general public. There are, therefore, four common avenues of defense against workers’ compensation claims involving Valley Fever:

  • If lab tests show negative results for Valley Fever but these are contradicted by a doctor’s opinion, there is a strong opportunity for defense if an exact copy of the negative lab tests is obtained.
  • Negative symptoms combined with a negative lab test are a possible avenue of defense.
  • Valley Fever can be recurring, and therefore a pre-existing condition that would not be covered under workers’ compensation.
  • Directly compare the employee’s risk of exposure to that of the general public through complete discovery and history of residence, travel, and illnesses, among other factors. If the employee’s risk was not greater than that of the public, the employee may not meet the bar of proving industrial exposure.

As one of the top workers’ compensation defense firms in the nation, Adelson, Testan, et al. is experienced in defending against all types of claims, including Valley Fever. Learn more about Valley Fever, including how it is spread, treatment options, diagnosis, complications, and further defense strategies by watching David Tew’s video seminar on Valley Fever on YouTube.

Compounding Drugs Could Create Higher Workers Compensation Liability

Jeffrey M. Adelson, managing partner of the Santa Ana, California office of Adelson, Testan, Brundo & Jimenez, the national workers’ compensation defense firm, was recently quoted in an article on the front page of Business Insurance discussing the risks and costs associated with contaminated compound drugs in workers’ compensation cases.

Concerns over the practice of large scale compounding are rising following an outbreak of meningitis linked to a New England drug compounding company, and as Adelson noted for Business Insurance, this could have far reaching implications for employers.

How Drug Compounding Becomes a Risk

Under current regulations, in most cases compounded medication should only be manufactured to meet the customized dosage needs of individual patients via prescription when more commercially available drugs are not adequate. Exceptions would include cases of national drug shortages.

However, it appears that some pharmacies might be manufacturing compounded medication on a larger scale without prior approval by the FDA and other regulatory bodies. This appears to be the case with New England Compounding Pharmacy, Inc., the pharmacy linked to doses of injectable steroids contaminated with meningitis that have resulted in the loss of 20 lives and caused 250 confirmed meningitis cases.

Ordinarily, compounding pharmacies are not subject to the greater oversight put on large scale manufacturers of compound drugs, nor are they subject to the same price controls. This sets up the scenario in which batches of contaminated drugs are distributed, which could potentially raise the cost of a workers’ compensation claim.

Contaminated Compounds and Workers’ Comp

In his observations to Business Insurance, Adelson pointed out not only the likelihood of a workers’ compensation claimant receiving contaminated medication in large scale cases like that of the New England Compounding Pharmacy, but the ways in which this could impact the cost of workers’ compensation claims:

  • As the contaminated medication would be administered under the original workers’ compensation claim, the employer and insurer could be held liable for the additional costs to treat the health problems arising from the contamination.
  • Contamination with bacteria such as meningitis that can cause lifetime disability and even death “could turn a typical claim into a catastrophic case,” says Adelson.
  • Employers could protect themselves by subrogating under a product liability argument. Even so, the additional costs represented by taking this defense through to resolution could inflate the workers’ compensation claim.

Adelson, Testan, et al. is committed to proactively representing its clients’ litigation needs in workers’ compensation defense. We encourage our clients to ask questions about emerging issues like drug compounding and how this could impact existing and future workers’ compensation claims.

 

Tips to Avoid Costly Employers’ Liability for Distracted Driving

Every year, distracted driving injures or kills hundreds of thousands of people in the United States. Activities such as eating, checking maps, and talking or texting on cell phones while driving are dangerous for any driver, but, for those driving commercial vehicles, the risk of doing harm to someone else while distracted increases tremendously.

The size, weight, and longer stopping distance of commercial vehicles mean that only a second of driver distraction can result in a life changing accident for the driver and those sharing the road. Unfortunately, not all commercial drivers have gotten the message, but the Workers’ Compensation attorneys of Adelson, Testan, Brundo & Jimenez are working to change that.

The Distraction Is Worse Than Many Assume

In today’s world, multitasking is accepted as a way of life. In any environment, multitasking necessarily reduces an individual’s focus on any one task which, in turn,  increases the chances of errors.  Statistics compiled by the U.S. Department of Transportation confirm:

  • In 2010, 18% of all crashes involving an injury involved reported distraction.
  • Those using hand held devices such as cell phones and audio players while driving are four times more likely to be involved in a crash that causes injury.
  • The risk of a crash increases by 23 times over focused driving when the driver is text messaging.

Clearly, no matter how accustomed one is to multitasking, it is not possible to drive safely while distracted.

Employers of Commercial Drivers Must be Diligent

In many cases, the regulation of commercial driver behavior is stricter than that of other drivers. For example, commercial drivers using handheld cell phones can face fines of up to $3,000 and lose their commercial driver’s license and fines to the employer can be as much as $11,000 per incident. Nevertheless, crashes involving distracted commercial drivers are frequent. Employers of commercial drivers must be aware of employee behavior while employees are behind the wheel of company vehicles, since employers can be held liable for an employee’s distracted driving. The consequences of not so doing can be severe:

  • Employers can be held responsible for paying worker’s compensation for workers injured due to distracted driving, which might not be insurable.
  • Negligence per se can be established against the employer of a distracted driver, leading to punitive damages.
  • Employers found grossly negligent may face additional fines, costs, and license revocations arising from a distracted driving incident.

ATB: Working to Solve the Problem

The Law Offices of Adelson, Testan, Brundo & Jimenez takes distracted driving seriously. As experienced workers’ compensation defense attorneys, we work with employers to protect their businesses against exposure to distracted driving by employees and the costs associated with workers’ compensation litigation. Employers can take steps to mitigate the business risks of employee distracted driving, including updating company policies and manuals to include unambiguous language concerning the use of electronic devices while driving, using technology to monitor and control employee driving habits, and communicating regularly with employees about expectations for vehicle use. These steps can not only help shield transportation businesses in a workers’ compensation defense case, but reduce the chances of an incident proactively.