WCAB Regulatory Update Hearing Scheduled

The Workers’ Compensation Appeals Board is moving ahead with proposed updates to its rules of practices and procedures including a controversial proposal to create a new case designation that critics say is not authorized by the board’s governing statutes. The formal proposal is now out for public comment, and a public hearing is slated for … Read More »

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WCAB Faces Pushback Over New Draft Rules

A draft proposal to rework the Workers’ Compensation Appeals Board’s Rules of Practice and Procedures generated controversy and strong push back from carrier representatives and qualified medical evaluators (QMEs). The changes are being billed by regulators as being a clean-up effort with largely non-substantive changes, but many in the workers’ comp community saw it differently. … Read More »

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Report Recommends Updates To Med-Legal Schedule

California’s effort to update its medical-legal fee schedule should focus on ways to fairly reimburse qualified medical evaluators (QMEs) for the most complex cases without creating an incentive to spend more time than necessary to maximize payments. Instead, researchers from Rand Corp. say that the state should focus on extending its flat-rate payment system to … Read More »

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Community Calls For Med-Legal System Reform

The Division of Workers’ Compensation says it will begin forming stakeholder groups to work on rewriting the state’s medical-legal fee schedule (MLFS) and the rules surrounding the delivery and review of medical records. State officials got an earful at a hearing last week from qualified medical evaluators (QMEs) who are fed up with outdated pay … Read More »

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Workers’ Comp Is Profitable, But Expense Ratio Ticks Up

California’s workers’ comp insurers last year spent 38 cents out of every premium dollar on adjusting claims, commissions, and expenses other than benefits for injured workers, according to a new statewide report about the industry’s 2017 underwriting experience. The industry saw its pre-tax underwriting profit climb again to 8.4% of earned premium (see chart). The … Read More »

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QMEs Demand Input On Fee Schedule

The Division of Workers’ Compensation’s efforts to rewrite the rules for medical-legal billing in California’s workers’ comp system is running into a firestorm of opposition. A recent forum posting of the draft changes generated over 500 pages of comments. Sources say that Division leadership got an earful at a recent meeting of medical specialists. Much … Read More »

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Some QMEs Get Deals

Exclusive Qualified medical evaluators (QMEs) and the Division of Workers’ Compensation have had a running battle over the past year involving denied reappointments due to disputed billings for complex medical evaluations. Hundreds of QMEs were denied reappointment, and some are challenging the Division’s actions in court. Others, however, are opting to settle and get back … Read More »

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