Table of Contents

Executive Summary:

I. Background

A. Data and Methodology

B. Expectations of report quality, frequency and cost

II. Distribution of reports by nature of reporting physician

Chart 1: Distribution of reporting physician

Chart 2: Portion of primary treating physicians that were also QMEs

III. Report quality

Chart 3: History, Present condition, Physical examination findings

Chart 4: Diagnosis, Causation, and P&S status

Chart 5: Work restrictions, Objective findings, Subjective complaints

Chart 6: Apportionment, Future medical

Chart 7: Ratability of reports

Education and Notification of Primary Treating Physicians

III. The impact of presumption on the frequency and cost of reports

Chart 8: Mean number of reports/claim: Total and by requesting party

Chart 9: Percent of claims with reports requested by only one party

Chart 10: Percent of claims with reports requested by both parties

Chart 11: Percent of claims with report by applicant and/or defense

Chart 12: Percent of claims with no reports at 28 months after beginning of accident year

Chart 13: Percent of claims with no reports by quarter of injury —Valued at 16 months after date of injury

IV. Litigation and Presumption

Attachment 1

Attachment 2

Report on Quality of Treating Physician Reports and Cost-Benefit of Presumption in Favor of the Treating Physician

Prepared for the Commission on Health and Safety

and Workers’ Compensation

Frank Neuhauser, Survey Research Center

University of California at Berkeley

Executive Summary:

The 1993 reforms made a number of significant changes to the medical-legal reporting process. These changes included requiring that the primary treating physician (PTP) or the physician’s designee "render opinions on all medical issues necessary to determine eligibility for compensation" (LC 4061.5). When additional medical reports are obtained for assessment of permanent disability, permanent and stationary status, medical eligibility for vocational rehabilitation, medical treatment, and the existence of new and further disability, the findings of the treating physician are presumed to be correct (LC 4062.9). These legislative changes had the effect of reintroducing the importance of the treating physician that had been curtailed by the 1989 reforms and adding the additional authority of rebuttable presumption.

Numerous parties have challenged the value of the change in the treating physician role and particularly the presumption given to the reports. These complaints generally involve 1) a perception of the low quality of the treating physicians’ reports and 2) the problem of poor quality reports being given special authority. Many observers feel that presumption has led to problems with "doctor shopping" by the party with medical control and increased litigation.

However, quality is only one consideration. The legislation in part meant to reduce the frequency of medical reports by reducing the incentive of any party to request a report from a second (or third) forensic physician. Since the original report by the treating physician is presumed correct, it is less likely that a second report will prevail in a dispute and hence less likely that one will be requested.

The Commission on Health and Safety and Workers’ Compensation undertook an effort to evaluate the quality of treating physician reports and the cost-benefit of the PTP presumption under 4062.9. The preliminary results of this effort find:

In short, changes to the status of the PTP made during the 1993 reforms have resulted in medical-legal decisions based on poorer quality reports without any apparent cost savings. In addition, there is consensus within the WCQB that presumption has increased litigation and curtailed the discretion of Workers’ Compensation Judges to craft reasonable decisions within the range of evidence.

In view of these findings the preliminary recommendation is to curtail the presumption given to the findings of the primary treating physician. This could involve elimination of the special authority given to the PTP or at least the use of some lower legal standard granting the reports "great weight" but not presumption.

In response to several comments on the draft of this report it should be noted that the Commission did not find reason to nor does it recommend reducing the role of the PTP in case management and reporting under Labor Code 4061.5

These findings include several important caveats. First, the sample includes only approximately four hundred reports drawn from four WCAB offices. Second, the reports were drawn from claims with dates of injury in 1994 and 1995 on which the claim closed before the end of 1997. The quality of PTP reports may have improved as physicians became more knowledgeable about the requirements for reporting. Third, the data on the cost and frequency of medical-legal reports are for insured employers only and cover dates of injury through 1995 and medical legal reports submitted prior to the second quarter of 1998. Again, conditions could have changed in subsequent injury years and reporting periods. Finally, the quality of reports discussed here refers to completeness and ratability as measured by standards set for QME reports. A report could be less complete or less clear but in actual application these problems may be outweighed by other benefits. For example, the opinion may still be more informed, resulting in a more accurate or less biased rating.

