Thursday, May 15, 2014

Cycling In The Wind

The full moon coincided with huge high pressure over the west to create a spectacular moonset on my bicycle ride yesterday morning.

A full moon means wildly swinging tides, and in this case, the spectacle accompanied days long Santa Ana conditions which meant the morning was abnormally warm, and calm - before the winds out of the north east picked up.

I got on the bicycle a bit earlier than usual that morning because I knew the winds would eventually fill in to the beach.

Santa Anas are a katabatic wind—katabatic meaning "to flow downhill" in Greek. The National Weather Service defines Santa Ana winds as "Strong down slope winds that blow through the mountain passes in southern California. These winds, which can easily exceed 40 miles per hour (18 m/s), are warm and dry and can severely exacerbate brush or forest fires, especially under drought conditions."

If you have been watching any news whatsoever you know that the north San Diego County area was particularly hard hit with fires provoked by the wind.

Surface winds are highly influenced by geography. In the normally cooler months, the Southern California deserts are cool. The high pressure pushes the air from the desert areas out towards the coast, channeled down the valleys and canyons and through the major mountain passes.

As the wind descends, the air not only becomes drier, but also warms adiabatically by compression.

Consequently, the Southern California coastal region gets some of its hottest weather of the year during autumn while Santa Ana winds are blowing. During Santa Ana conditions it is typically hotter along the coast than in the deserts.

Moonset in Ventura, 5/14/14 before the wind.
I can testify first hand that this is true. The Oxnard Plain in Ventura County always seems to be the epicenter of Santa Ana wind events.

Because of the geography of the region, the winds seem to occur suddenly - from zero to thirty miles an hour out of nowhere, and because the wind encounters many geographic features as it travels to the coast it tumbles, creating significant turbulence (what we on the ground refer to as "gusty" wind).

Riding a bicycle in thirty mile an hour wind (gusting to forty) is no fun. I'd rather just ride uphill. The gusty nature of Santa Ana winds makes bike handling much more difficult and sometimes dangerous when going downhill.

Because the winds gust so dramatically it is also much more fatiguing to ride in these conditions. But if you plot the right course you may be lucky enough to have a tail wind home - and the winds can get you consistently moving over 30 miles per hour on flat ground with very little effort.

California workers' compensation is like riding a bicycle in Santa Ana winds.

So I guess it was fitting that I was part of a panel speaking to a packed house of members of the Ventura County Employer Advisory Council about workers' compensation.

The attendees were truly engaged and wanted to understand why the system does what it does and how that affects what they pay for insurance.

Part of my opinionated pitch was, as you might guess, that workers' compensation has become much more about procedure than the substantive job of delivering benefits.

Procedure is wielded by both the applicant and the defense sides depending on perceived advantages. It goes both ways.

So it was serendipitous I suppose that a panel opinion by the Workers' Compensation Appeals Board last month said that a defensible position for defendants is that requests for treatment must follow specific form protocol, otherwise it can be denied. The request doesn't actually need to be on a specified form but it must be made in writing, and clearly state "Request for Authorization" at the top of the first page of the document.

The first page must also list all the requested medical services, goods or items and the request must be accompanied by documentation substantiating the medical necessity for the requested treatment, according to the Division of Workers' Compensation.

In Torres-Ramos v. Marquez, No. ADJ982471, the applicant had suffered a compensable industrial injury in May 2005 and his treating doctor sent him for a consultation with a pain management specialist in June 2013 (over eight years later!). The specialist then requested authorization to provide percutaneous peripheral nerve stimulation to Torres-Ramos while weaning him off his narcotic medication.

The specialist did not make this request on the required, specific DWC Form, but rather, mentioned it in his report to Redwood Free Insurance Co. and Berkshire Hathaway on Sept. 23. Berkshire Hathaway denied authorization by letter dated Sept. 29 and sought invocation of the Utilization Review process.

At issue before the Workers' Compensation Judge was whether there was a proper request for authorization for treatment and a timely denial. The WCJ essentially said no to the first, so the second was moot.

Torres-Ramos petitioned for reconsideration of the WCJ's decision, and the defendants sought removal of his referral of the dispute to IMR.

Explaining his ruling, the WCJ opined that the fact that the request for treatment had been improperly made did not mean that the defendants didn't have to provide the treatment, but the dispute had to go to IMR for a determination of medical necessity.

The WCAB adopted the rationale of the WCJ.

It feels like each California work comp reform, in this instance the 2012 adoption of SB 863, puts high pressure on the system. The pressure creates winds of case law that sweep down through the valleys and passes of procedure, tumbling, gusting, turbulent.

And you never really know when these winds are going to actually arrive at the coast. It could be calm one moment, and the next moment you will be heading for cover from all of the dust and debris carried by the winds.

One thing for sure, the winds affect everyone in the path indiscriminately. Hopefully one can seek shelter.

But if you're out on a bicycle hopefully you have a tail wind home. Otherwise it is a very fatiguing ride, and sometimes dangerous.

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