Most Recent Articles
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Mar 22, 2024
AmTrust/Genex Use ODG to Deny Pre-Op Clearance
California law instructs physicians and claims administrators to consult the Medical Treatment Utilization Schedule (MTUS), adopted from the American College of Occupational ...
Apr 2, 2024
CA UR: AmTrust & Genex Deny Care With ODG (Again)
What suffering must befall injured workers before California bothers to enforce its meager Utilization Review (UR) requirements?When considering which treatments are n...
May 9, 2024
CA DWC Deletes Med-Legal FAQ From Website
California’s Division of Workers’ Compensation (DWC) is supposed to have a critical role in enforcing state laws and regulations. Just as critically, the DWC has a duty to
May 16, 2024
CA DWC Website Deletions Enrich Claims Administrators
Given the complexity of workers’ comp (and the myriad ways claims administrators improperly deny requests for treatment and payment), knowledge is a precious resource for pro...
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Jul 24, 2024
CA DWC to Impose Costly New Reporting Burdens on Providers
California’s Division of Workers’ Compensation (DWC) is proposing major changes to the forms providers use for injured workers’ Progress Reports, the Doctors’ First Report of...
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Aug 5, 2024
EK Health: Denying Care Helps Injured Workers
EK Health wants you to know that Utilization Review (UR) is not a soulless tool that payers use to deny injured workers the care recommended by their treating physicians....
Aug 8, 2024
daisyData: CA RFA & Utilization Review 2024 Data
In California, Utilization Review (UR) is the mandatory process by which claims administrators decide whether or not to approve treatment requests submitted by doctors treati...
Aug 21, 2024
CCCSIG Adds Bogus "Expiration Date" to UR Approval
Let’s be absolutely clear: in California workers’ comp, treatment authorization does not expire. Once Utilization Review (UR) determines that treatment is authorized, there i...
Sep 4, 2024
The $10,000 Lie California Tells Injured Workers
Lie: California workers receive immediate and continued treatment (up to $10,000) when they file a work injury claim.Fact: California allows claims administrato...
Sep 17, 2024
CA SB 636 Demands CA-Licensed UR Physicians
California Senate Bill 636, which addresses a vital aspect of the Utilization Review (UR) process in workers’ comp, is on the Governor’s desk awaiting his signature.In...
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Sep 18, 2024
Liberty Mutual: 23-Month Wait for Surgery in CA
If you need proof of how dysfunctional California workers’ comp is—and that absurdly long claim durations have become the appalling standard—see the 23-month ordeal an injure...
Sep 19, 2024
Sedgwick Boasts 54% Denial Rate for Injured Worker Treatment
Editor’s note: As predicted below, Sedgwick removed the 54% statistic from its marketing website, shortly after the publication of this article. Who coul...