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2nd DCA Grants Review to Dispute Over IMR Timeline Requirements

03/16/2016
mechanism for the 30-day time limit is an indication that the deadline is "directory" or "discretionary." They also say there is nothing in the Labor Code that makes an IMR decision invalid if it's not issued within 30 days and there is no statute that allows medical treatment disputes to be determined

Category: News

Expenses Surpass Medical as Largest Category of Costs in 2014

03/16/2016
treatment was not necessary about 88 of the time. Employers pay the cost for IMR. And carriers and claims administrators have the burden of providing medical records to the IMR organization. The CHSWC annual report includes a discussion of the volume of IMR applications and decisions but does not

Category: News

DWC Proposes Penalties of $8.25 Million for Untimely Submission of IMR Records

03/09/2016
Eight California claims administrators face a total of 8.25 million in administrative penalties for not submitting medical records to Maximus Federal Services within the time period allowed by law. Eight claims administrators face a total of 8.25 million in penalties for not submitting

Category: News

DWC to Penalize Claims Administrators over IMR Medical Records

02/29/2016
providing medical records. "They should be assessed the full amount at this point" he said. The DWC said in a Newsline released in November 2014 that it would initiate the procedure to assess administrative penalties for failure to submit relevant records in cases currently pending IMR. The statement

Category: News

Baker Says Changes Are Moving System in Positive Direction

02/26/2016
staff counsel Alan Hersh said the division's IMR contractor Maximus Federal Services is doing its job. On the other hand claims administrators have dropped the ball in terms of getting medical records to Maximus within the 15 days they're allotted by state law. He warned that the DWC has statutory

Category: News

DWC Announces New System to Submit IMR Applications, Medical Records

02/24/2016
the most reliable way to transmit medical records to Maximus Federal Services the division's independent medical review provider. The system also makes it easier to track applications and records than paper or fax submissions the division said. "We believe utilizing MOVEit for IMR applications

Category: News

Analyst: Consider UR Exemptions for Some Treatments

02/22/2016
on independent medical review and independent bill review. The Division of Workers Compensation received 253771 applications for IMR in 2015 an 11.2 increase from the previous year. Looking at only eligible applications the division received 165619 last year a 13.6 increase. Applications

Category: News

Expectations for DWC's UR Audit Ramp Up Mixed

02/16/2016
behind the windows is a seriously dysfunctional system that window dressings can't possible have any appreciable impact on." Gurvey said he doesn't expect the audits will involve an investigation into what medical records and reports were actually reviewed the time taken to review a request which

Category: News

CAAA Urges 3rd DCA to Uphold WCAB Ruling on Mandatory Nature of IMR Timelimits

01/21/2016
of Workers' Compensation reported. The DWC said the average turnaround time had dropped to about 24 days by March 2015 and IMR decisions were being issued within 10 days from receipt of complete medical records by the end of the year. The 1st DCA's ruling in the Stevens case is currently on

Category: News

DWC Working to Improve Listing of IMR Records

10/26/2015
The Division of Workers' Compensation is working with Maximus Federal Services to improve how medical records are identified in independent medical review determination letters a spokesman said on Friday. Applicants' attorneys said the decisions they're receiving don't always identify all the

Category: News

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