Gino DiCaro

Court of Appeals upholds workers’ comp. chiropractic cap

By Gino DiCaro, VP, Communications

Capitol Update, June 6, 2008 Share this on FacebookTweet thisEmail this to a friend

Once again, a California court has upheld provisions of the 2004 Workers’ Compensation reforms.  The 1st District Court of Appeals’ published on Monday, June 2, their decision in Facundo-Guerrero v. Workers’ Compensation Appeals Board (WCAB).  The case challenged the constitutionality of the 24 visit cap for chiropractic treatment and occupational therapy. The court reject the challenge on the basis that the "Legislature has legal authority to enact a law limiting petitioner's right to receive chiropractic treatment."

The claimant, Jose Facundo-Guerrero, sought 76 chiropractic treatments. Nurserymen's Exchange Inc. and its insurer, Argonaut Insurance Co., denied the care based on the 24-visit cap imposed by SB 228 in 2003. Facundo-Guerrero brought his rejected claim before the WCAB, which did not rule on the matter because it felt that the question of constitutionality was out of their jurisdiction. Therefore, the 1st District Court of Appeal heard the case and the justices found that there was "nothing unconstitutional" about the cap that the legislature enacted in SB 228.

A reversal of this provision would ultimately result an in significant cost to the Workers’ Compensation System.  The caps were put in place to control the abuse of medical benefits that often do not result in getting the worker back to work sooner.  Unfortunately, this decision can still be appealed and be heard by the California Supreme Court.  The California Applicant Attorney Association (CAAA) has already expressed their dissatisfaction with the court decision and has vowed to continue fighting to change or overturn provisions of the Workers’ Comp. reforms.  Representatives from CAAA have also questioned the need for "judicial guidance" on future earning capacity and apportionment issues within the current WC system.

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