 

I. Background

A. Data and Methodology

The data for this report are derived from two sources. Approximately four hundred randomly selected files were drawn from four WCAB offices (Fresno, Oakland, Los Angeles, and San Francisco). The files were randomly selected by computer from all claims filed with the WCAB, with dates of injury in 1994 and 1995, and that closed prior to November of 1997. Some files and reports were subsequently deleted from the study because the file contained no medical-legal reports or the issue in dispute was not covered under Labor Codes 4061 or 4062.

For each file, all medical-legal reports were selected and coded according to physician status (treating physician, QME from a panel, AME, and applicant or defense QME). In addition, the qualification of the treating physician as a QME was checked against a database of QMEs supplied by the IMC and covering the period under study. As a result, the physician category ‘PTP’ could be further divided according to whether or not a doctor was also concurrently registered with the IMC as a QME.

The Disability Evaluation Unit (DEU) evaluated each report against a subset of the criteria used by the Industrial Medical Council (IMC) for evaluation of QME reports and additional criteria. These criteria were selected in consultation with several raters, the manager of the DEU, and the IMC. The criteria selected are included in Appendix 1.

Data for estimating cost and frequency of medical-legal evaluations were obtained from the Workers’ Compensation Insurance Rating Bureau (WCIRB). The Rating Bureau conducts an annual survey of permanent disability claims. This survey includes data on each medical-legal report for each claim in the survey sample. The data cover the cost, date of service, and the party requesting the evaluation.

Data from the survey are available on approximately 3,000-3,500 claims for each calendar year starting in 1989 and currently available through injury year 1995. As claims mature the average number of reports per claim increases. Because the 1995 injury claim data was only available through April 1998, all survey data were standardized with evaluation at 28 months after the beginning of the calendar year in which the injury occurred.

B. Expectations of report quality, frequency and cost

The 1993 reforms reintroduced the role of the primary treating physician requiring that the physician address the permanent and stationary status of the injured worker, level of permanent impairment, eligibility for vocational rehabilitation, and the need for future medical treatment. The reforms also made the findings of the PTP presumptively correct when an additional report was obtained covering these issues.

This presents a threshold requirement against which any party must assess the value of obtaining an additional report. To be of value, an additional report must be expected to result in findings that will improve the requesting party’s case AND must also be expected to rebut the presumption offered to the findings of the PTP. The expectation was that this would reduce the number of reports requested especially by defense. The defense faces the direct and indirect costs of obtaining a second report. The applicant side faces the indirect costs and under some circumstances the direct cost.

A decline in reports will be reflected in two measures. First, with fewer reports requested, the average number of reports per claim will decline. In addition, the expectation is that the number of claims with no reports paid under the medical-legal fee schedule will increase. However, once one side in a represented case opts for a medical-legal report, the threshold faced by the other side is lowered. When both sides obtain medical-legal reports, the PTP report no longer controls.

After the reintroduction of the treating physician role, numerous observers commented on the perceived lack of quality of these reports. The contention was that PTPs were generally unqualified (and some said unwilling) to determine medical-legal issues formerly determined by forensic physicians. However, this contention ignored the possibility that many treating physicians were likely to be capable, even highly qualified, to make these determinations. Many treating physicians, particularly those operating in industrial medicine clinics or similar operations, were likely to also be Qualified Medical Evaluators.

In addition, while the quality of these reports was called into question by most observers, the IMC had also found numerous problems with reports submitted by QMEs. Consequently, the quality of these reports was judged not against a standard (which is appropriate for the IMC’s evaluation of QME reports) but rather against the quality of reports submitted by doctors other than the PTPs. Moreover, the most appropriate comparison is to evaluate the PTP reports against those reports written by Panel QMEs in unrepresented cases and applicant and defense QMEs in represented cases. The expectation was that AME reports would be of high quality.

