The Home Health Care Burden

by Jeremiah L. Paul (March 23, 2016)

Many of us have experienced that gut-wrenching moment of receiving an out of the blue demand for reimbursement of hundreds of thousands of dollars for home health care. I was recently presented with such a demand, and as is often the case, the demand was accompanied with little to no proof or explanation. So, what is the injured worker’s burden of proof for home health care services?

As a part of SB863, the legislature enacted Labor Code Sections 4600(h), 4603.2(b)(1), and 5307.8, in an attempt to reign in out of control home health care costs. In the en banc decision of Hernandez v. Geneva Staffing, (2014) 79 CCC 682, the WCAB clarified the applicant’s new burden of proof.

As an initial matter, the WCAB confirmed that the SB863 changes apply to requests for home health care services in all cases that are not final regardless of date or injury or dates of service. Therefore, the WCAB identified two conditions which are a part of the injured worker’s burden of proof. First, the home health care services must be prescribed by a physician. Second, the employer’s liability is subject to either Section 5307.1 (which is not applicable as there is not yet an OMFS for home health care) or Section 5307.8.


by Sam S. Brar (March 23, 2016)

Labor Code (LC) 4850 provides wage loss benefits at the full rate without reduction as is the case with temporary total disability benefits for certain peace officer employees. A general overview of LC 4850 can be found by reading the companion B&B blog article “What is 4850 time” which can be found here. This article will go beyond the basic definition and workings of 4850 to discuss supplemental issues that inevitably arise given 4850’s parallel nature to TTD benefits as a wage loss replacement benefit.

104 Week Cap

The article previously linked discusses the impact payment 4850 benefits have on the 104 week TTD cap imposed by LC 4656. I will briefly discuss subsequent judicial and legislative activity with regards to what has been a dispute over whether the 104 week cap includes benefits paid under LC 4850.

Expedited Hearings: More Options Than You Think

by Sahar Jaberi (March 22, 2016)

Despite what some may contend, the requirements for requesting an Expedited Hearing are quite broad per the Labor Code.

Labor Code Section 5502 sets out specific requirements for requesting an Expedited Hearing. Of course, the claim must be accepted and the issues are generally limited to medical treatment, entitlement to temporary disability benefits, whether there is a validly established MPN, or disputes among carriers as to who should pay benefits.