Vol. 6, Issue 10

Find Solutions & Strategies                 March 9, 2015

UR and IMR Best Practices
  
Loosening the rope on the UR/IMR Gordian Knot 
In This Issue
A Note From the Editor
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utilization review and independent medical review best practices

Karen C. Yotis, our Feature Resident Columnist, provides insights into workplace issues and the nuts and bolts of the workers' comp world. 

 

While UR and IMR continue to generate controversy, the workers' compensation community is still trying to make sense of UR/IMR and learn how to incorporate the basic process into their practice. Anticipating significant interest around the ins and outs of this shape shifting topic, the DWC hosted at its recent 22nd Annual Education Conference an SRO session titled "Utilization Review (UR) and Independent Medical Review (IMR)" presented by George P. Parisotto, an attorney from the Department of Industrial Relations, and Rob Nydam, J.D., Director of Operations at MAXIMUS Federal Services...read more.

LAST WEEK TO SAVE $$$:
DWC CONFERENCE ATTENDEES SAVE 20%

All DWC conference attendees can take advantage of special conference discounts through March 16, 2015. Whether you want print or ebook, we've got your research solutions:

 

*Herlick, Calif. Workers' Comp. Handbook (2015 Ed.)

*Workers' Comp. Laws of Calif. (2015 Ed.)

*Workers' Compensation Index (2015 Ed.)

*Rassp & Herlick, California Workers' Compensation Law

*Hanna, Calif. Law of Employee Injuries & Workers' Comp.

*Lawyer's Guide to AMA Guides & Calif. WC (2015 Ed.)

 

Christine Hyatt

To take advantage of this offer, contact Christine Hyatt:

Direct: 937-247-8166

Email: [email protected]

 

Receive a complimentary booklet on reducing workers' comp costs when you contact Christine to purchase a LexisNexis book! Offer good while supplies last.

court interpreter as employee

United States Supreme CourtIn Hassan v. County of Los Angeles, 2015 Cal. Wrk. Comp. P.D. LEXIS 18, a split panel WCAB affirmed the WCJ and held that the applicant, a court interpreter, who suffered industrial injury to multiple body parts, was an employee of the defendant County of Los Angeles, and not an independent contractor, because the County exercised control over her work...read more.

DEMOLITION OF WORKERS' COMP

 ProPublica and NPR's new series "Insult to Injury" examines the "demolition" of the workers' comp system, the "geographic lottery" of workers' comp benefits

 

Journalists Michael Grabell and Howard Berkes have undertaken an "unprecedented look at the unwinding of workers' comp laws across the country" including California, where "anonymous doctors never see patients" and practically every treatment request is subject to the delays in the UR process. Commenting on SB 863, retired WCJ John C. Gutierrez lamented that that only interest being protected by the new laws is industry, while workers are "losing their voice." Read the first article. Read the second article. View the interactive U.S. map to see which states have cut or raises benefits during the past decade. View the interactive chart for workers' comp rates.

osha study: COST SHIFTING, INCOME INEQUALITY, INCREASED RISK OF INJURY IN THE WORKPLACE

Who bears the cost of workers injuries? 63% is paid out of pocket by workers, their families and private health insurance, while taxpayers pay 16% and workers' comp pays only 21%.

 

Dollar MagnifierOSHA has released a study that examines the inequality that results from a workplace injury and the costs of failing to protect workers on the job. The main points are:

 

> Work injuries and illnesses impose heavy costs on workers, families, and the economy

> Injured workers and taxpayers subsidize high hazard employers

> The changing structure of work in the U.S. increases risk of injury and contributes to income inequality

> Occupational injuries and illnesses strain social insurance programs and result in taxpayer subsidies of unsafe employers

> The most effective solution is greater efforts to prevent work injuries and illnesses.

california compensation cases

Cal Comp CasesNo Post-Retirement Period of Disability  Found: Cal. Comp. Cases February Advanced Postings. Lexis.com and Lexis Advance subscribers can read it.

california news headlines

CA: AB 1124 Would Create Drug Formulary to Reduce Workers Comp Costs.

CA: AB 305 Would Eliminate Gender Bias in Workers Comp System.

CA: DIR Cracks Down on Underground Economy, Assesses $4.2M in Unpaid Wages.

CA: State Fund to Co-sponsor Injury and Illness Prevention Training Program.

CA: CWCI Announces 2015 California Workers' Comp Case Law Seminar.

CA: Drobot, Former Pacific Hospital Succeed in Having Conspiracy Claims Thrown Out.

Obama's Budget Proposal Mandates Reporting of Workers Comp Benefits to SSA.

ProPublica Comments on OSHA Study of Inequality, Lack of Workplace Safety. 

The Atlantic: Workers Comp Policy "Doesn't Really Seem to Involve You Until It Does".

PBS Newshour Interviews Journalists of ProPublica Expose on Workers Comp.

Study Examines Commute Time, Loss of Sleep for Workers With Multiple Jobs.

ACOEM Releases Position Statement on Genetic Screening in the Workplace.

CMS Issues Final Rule to Implement Appeal Procedure Under SMART Act.

CMS Final Rule on Appeals Process Not Changed Much From Earlier Proposed Rule.

eNewsletter archives

Take a deep dive into our past eNewsletters for 2015 and prior...warning - some links to articles may not work...report any linking problems to [email protected].
 
March 2, 2013: A is for Apportionment.
February 17, 2015: Special Issue on QMEs and AMEs.
February 9, 2015: A Post-Dubon II Game Changer?