II. Distribution of reports by nature of reporting physician

The data on the distribution of the reporting physician is drawn from the files sampled from the WCAB. Again, these data are from a sample of limited size and of claims with injury dates in 1994 and 1995 that closed by late 1997. Therefore, the distribution of applicant and defense reports is likely to underestimate the true frequency of these reports. This is likely to be the case if represented claims, at least those with competing medical-legal reports, are less likely to close within the first 18-30 months after injury. A number of claims, as expected, include more than one report (for example, a treating physician report and a Panel QME, a treating physician report and a applicant or defense QME, or an applicant and defense report).

Chart 1: Distribution of reporting physician

As shown in Chart 1, 39% of reports were by treating physicians (63% of claims included a PTP report). 25% of reports were applicant or defense QME reports (41% of claims). 24% of reports were by Agreed Medical Evaluators (39% of claims) and 13% were QMEs drawn from a panel by an unrepresented worker.

Of more importance to this discussion is the following chart showing the portion of primary treating physicians who were also QMEs at the time that they submitted the PTP report. In this sample, nearly 60% of PTPs were also qualified medical evaluators registered by the IMC.

 

 

Chart 2: Portion of primary treating physicians that were also QMEs

This distribution is of considerable importance for evaluating the quality of PTP reports. First, the higher the proportion of PTP reports written by physicians who were also QMEs the higher the expectations for the quality of these reports relative to reports by doctors acting as QMEs. The proportion of QMEs among reporting PTPs is high, but consistent with expectations that medical treatment of serious occupational injuries is concentrated among a subset of physicians experienced with occupational injuries. One-third of these claims did not include a PTP report either because an AME was selected or applicant and defense both selected QMEs. Among these claims, it is possible that the portion of treating physicians who are QMEs was lower.

 

III. Report quality

If the quality of PTP reports is lower than that of other forensic reports, this may be the result of factors other than the ability and knowledge of the reporting physician. PTP reports are often paid under the medical fee schedule, and when paid under the medical-legal fee schedule, are paid at a discount to other forensic reports. In addition, these reports were issued in the course of treatment, and consequently may consistently overlook issues that were addressed in previous reports issued earlier in treatment. For example, the history of the injury is part of a complete medical-legal report. However, the treating physician may overlook this when issuing a report, assuming that it was sufficient to cover the history in earlier reports.

The existence of PTPs who are also QMEs offered this evaluation an opportunity to assess the issue of the knowledge and training of the PTP separate from the possible impact of reporting on forensic issues in the course of treatment. If the quality of reports was affected solely by the treating environment, the reports by QME and non-QME PTPs would show similar quality characteristics. Consequently the following charts break out treating physicians separately according to their status as QMEs.

The following several charts exhibit the findings on the quality of reports by each physician type. The data shown cover the main criteria assessed in the evaluation. For each criterion, the measure is whether the information was reported in a manner considered acceptable for rating and settling indemnity and future medical issues. For each report, each criterion was rated acceptable or not acceptable. Therefore, a mark of 50% means that half of the reports by that physician type failed to adequately report on the issue. A mark of 85% means 15% or reports were inadequate on the issue.

Chart 3: History, Present condition, Physical examination findings

Chart 4: Diagnosis, Causation, and P&S status

Charts 3 and 4 indicate that the quality of reports by treating physicians on five of these six issues was lower than those by other types of reporting doctors. For four of the six issues (not including diagnosis and P&S status) the differences were substantial. In general, the report quality of PTPs exhibits only limited differences depending upon whether the PTP was a QME or not. This suggests that across this range of issues, much of the problem may be in the nature of the reporting process rather than the knowledge of the reporting physician. This is consistent with these criteria (other than P&S status) which are likely to have been reported on earlier in the treatment process. However, the reports are of consistently lower quality and the non-QME PTPs are consistently inferior to all other groups.

