Keep CAAA Out of the Bedroom

Keep CAAA Out of the Bedroom
by Mark Fletcher, Esq.

 

The California Applicant's Attorneys Association (CAAA) recently met in Palm Springs to discuss ways to re-energize their post SB-899 practices. No longer content to keep their heads in the sand and deny that the laws have changed, CAAA has started to look for creative ways to "twist" the new laws to their advantage. The most recent plan of attack: misapply sleep disorders and other AMA-based impairments to increase impairment ratings.

CAAA is focusing on three primary aspects of the AMA Guides (5th Edition) to increase impairment and, ultimately, disability:


  • Obstructive Sleep Apnea (Chapter 5, Respiratory System)
  • Sleep Arousal Disorders (Chapter 13, Central and Peripheral Nervous System)
  • Pain (Chapter 18)
The strategy? Dramatically increase orthopaedic impairment rated per Chapter 15 (The Spine), Chapter 16 (Upper Extremities), and Chapter 17 (Lower Extremities), by misapplying Chapters 5, 13 and 18.

You can defend against such overreaching! There are numerous defenses, and they are all found in the AMA Guides.

Medical Provider Network CAAA Fights Transfers. How Can You Fight Back?

Medical Provider Network
CAAA Fights Transfers. How Can You Fight Back?

by Sherri Dozier
 
How long does it take to create a habit? Some say twenty-one days. Others will tell you four weeks. Wait a minute. This is workers' compensation folks! One year later, and we're still not in the Medical Provider Network (MPN) habit.

Despite allegations to the contrary from CAAA, the legislative intent behind MPNs is not to conspire against injured workers. The goal, rather, is to provide the transition of an injured worker's medical treatment to an employer's MPN unless one or more exceptions are applied. Exception, according to Webster's Dictionary, means "that which is different, that which is excluded." It means it doesn't happen very often (despite CAAA's efforts to the contrary)!

So what are those narrowly defined exceptions to the transfer of medical care to your MPN?