California Appellate Tracker

King v. CompPartners, Inc.

September 25, 2018

The workers' compensation system pre-empts tort claims by workers against employers’ utilization reviewers, who are empowered to modify or deny treatment requests.

Under current workers compensation law, utilization reviewers, acting on behalf of employers, determine whether the plan recommended for the treatment of an employee’s industrial injury is medically necessary after consulting a schedule of uniform treatment guidelines. If the utilization reviewer concludes that a recommended treatment is not medically necessary, he may modify or deny the treatment request. (Lab. Code, § 4610.) This decision holds that the worker’s compensation system preempts tort claims by a worker against a utilization reviewer for improper denial or modification of his treatment plan.

California Supreme Court (Kruger, J.; Liu, Cuellar & Grover, JJ., concurring); August 23, 3018; 5 Cal. 5th 1039

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King v. CompPartners, Inc.

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