The Division of Workers’ Compensation (DWC) has announced updated disability rates for 2021. As of January 1, 2021, the minimum TD rate will increase to $203.44 per week and the maximum TD rate will increase to $1,356.31 per week.

The DWC has issued a final ruling on a long-standing anti-fraud case against convicted medical provider Michael E. Barri, D.C. At issue was $18 million in medical liens filed in 944 workers’ compensation cases. Dr. Barri was suspended from participating in the workers’ compensation system on April 3, 2017 following a guilty plea to federal conspiracy charges and illegal kickbacks from patients.

On August 12, 2020, the DWC issued additional guidance regarding hearing procedures that will go into effect on August 17, 2020. Beginning August 17, 2020 our “new normal” of telephonic appearances will remain in place for Mandatory Settlement Conferences, Priority Conferences, Status Conferences, Case-in-Chief Trials, Lien Conferences, and Expedited Hearings.

The DWC has issued an updated Newsline regarding the policies and procedures before the WCAB due to the ongoing COVID-19 pandemic. The existing policies and procedures from the earlier April 3 and April 28 DWC’s Newslines have been extended. Some minor changes regarding lien hearings, as detailed below, will go into effect on June 8, 2020.

Please note that the filing procedures based on the DWC Newsline seem contradictory. At this time, our understanding is that filings must still be done via e-filing or by mail. The Board will not accept any in-person filings. This is consistent with the previous guidance issued on March 16, 2020, and remains our understanding until further clarification is issued by the board.

The Division of Workers’ Compensation (DWC) has issued an important update regarding the modified hearing calendar and filing procedures. This is effective as of April 6, 2020 but may be changed as circumstances dictate.

Pursuant to DWC Newsline Dates March 19, 2020, Guidance on Medical Evaluations

When a case is settled by Compromise and Release for $25,000 or more with an applicant that is on Medicare, or is expected to be on Medicare within 30 months, the best practice is to obtain a Medicare Set-Aside agreement to prove that it is not the intent of the parties to shift liability to Medicare for future medical treatment.

On September 5, 2019, the Sixth Appellate District issued an Opinion affirming the Workers’ Compensation Appeals Board’s determination to disallow TTD benefits for lost time from work for medical treatment after return to work.  On September 16, 2019 the opinion was certified for publication, making this a citable case. Renee Skelton v. Workers’ Comp. Appeals Bd. (citation not yet available.)

In 2020 the California State Average Weekly Wage (SAWW) will increase from $1,276.00 to $1,325.00 which equals an increase of 3.84013% for temporary total disability (TTD), permanent total disability (PTD) and other workers’ compensation benefits that are tied to SAWW increases.  The SAWW is defined as the average weekly wage paid to employees covered by unemployment insurance as reported by the U.S. Department of Labor for California for the 12 months ending March 31 in the year preceding the injury.

On May 16, 2019, we issued a GMK Alert with regard to the En Banc decision in the matter of Wilson v. State Cal Fire, 2019 Cal. Wrk. Comp. LEXIS 29 determining the meaning of catastrophic injuries per Labor Code Section 4660.1(c)(2)(B).

On January 4, 2019 the Centers for Medicare & Medicaid Services (CMS) issued the newest version (2.9) of the Workers’ Compensation Medicare Set Aside Arrangement (WCMSA) Reference Guide.

On September 26, 2018, California Insurance Commissioner Dave Jones announced that California will recognize a new adjuster certification system known as the Universal Claim Certification (UCC). The UCC is also recognized by Florida, Texas, Georgia, Alabama, and Missouri. It was created by the Claims and Litigation Management Alliance (CLM) with the goal of becoming a federally recognized program, in order to eliminate the process and expense of obtaining a separate license to work in each state.

In 2019 the California State Average Weekly Wage (SAWW) will increase 2.971% for temporary total disability (TTD), permanent total disability (PTD) and other workers’ compensation benefits that are tied to SAWW increases. The SAWW is defined as the average weekly wage paid to employees covered by unemployment insurance as reported by the U.S. Department of Labor for California for the 12 months ending March 31 in the year preceding the injury.