Charts 5 and 6 indicate problems with the quality of PTP reports that likely arises out of insufficient knowledge or preparation. On these five critical issues, the poor quality of PTP reports is driven almost completely by the quality of reports by non-QME PTPs. These issues are central to the P&S report and less likely to have been the subject of earlier reports. Consistent with this, the data show little distinction between the quality of reports by PTPs who are QMEs and other QMEs reporting in the role of forensic physician. However, reports by non-QME PTPs were inadequate on four out of five of these issues a significantly greater portion of the time.

Chart 5: Work restrictions, Objective findings, Subjective complaints

Chart 6: Apportionment, Future medical

The issue of report quality is often summed up by whether a report is "unratable." In practice, this is a poor measure. At least in current practice, reports, even when of poor quality, are rated for purposes of determining issues of permanent disability. The practice of the DEU is to rate reports, even poor quality reports, and qualify the rating with comments. Consequently, for purposes of this study, the DEU was asked to evaluate the reports against three standards. Was a report ratable without qualification? Was it ratable but the rating would have been qualified? Or was a report unratable?

The results of this portion of the evaluation are exhibited in chart 7. Across all reports, approximately 40% were considered subject to qualification or unratable, with AME reports exhibiting substantially higher quality. Consistent with the earlier charts showing problems with the quality of treating physician reports, the PTP reports were of significantly lower quality. Again, this problem was driven entirely by the ratability of reports by PTPs who were not QMEs. The quality of reports by QMEs acting as PTPs was indistinguishable from other types of reporting physicians on this criterion.

Chart 7: Ratability of reports

 

 

 

 

 

 

 

In summary, the quality of treating physician reports is consistently below reports by physicians acting in a forensic role. For some of these problems, the prescription is likely to involve informing treating physicians of the need to report on issues in the P&S report even if these issues were covered in earlier reports. However, for a range of issues the problem appears to involve a lack of understanding or training on these important areas. This suggests a more complicated and costly education process would be necessary to bring non-QME PTPs up to the level of forensic doctors.

Education and Notification of Primary Treating Physicians

The Industrial Medical Council has actively sought to educate treating physicians on the requirements of medical-legal reporting. However, these efforts may have trouble resolving the problems exhibited in the above data. None of the PTPs who were not QMEs had more than a single report in the sample. Many of the QMEs reported on multiple claims (up to six) within the sample. This was a small sample and QMEs could act as PTPs and forensic doctors. But the implication is that individual PTPs who are not QMEs report only infrequently on serious occupational injuries. Educational effort will be less successful to the extent that the target audience is large (all PTPs) and marginally interested (write few reports).

These data do make it clear that the reporting by PTP is affected by their role as PTP and just by their knowledge and qualification as forensic specialist. For these issues (charts 3 and 4) notification of the PTP about reporting requirements near the time the worker is expected to reach P&S status is likely to improve the reporting substantially.

 

III. The impact of presumption on the frequency and cost of reports

In view of the apparent poor quality of many PTP reports, a second issue is important: Are the savings from the special role afforded the PTP in the 1993 reform legislation sufficient to balance the problems described above?

As noted earlier, the requirement that the primary treating physician report on the several issues covered in LC 4061 and LC 4062 coupled with the presumption afforded the PTP that these findings are correct was expected to reduce the frequency of medical-legal reports and consequently the total cost of these reports. Early data on post-reform claims showed promising trends in the frequency of claims with no medical legal reports and reductions in the average number of reports per claim and costs per report.

However, more mature data and larger samples available on the two most recent PD Surveys conducted by the WCIRB put in considerable doubt the early conclusions about the impact of the changes in the treating physician status on frequency and costs. The trends in cost per report appear to be driven almost entirely by the changes in the medical-legal fee schedule. At the same time, the trends in the frequency of reports preceded the reforms by at least a year, suggesting the cause of the improvement was driven by forces other than the 1993 reforms.

