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Employers Say Dubon Adds to SB 863 Malaise
03/17/2014
for IMR.
An IMR request can be withdrawn at any time. However if it is withdrawn after the case was declared eligible but before the medical reviewer receives medical records the employer has to pay a 215 fee for the withdrawn request. If the application is withdrawn after the reviewer received
Category: News
Attorneys Predict Upswing in Litigation on UR Denials, Post-Dubon
03/04/2014
having ever spoken to the worker's treating doctor or looking at all of the medical evidence from the treating doctor and the panel qualified medical evaluators in the case.
"So all the experts say 'yes he needs this' but the UR doctor who didn't see all the records and didn't see the patient and
Category: News
WCAB Issues En Banc Rulings on UR/ IMR and QMEs
02/28/2014
and the agreed medical evaluator.
The judge found that deGrange's failure to review all of the relevant medical records was "a critical error" but she said such a procedural defect had to be resolved by IMR based on SB 863's creation of Labor Code Sections 4610.5 and 4610.6.
Sections 4610.5
Category: News
Pomona Seminar to Explain IMR /IBR Regs
02/21/2014
for applicants and defense attorneys involved with medical-treatment or billing disputes.
The DWC Newsline issued Feb. 13 noted three of the changes to IMR 1 revisions to the IMR application form and improved instructions; 2 clarification that IMR determination cannot be based solely on
Category: News
OAL Approves Independent Bill- and Medical -Review Rules
02/14/2014
' Compensation said any of the application forms for independent medical review that have been adopted as part of the emergency rulemaking process can be used until March 1.
In addition to revising the application form the final IMR rules clarify that a determination can't be based solely on information
Category: News
DWC Leaders Announce Changes for Comp Coming in Feb.
01/14/2014
medical need for a requested treatment.
Through the end of the year all IMR is being provided by Maximus Federal Services. Maximus secured a two-year no-bid contract to perform IMR for the DWC and its contract runs out at the end of this year.
Parisotto said he anticipated that the agency will
Category: News
CAAA Says IMR Rules Need More Work
12/31/2013
medical treatment is necessary based on both a summary of medical records listed in the utilization-review determination and any documents submitted by the injured worker. The proposed rules say no IMR determination can be issued based solely on the information provided by a utilization-review
Category: News
Duplicate and Incomplete IMR Applications Contributing to Delays
12/19/2013
also to submit documents and medical records via the internet. The electronic portal will also allow the injured worker to opt to receive correspondence by email and to log into the system to see the status of his case.
Shields said the goal is to have the electronic application process working by
Category: News
Decisions Pending on More than 95% of IMR Applications
12/16/2013
applications for independent medical review.
"During this time Maximus issued 2545 evidence-based medical decisions and the Division of Workers' Compensation declared 105 applications ineligible for IMR" Das said. "So obviously it's a big gap between the number of applications submitted and the number
Category: News
DWC Posts Revised IBR, IMR Rules for Comment
12/13/2013
review-rules for public comment.
The division on Dec. 6 posted revised IMR rules that would have authorized decisions in cases where the claims handler does not forward medical records as required by statute to the review organization to be based on the summary of the injured worker's medical condition
Category: News
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