IMR Usage Down 20% From Historical Norms

California’s independent medical review program is driving down much of the medical expense in the workers’ compensation system. But since its inception, usage has been far higher than expected. The number of IMRs – is still higher than the drafters of the Baker Workers’ Comp Reform – SB 863 expected, but full-year data for 2020 … Read More »

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Copy Service Fee Schedule Still in Play

The Division of Workers’ Compensation is reviewing pages of comments and over an hour of public testimony that offered both support and criticism of its proposal to update California’s copy service fee schedule. The proposal would increase the flat-fee payments by $45 or 25% and institute a new meet and confer process intended to cut … Read More »

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Pandemic-Related Claims Down in 2021

The Workers’ Compensation Insurance Rating Bureau reports that claims from workplace exposure to the SARS-CoV-2 virus resulting in workers’ comp claims all but disappeared from March through July this year. But researchers expect a rebound in the second half of the year following the higher infection rates seen from the Delta variant. The Bureau is … Read More »

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Med-Legal Costs Jump

The California Workers’ Compensation Institute (CWCI) is warning that costs for med-legal services are up by 67%. It happened when the Division of Workers’ Compensation (DWC) rolled out a new med-legal fee schedule earlier this year. The Division called the new schedule a 25% pay raise for the state’s qualified medical evaluators. But the initial … Read More »

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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 »

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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 »

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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 »

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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 »

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