Chart 8: Mean number of reports/claim: Total and by requesting party

Chart 8 shows the average number of medical-legal reports per PD claim for insured employers. These data are for claims valued at 28 months after the beginning of the accident year (e.g., April 1997 for claims occurring in 1994). While 1994 and 1995 have lower average claim frequency than earlier years, this appears to be a continuation of a trend that preceded the 1993 reforms by several years.

 

 

Chart 9: Percent of claims with reports requested by only one party

 

Chart 10: Percent of claims with reports requested by both parties

Charts 9 and 10 indicate that while there has been little change over the time of the years covered by the survey (1989-95) in the portion of claims with only one party requesting a report, either applicant or defense, the decline in the average number of reports is being driven in major part by the decline in claims where both parties requested reports. In addition, Chart 10 demonstrates that this trend away from the ‘dueling docs’ began in the early 90’s and was little affected by the 1993 reforms. Chart 11 shows the same trend for data on the percent of claims with a report requested by each party, whether or a report was request by another party or an AME report was involved on the claim.

Chart 11: Percent of claims with report by applicant and/or defense

Finally, these data were used to evaluate the mostly likely area where the impact of presumption would appear. That area is consistent with the expectation that the number of claims with no reports requested would increase substantially. If the threshold presented by presumption in favor of the PTP reduced parties’ willingness to obtain additional medical-legal report, this should be apparent through an increase in claims with no reports. However, Chart 12 shows that the trend in claims with no reports began in 1992 and leveled off in 1994, even though PTP presumption applied only to claims with dates of injury in 1994 or later.

Chart 13 offers a more detailed look at this trend. Since chart 12 shows a higher level of no-report claims in 1994 and 1995 than in 1993, the data were broken down by quarter of injury. If the difference in the portion of no-report claims between 1993 and 1994/95 was the result of the reform the rather than an underlying trend in the system, we would expect a jump in the graph between 1993 and 1994. If the cause was an underlying trend independent of the reforms we would expect the 1993 injury year to exhibit a trend starting out low in the first quarter and increasing through the fourth quarter to a point similar to 1994 data. The latter effect is what we observe in these data, suggesting that the presumption given to the treating physician had little apparent effect on the frequency and consequently the total cost of medical-legal reports.

Chart 12: Percent of claims with no reports at 28 months after beginning of accident year

Chart 13: Percent of claims with no reports by quarter of injury —Valued at 16 months after date of injury

 

The data from the WCIRB PD Claims Survey give no indication that the increased role of the treating physician, particular the presumption granted to the findings of the PTP, has reduced the cost of medical-legal reports. Given that the PTP reports appear to be of poorer quality than those of forensic doctors, the preliminary findings suggest that the presumption granted the treating physician should be discontinued.

 

IV. Litigation and Presumption

The Commission on Health and Safety and Workers’ Compensation recently participated in a series of meetings for Workers Compensation Judges (WCJs). A portion of each of these meetings involve a discussion of litigation surrounding the issue of presumption. The WCJs raised a number of concerns about the impact of presumption on the litigation process. They indicated that presumption had increased the level of litigation within the system for two reasons. First, there was substantial litigation over presumption, for example who was the PTP, attempts to rebut presumption, and the scope of presumption. Attachment 2 includes a summary of major cases brought before the Appeals Board dealing with the issue of presumption.

Second, the judges felt that litigation was increased because the party without presumption felt required to litigate over numerous other issues as its only recourse for being able to motivate a compromise agreement with the party that controlled presumption. Finally, the WCJs were concerned that the impact of presumption was to limit the range of judicial discretion when crafting decisions based on the range of medical evidence.

For these reasons, the judges were nearly unanimous in their opposition to the retaining the current standard as defined in 4062.9. Comments on the earlier draft of this report included two recommendations that appear to be consistent with the comments of WCJs at these sessions. One comment recommended language similar to that found in Amos v. Director, Office of Workers’ Compensation, US Court of Appeals, Ninth District, No. 96-70988.

