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Monday, May 18, 2015

3rd DCA Accepts Review of Constitutional Challenge to IMR

  • By Sherri Okamoto
  • State: California
  • Topic: Top
  • - Popular with: Legal
  • -  0 shares
The California 3rd District Court of Appeals has agreed to hear a constitutional challenge to the in…

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Garry Crosby Nov 3, 2016 a 7:58 am PDT

interesting to read that SCIF belives that IMR is unbiased in its opinion. Next the UR is unbiased!!!!!!! unless the review is done totally independent off the ins company, there will not be an unbiased review done. When the reviewer's earnings r linked to the no of denials that r given, there is no impartiality. Lastly LC 4600 has been violated, ignored and disregarded by this whole process. The LC 4600 should read as follow: no injured worker in CA is entitled to medical treatment esp to cure/relief their work related injuries and let the private ins industry/medicare/medical absorb all the costs as it is happening now

Carolyn Van Dusen Nov 3, 2016 a 7:58 am PDT

right, since you all think that UR denies everything and that IMR just rubber stamps it, then there should no longer be work for all us adjusters. Accept we are as busy as ever. Why is it that only SoCal has a problem with UR, IMR and MPN?

Jason Bernard Nov 3, 2016 a 7:58 am PDT

Money, I can't speak for all of SoCal, heck, I don't even live there. But I can tell you my problems with UR, IMR and MPN. I lost my hand in a construction accident months ago. There is no disputing the fact that it is work related. I had surgery to amputate my hand and have had several follow up procedures dealing with nerve pain. My physician prescribed for me a course of occupational therapy visits. My adjuster referred this request to UR. UR denied the therapy request and IMR agreed with them because it "was not medically necessary (states a doctor that never examined me).". This putrid decision is binding for 9 more months. My MPN affiliated physician, states he doesnt want me to attend any therapy because he doesn't want to get removed from MPN. Selfish a-hole. So I suffer with no therapy. this system is crappy even here in Northern California. I hate this system. I hate typing this post with one hand. I hate the anonymous IMR jerk that said I can't get therapy. I hate my adjuster for not having the brains to just approve the 8 visits. I hate my doctor for not fighting for my appeal. I hate putting on a belt with one hand. I hate trying to squeeze shampoo from a bottle. I hate the coworker that inadvertently crushed my hand. I hate that anything I say falls on deaf ears. People like me post here and pretend like it means something. DIR doesn't care. DWC doesn't care. Nobody cares. In 20 minutes nobody even going to see this post. It doesn't mean a thing. Right VIAW? Right American Medical Association? Right Authors of 863? Right Gov Brown? None of you do a thing to help me. None of you do a thing to ensure I can one day meet my IMR reviewer and speak with him face to face. And money wants to know why SoCal doesn't like UR and IMR. NEWSFLASH Money.... Anybody that has to deal with it doesn't like it. It is STUPID. PS.... It Took me 90 minutes to type this. What a waste.

Carolyn Van Dusen Nov 3, 2016 a 7:58 am PDT

OneHanded Joe. I am sorry to hear about you losing your hand and your resulting issues. UR and IMR follow guidelines set forth by the medical community. The issue that your PTP has with UR is simple, provide the rational, the medical reasoning for the request. what you don't see is the incomplete or unsupported request for treatment. I obviously cannot explain the issue in your case but I can't count the number of times we received "OT 2 x 3" with no body part, no explaination as to why, what is the expected outcome. this system is not designed to help you. never has been. Your attorney, if you have one, doesn't really have an interest in your complete recovery, they want you to suffer because it makes them more money. if you were in SoCal, your PTP would have been a Chiro and you would have had 5 or 6 other doctors doing all sorts of "treatment, like shockwave therapy and had you on 2 or 3 topical creams because they can bill 1000 times the actual cost. Read the Landmark case that is going on. The creams killed a child. UR, IMR and the MPN is not your problem, it is the nonsense that goes on in this state. Move to Oregon, Washington, Nevada, Arizona and see what real medical treatment is like.

John A. Don esq. Nov 3, 2016 a 7:58 am PDT

IMR reviewers are as unbiased as a Cubs fan in Wrigley Field!

John Kamin Nov 3, 2016 a 7:58 am PDT

It will be interesting to see if this lands in front of Andrea Hoch at the 3rd DCA. If she is on the panel, I would presume that her vote will side with the SB 863 proponents.

Keith More, Esq. Nov 3, 2016 a 7:58 am PDT

it appears to me that what SCIF is saying about the plenary powers allowing the legislature to decide "who decides issues, what evidence may be used ...", is a direct violation of Marbury v Madison. The Judicial branch is an equal branch of government. Since when does the legislative branch tell the Judicial branch who decides issues and how. It would be nice for the Legislative branch to give some credit to the Workers Compensation Appeals Board judges. It would also be nice if an Appellate Court would stand up for its bretheren regardless of their status as Commisioners or Judges.
Isn't it clear that IMR and UR just don't work !!! When paraplegics and quadriplegics are denied fundamental treatment it is about time to take a closer look and realize this just is not right.

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