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Tuesday, November 22, 2022

DWC Announces Modifications to QME Forms

  • State: California
  • Topic: WEST
  • - Popular with: Legal
  • -  0 shares
The California Division of Workers’ Compensation opened a 15-day comment period on proposed ch…

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Jesse Marino Nov 22, 2022 a 9:56 am PST

DON’T DO IT!
What an absurd decision that would be.

The legislature decided to have the reporting done in 60 days years ago. Even that is too slow to get INURED WORKERS, expedited medical treatment, and resolve issues on claims.

This would allow an extra 30 days for reporting and further delay medical treatment for INJURED WORKERS. Why? Because a computer and probably 2 employees that issue replacement panels get to issue 10,267 instead of the 24,995 replacement panels in 2019.

Thousands of INJURED WORKERS will suffer so that a computer and a few State employees can work less. Not a good trade-off.

Whatever happened to an expedient benefit delivery system?

Could we investigate why doctors do not issue timely reporting in 60 days?

No, let’s make the INJURED WORKERS pay for their delays.

If this change passes, when we get a replacement panel, we must wait ANOTHER 90 DAYS!

A PQME can take over ½ a year to get issued – at best, for those 10,267 INJURED WORKERS that need them!

Expedient medical treatment and resolution of issues or ABSURD!

No on this!

Steven Chandler Nov 23, 2022 a 8:34 am PST

So, wait a minute here... The decision period to determine compensability has been drastically reduced in all COVID claims and now reduced in presumptive (though rebuttable) claims despite insurers and self-insureds having to rely on the expediency of 3rd parties (AOE/COE reports, obtaining records, and more) in fear of the looming presumptive acceptance of a claim; however, QME's are rewarded not only with a substantial increase to the hourly fee when many already pad their hours and now, it's likely that they'll be given even more time? Again, this is driving costs in this state to even higher amounts without providing meaningful resolutions. It's a backwards way of offloading costs from the healthcare plans, including Medicare, onto employers and insurers and reviving the old, 24-hour, single payer care model into a system that is rampant and overrun with fraud!

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