In this case (under Longshore and Harbor Workers’ Compensation Act) the court found

"Where an injured employee seeks benefits under the LHWCA, a treating physician’s opinion is entitled to special weight. As we have explained in the context of Social Security cases, "we afford greater weight to a treating physician’s opinion because ‘he is employed to cure and has a greater opportunity to know and observe the patient as an individual.’" [Magallanes v. Bowen quoting Sprague v. Bowen] The same logic applies in cases involving industrial injuries.

Another comment on the draft offered the following wording.

"[T]he opinion of the treating doctor is entitled to great weight, giving consideration to the doctor’s treatment, the opportunities the doctor has had to observe and evaluate the patient, and the accuracy and consistency of the history of injury and of the residual disability deriving therefrom."

Either of these or some similar standard for treating physician reports may be preferable to the current wording of LC 4062.9 in the absence of evidence that the presumption accorded treating physician is accomplishing important public policy objectives.

 

 

Attachment 1

 

MEDICAL LEGAL REPORT REVIEW

TIER ONE

 

PRESENT?

NOT

YES NO SURE

____ ____ ____ 1. Summary Form included

____ ____ ____ 8. History of the injury

____ ____ ____ 9. Present Complaints

____ ____ ____ 11. Physical examination findings

____ ____ ____ 14. Diagnosis

____ ____ ____ 15. Permanent and stationary

____ ____ ____ 16. Objective, subjective factors

____ ____ ____ 17. Work limitations (if needed)

____ ____ ____ 18. Cause of the disability (work causes/work contributed)

____ ____ ____ 19. Treatment indicated

____ ____ ____ 26. Signature of physician

 

Report Number __ __ __

Treating Phys.___

AME ___

Appl./Def QME ____

Panel QME___

Unknown ____

Date of Review ______ Reviewer_______

 

MEDICAL LEGAL REPORT REVIEW

TIER TWO

ACCEPTABLE ?

YES NO NA

___ ___ ___ 27. HISTORY (if not acceptable, check what is missing)

___History of injury ___Present complaints ___Past history

___ ___ ___ 28. PHYSICAL EXAMINATION

Information is adequate and is consistent with Packard Thurber/Guidelines

___ ___ ___ 29. PERMANENT AND STATIONARY

P and S determination is made. In general, the physician should give a permanent rating for someone who is P & S only. One exception to this rule: IW who has a progressive disease. In this case a tentative rating can be given. The physician may speculate that the IW will be 100% disabled in the future or can state that the IW needs to be examined again in the future. Another exemption is when the IW refuses treatment.

___ ___ ___ 30. OBJECTIVE FACTORS

Comparative measurements or percent loss of active motion is noted as required in Packard Thurber/Guidelines.

___ ___ ___ 31. SUBJECTIVE FACTORS (If no, check areas of inadequacy)

Should specify degree and frequency/use the words of art correctly.

___ Frequency __ Severity

___ words of art used incorrectly

___ ___ ___ 32. WORK RESTRICTIONS

Report contains work restriction which are consistent with the rest of the report and with the loss of pre-injury capacity. Work restrictions should apply to open job market, not for the present job or Report does not confuse the need for work restrictions with the need for vocational rehabilitation.

___ Work restrictions given in pounds and prior ability in pounds given

If ‘No’ check areas of inadequacy:

___WC guidelines used incorrectly

___Work restrictions do not consider open labor market

___Work restrictions given in pounds and prior ability in pounds not given

___Work restriction(s) inconsistent with voc rehab limitations

___Other

Present?

___ ___ 33. REASONS FOR OPINIONS ON DISABILITY STATUS

Yes No Report must contain explanations or listing of reasons supporting the conclusions/opinions as to the level of the disability.

 

___ ___ 35. APPORTIONMENT

Yes No Report has physician’s opinion or apportionment, if applicable. Apportioned to disability not to impairment or for causation. Must have valid reasons for apportionment. Report can mention normal progress of underlying disease.

