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Friday, October 31, 2014

JOSÉ DUBON: The Human Face Behind WCAB Decision

Brett Gowen
Today's post by Brett Gowen of the California Bar is shared from

Imagine if this was you or your spouse. The California Legislature passed SB 863 and the recent Dubon case has taken the Workers’ Compensation courts out of deciding medical issues. This has effectively denied crucial medical care for thousands if not hundreds of thousands of California citizens. If the Insurance company denies a treatment and does not follow the law, you will likely not get your day in court to challenge the violations. Read the full story from C.A.A.A below:

California Applicants’ Attorneys Association (CAAA): JOSÉ DUBON: The Human Face Behind WCAB Decision; Consequences of Insurers Gaming UR System, Withholding Medical Records

The California Applicants’ Attorneys Association (CAAA), whose members represent Californians injured on the job, today released a UR DENIED story on José Dubon, the injured laborer whose case has resulted in three different Workers’ Compensation Appeals Board decisions, addressing what insurers are required to provide to Utilization Review (UR) to make the UR valid. Insurance carriers’ Utilization Review (UR) denies one in five physicians’ requests for medical treatment – up to 3,500,000 per year. The Dubon v. World Restoration case is an excellent example of the widespread failure of claims administrators to provide adequate medical records to the UR reviewer. “José Dubon’s case has produced a WCAB...

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