Most Recent Articles

RAND Gets $300K for UR Study—What's the ROI?

The California Department of Industrial Relations (DIR) plans to address the state’s broken Utilization Review (UR) system—by paying frequent contract recipient RAND Corporat...

CA RFA Hell: Affirmative Cites the Most Cynical Excuse Yet to Deny Care

What’s the most absurd, bureaucratic, procedurally abusive excuse a claims administrator ever used to deny care to an injured worker?We’ve seen our share of bad-faith ...

Zurich: Vague Authorization Creates More Treatment Friction

Insurer Zurich North America offered a classic example of the bureaucratic absurdity that plagues California’s treatment authorization process, issuing a baffling, time-bound...

CA DWC's UR Audits: A Keyhole View of a Statewide Crisis

As early as 2016, California legislators recognized the potential for payers to abuse Utilization Review (UR), the process by which payers decide whether to deny or approve t...

CA's "Cost Control" Mechanisms May Be the Most Expensive Parts of the Claim

Employers in California pay more for workers' comp coverage than in almost every other state, and the gap is widening. In our view, thereason isn't provider or ...

Does CA Workers’ Comp Cause Secondary Psych Injuries?

New research illuminates a serious problem for injured workers: secondary psychological injuries resulting from the sheer hardship of navigating workers’ comp systems....

CA DWC to Enact Useless New UR Regulations

The California Division of Workers’ Compensation (CA DWC) will enact new regulations to (theoretically) streamline authorization for injured workers’ care, effective April 1,...

CA Employers Need to Know: Is It the Injury or the UR System?

Last year, California raised employers’ workers' comp premiums by 8.7% while other states continued to cut rates, some for over a decade straight. Across the nation, premiums...

CA: CNA "Authorization" Doesn't Authorize Anything

CNA sent a California provider a treatment authorization letter that may double as a setup for nonpayment. The letter purports to authorize care while simultane...