Newly Published Decision Annuls 100% PD Award

The Sixth District Court of Appeal ordered publication of a decision annulling a 100% permanent and total disability award that was based solely on a psychiatric injury stemming from the sexual abuse by a treating physician. The court remanded the case to the Workers’ Compensation Appeals Board to consider permanent disability issues surrounding the underlying … Read More »

This content is only available to premium subscribers. Please login here log in

Read More »

Democrat Proposal A Major Cost Driver For Employers

California employers can expect to pay more, a lot more, if a proposed bill to create a state-run wraparound medical provider network (MPN) becomes law. Experts note that employers will pay millions to develop and maintain this state-run all-encompassing network. The proposed change will drive up the cost of care by losing network discounts on … Read More »

This content is only available to premium subscribers. Please login here log in

Read More »

Injuries Were Treated As Fast Or Faster During The Pandemic

Industry veterans expressed concerns last year about an interesting trend in emerging workers’ comp data. It showed a sharp drop off in medical treatment during the stay-at-home periods ordered in response to the COVID-19 pandemic. Studies have shown that delays in the initial treatment of an injury have long-term, costly effects on workers’ comp claims. … Read More »

This content is only available to premium subscribers. Please login here log in

Read More »

Employers, Carriers Push Back Against Med-Legal Fee Proposal

California’s employers and insurance carriers are raising concerns that the Division of Workers’ Compensation’s proposed med-legal fee schedule (MLFS) update will increase costs more than is projected and, worse, create new friction points in the system. Employers assert the proposal does little to prevent billing abuse and that the Division’s proposal fails to ensure high-quality … Read More »

This content is only available to premium subscribers. Please login here log in

Read More »

How Many Workers’ Comp Claims Linked To COVID

New data from the California Workers’ Compensation Institute and the Division of Workers’ Compensation show one in thirteen claims made in California are COVID-19 after the 30% negative test claims are denied. There have been 51,666 COVID-19 related claims made, of which 15,384 are denied largely because of a negative test. The ratio of denied … Read More »

This content is only available to premium subscribers. Please login here log in

Read More »

Proposed Med-Legal Fees Still Controversial

The Division of Workers’ Compensation’s latest proposal for updating California’s med-legal fee schedule (MLFS) is continuing to generate controversy and pushback from the workers’ comp community. The Division’s initial proposal in 2018 generated over 500 pages of mostly negative comments from the state’s qualified medical evaluator (QME) community and now, two years later, its latest … Read More »

This content is only available to premium subscribers. Please login here log in

Read More »

Early COVID-19 Claims Accepted And Denied

The full impact of the COVID-19 pandemic on workers’ comp claims remains to be seen. Still, the California Workers’ Compensation Institute says a review of early claims show the majority were accepted or were only denied when the employee tested negative for the coronavirus. Many other claims were still under investigation at the time of … Read More »

This content is only available to premium subscribers. Please login here log in

Read More »

UR Reforms, Drug Formulary Boost Treatment Approvals

Recent reforms that established a prescription drug formulary for California’s workers’ comp system, and which created a utilization review exemption for many treatments rendered during the first 30 days of an injury, are boosting treatment approval rates for injured workers. A new study using industry claims data indicates that additional reforms could decrease the number … Read More »

This content is only available to premium subscribers. Please login here log in

Read More »