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verification required for imr appeal |
We are all on notice of the need to pay attention to the verification requirements . . . and should treat this decision as a red flag for future conduct
 The W.C.A.B. has issued another "Significant Panel Decision*" addressing another procedural issue under SB 863. In Torres v. Contra Costa Schools Insurance Group, SCIF, the W.C.A.B. has addressed the procedural status of an appeal of an IMR decision to the W.C.A.B. where the applicant attorney has failed to verify the Petition as required by Labor Code § 4610.6(h) and ADR 10450(e)...read more.
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UR request for additional information |
UR was not defective when the request for additional information necessary to make the UR determination was signed by a non-physician
 In a noteworthy panel decision issued August 21, 2014, the WCAB in Newton v. Jack-In-The-Box, 2014 Cal. Wrk. Comp. P.D. LEXIS - , rescinded the WCJ's award of medical treatment in the form of aquatic therapy after the defendant objected to the WCAB's 7/7/2014 Notice of Intention to Award Medical Treatment [see Newton v. Jack-In-The-Box, 2014 Cal. Wrk. Comp. P.D. LEXIS 356], which was based upon the WCAB's finding that the defendant's 8/11/2013 utilization review decision was materially defective pursuant to Labor Code § 4610(e) because it was signed by a registered nurse rather than a physician...read more.
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new cwci study produces benchmark data on physician reporting in california workers' comp |
 A new CWCI study finds that the average number of first-year medical reports per claim provided by California workers' comp treating physicians to claims administrators rose by 123% in the 12 years leading up to the adoption of the new physician fee schedule, fueled in part by increases in evaluation and management (E/M) services used to treat injured workers and in the number of physician reports per E/M service, but claims organizations note that reports still do not always meet regulatory requirements or include all of the medical information needed for effective claims management...read more.
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Verification Required for IMR Appeal