___ ___ __ 38. RATABLE WITHOUT QUALIFICATIONS

Yes No NA The rater was able to rate the report and was not compelled to qualify the rating due to inconsistent or incomplete data.

Report Number __ __ __ Reviewer__________________ Date___________

 

 

<Attachment 2

TABLE OF CASES

TREATING PHYSICIAN PRESUMPTION, LABOR CODE 4062.9

This list of cases was prepared by:

Raymond F. Correio

Workers’ Compensation Law Judge

WCAB,

2701 Ocean Park Blvd. #220

Santa Monica, CA 90405-5200

Judge Correio has prepared summaries of these cases as part of numerous presentations before groups involved in workers’ compensation litigation and training sessions for other judges. The Commission appreciates Judge Correio’s offer to include this information in the current report.

 

Aleong v. Golden Eagle Ins. Co. (1998) 26 CWCR 134 (June, 1998)

Alisal Guest Ranch v. WCAB (Cooper) (1997) 62 CCC 1686 (writ denied)

Artichoke Industries, Inc., v. W.C.A.B. (Regalado) (1998) 63 CCC 799 (writ denied)

Ayala v. WCAB (1998) 63 CCC 427 (writ denied)

Bardigan v. WCAB (1998) 63 CCC 1053 (writ denied)

Barron v. State Comp. Ins. Fund (1997) 25 CWCR 86

Bauske v. WCAB (1998) 63 CCC 182 (writ denied)

Boyd v. WCAB (Warner Bros.) (1997) 62 CCC 498 (writ denied)

Bud of California v. WCAB (Diaz) (1997) 62 CCC 1262 (writ denied)

California Comp. Ins. Co. v. WCAB (Gale) (1997) 62 CCC 961 (writ denied)

California Pacific Medical Center v. WCAB (Alderson) (1997) 62 CCC 1188 (review denied)

Carr v. WCAB (1997) 62 CCC 1440 (writ denied)

Centinela Hospital Medical Ctr. v. WCAB (Buffington) (1998) 63 CCC 434 (writ denied)

City of Riverside v. WCAB (Dahlquist) (1998) 63 CCC 1107 (writ denied)

Claremont Unified School Dist. v. WCAB (Flaherty) (1997) 63 CCC 66 (writ denied)

Clark v. WCAB (Northrop Grumman Corp.) (1998) 63 CCC 1317 (writ denied)

Craftmaster v. WCAB (Morales) (1998) 63 CCC 1070 (writ denied)

Czarnecki v. Golden Eagle Insurance Co. (1998) 63 CCC 742 (Significant Panel Decision)

Eastman Kodak Co. v. WCAB (Brinson) (1997) 62 CCC 1591 (writ denied)

Employers First Insurance Co. v. WCAB (Morales) (1997) 62 CCC 1710 (writ denied)

Farmers Brothers v. WCAB (Archuleta) (1997) 62 CCC 1282 (writ denied)

Fernandez v. WCAB (1994) 64 CCC 440 (writ denied)

Fleming v. W.C.A.B. (Universal Studios, Inc.) (1998) 63 CCC 762 (writ denied)

Friendly Hills Medical Group v. W.C.A.B. (Zubiate) (1998) 64 CCC 138 (writ denied)

Friedman v. W.C.A.B. (1994) 64 CCC 242 (writ denied)

Gillette v. Culver-Newlin. Inc. (1998) (Administrative Director Decision; Order Denying Change of Physician) 26 CWCR 50 (March 1998)

Gipson v. WCAB (1996) 61 CCC 1247 (Presumption rebutted due to inaccurate history.)

