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Maximus VP to Discuss Golden State Reforms at National Forum

12/12/2014
that the company expected to be issuing decisions within the 45-day regulatory timeframe by the end of 2014. As of October 22 2014 Maximus still had 42000 IMR cases that were awaiting a final decision. Maximus said it had not received requested medical records from claims administrators on

Category: News

Employers Say IMR Records Penalties Could Force Judges to Play Doctor

12/03/2014
Federal Services the division's IMR contractor. For cases pending as of Monday the division said it will commence the penalty procedure if Maximus has not received relevant medical records by Dec. 15. The IMR process was created to keep disputes about utilization-review denials out of the Workers

Category: News

DWC to Fine Administrators for Not Submitting Medical Records for IMR

11/26/2014
recommended treatment simply because medical records were never provided. "It is truly incredible what we are seeing with the limited medical materials being sent to UR and to IMR and treatment decisions coming out based thereon" Gurvey said. "It is not clear whether it is intentional laziness or simply

Category: News

WCAB Issues New En Banc Decision Limiting Review of UR to Timeliness Issues

10/07/2014
Chief Counsel Kathy Zalewski joined the board in May. The board in February had ruled that an IMR doctor's failure to review all of the relevant medical records related to Jose Dubon's industrial injury had rendered the doctor's opinion invalid. The WCAB said therefore a workers' compensation judge

Category: News

DWC Holding IMR Record Submission Webinar

10/01/2014
The Division of Workers Compensation and Maximus Federal Services are holding a two-hour webinar on Oct. 22 to discuss with claims administrators the process of submitting records for independent medical review. The webinar will explore electronic submission of medical records with a primary

Category: News

App. Attorneys Surprised as Employer Appeals IMR Decision

09/24/2014
California applicants' attorneys haven't been happy with the independent medical review process mandated by SB 863 and several times have sought to overturn unfavorable IMR decisions with mixed results. Now it seems at least one employer has a beef with the process too. An IMR doctor in

Category: News

Caplane Says Decision on Reconsideration in Dubon Should Be Issued Soon

09/11/2014
over the hearing noted that there was "a wealth of medical records" that deGrange apparently had not reviewed however the judge found that Labor Code Sections 4610.5 and 4610.6 required that any challenge to the UR decision be resolved through the IMR process. Sections 4610.5 and 4610.6 introduced

Category: News

Maximus Implements Use of New Coversheets in IMR Records Submissions Process

08/07/2014
The Division of Workers Compensation on Wednesday announced a change in the way Maximus Federal Services will be collecting medical records from parties undergoing the independent medical review process. When Maximus sends a "Notice of Assignment and Request for Information" to parties the

Category: News

1st DCA Denies Review of Constitutional Challenge to IMR

06/19/2014
providing a complete fair review of medical records." By contrast defense attorney Lois Owensby of Laughlin Falbo Levy & Moresi said she found it "heartening" that the 1st DCA declined review of the Stevens case. Establishing the IMR process was "a significant part" of the reforms enacted by the

Category: News

Maximus Executive Predicts Timely IMR Decisions before Year End

06/13/2014
company is required by law to identify which medical records were reviewed on the final determination and many applicants submitted incomplete or duplicate requests. Because in most cases IMR decisions are final for at least 12 months Shields said Maximus was meticulous in going through paperwork to

Category: News

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