Griebel v. W.C.A.B. (1999) 64 CCC 255 (writ denied)

Guzman v. Employers Ins. of Wausau (1997) 25 CWCR 31

Hoag Memorial Hospital Presbyterian v. WCAB (Giannini) (1997) 62 CCC 1720 (writ denied)

Hunt-Wesson Foods v. WCAB (Ortiz) (1997) 63 CCC 85 (writ denied)

Ingram Micro v. W.C.A.B. (1998) 64 CCC 100 (writ denied)

Kagome Foods, Inc. v. WCAB (Saldana) (1999) 64 CCC 451 (writ denied)

Keulen v. WCAB (1998) 78 Cal. Rptr. 2d 500

King v. WCAB (1997) 63 CCC 123 (writ denied)

Larkin v. Los Angeles Unified School Dist. (1998) 26 CWCR 268 (October, 1998) (Administrative Director Order Denying Change of Treating Physician)

Lippincott v. WCAB (1997) 62 CCC 1301 (writ denied)

Lopez v. Employers First Ins. Co. (1998) 26 CWCR 261 (October, 1998) (Order Denying Reconsideration)

Manaquit v. Hotel Del Coronado (1997) 25 CWCR 49

Manning v. WCAB (1998) 63 CCC 1292 (writ denied)

Minniear v. Mt. San Antonio College (1996) 61 CCC 1055 (en banc) (writ denied; review denied)

Morningstar/Avoset Foods Corp. v. CAB (Toste) (1998) 63 CCC 464 (writ denied) (Also finding of no reasonable basis for petition.)

National Union Fire Insurance Co. V. WCAB (Velasco) (1999) 64 CCC 467 (writ denied)

Norrell Temporary Services v. WCAB (Ortiz) (1998) 63 CCC 206 (writ denied)

Paredes v. Pacific Employers Ins. Co. (1997) 25 CWCR 183 (7/97)

(1997) 25 CWCR 183 (7/97)

Paula Insurance Co. V. WCAB (Camacho) (1998) 63 CCC 1298 (writ denied/No reasonable basis for Petition)

Rajo v. Santa Barbara Cottage Hospital (1998) 27 CWCR 17 (2/99) (Decision After Reconsideration)

Reliance Insurance Co. v. WCAB (Smith) (1998) 63 CCC 477 (writ denied)

Robinson's/May v. WCAB (Keshawarz) (1998) 63 CCC 686 (writ denied)

San Diego Unified School District v. WCAB (Cooper) (1998) 63 CCC 1093 (writ denied)

Santillan v. Nothing But Girls (1999) (Administrative Director Decision (27 CWCR 87 (4/99))

Saragosa v. WCAB (1997) 62 CCC 750

Social Vocational Services v. WCAB (Adegunleye) (1997) 62 CCC 1626 (writ denied)

Southwest Airlines v. W.C.A.B. (1999) 64 CCC 280 (writ denied)

Speaks v. MidCal Aluminum, Inc. (1998) 26 CWCR 169 (July 1998) (Order Granting Reconsideration and Decision After Reconsideration)

Spectrum Office Systems v. WCAB (Jackson) (1998) 63 CCC 1116 (Writ denied; no reasonable basis for petition.)

Teledyne Ryan Aeronautical (HCM Claims Mgt.) v. WCAB (Ausem) (1997) 62 CCC 832 (writ denied)

Thrifty/Payless v. WCAB (Hardy) (1997) 62 CCC 1178 (writ denied)

Uboldi v. WCAB (Mad River Community Hospital) (1998) 63 CCC 1328 (writ denied)

Union Bank v. WCAB (Lloyd) (1997) 62 CCC 1609 (writ denied)

Universal Studios, Inc. v. W.C.A.B. (Fleming) (1998) 63 CCC 793 (writ denied)

Vidal v. WCAB (1997) 62 CCC 723, 724

VNO 025XYZZX v. WCAB (Promotional District Services.) (1998) 63 CCC 1202 (writ denied)

Wal-Mart v. WCAB (Ortiz) (1998) 63 CCC 1119 (writ denied)

Winters v. WCAB (1998) 63 CCC 1101 (writ denied)

Wooten v. WCAB (1998) 63 CCC 689 (writ denied)

99 Cents Only Store, Inc. v. WCAB (Hodges) (1997) 62 CCC 1580 (writ denied)