california division of workers' compensation

The Hartford Doubles Down on Improper Payment Denials (Part 2)

California consistently fails to uphold one of the most important legal principles of its workers’ comp system: treatment authorization assures payment to the healthcare prov...

The Hartford Doubles Down on Improper Payment Denials (Part 1)

California law requires insurers to honor authorization for medically necessary treatment as a legally binding, non-rescindable guarantee of reimbursement. The Hartford is ei...

New CA Intake Form for Workers' Comp Patients

Providers who treat injured workers can’t afford to let administrative oversights derail payment, especially in California. Any error or missing information can give a payer ...

Audit Complaint: CA DWC Must Address Gallagher Bassett Violations

Gallagher Bassett is violating California law and regulations through its vendor, InstaMed. The Third-Party Administrator (TPA)’s non-compliance i...

CA DWC’s List of “Active” MPNs Lists a Single MPN

Last week, daisyNews documented how Employers Compensation Insurance Company denied bills by questionably citing MPN non-membership,...

CA Providers: Good Luck Fighting MPN Payment Denials

Yesterday, daisyNews shared data on payment denials citing non-membership in Medical Provider Networks (MPNs) and, in multiple cases, showed that ...

Liberty Mutual Plays “IBR (and IMR) Chicken” on UPS Claim

Two unfortunate necessities exemplify the broken state of California’s dysfunctional workers’ comp system:Too often, payers deny an injured worker's care, and the work...

CA DWC: Providers Must Use RFA Form (While Payers Can Do What They Please)

In California, before treating an injured worker, a physician must obtain prior approval from the payer for all treatment. The California Division of Workers’ Compensation (C...

NY WCB Is Right to Celebrate. What Can CA Learn?

New York's Workers' Compensation Board (NY WCB) recently issued a bulletin touting its accomplishments over the last several years. While it’s hard not to be skeptical of a g...

CA SIBTF Paid $725,570 in Med-Legal Costs For a Single Claim

California employers pay four times more in Medical-Legal costs for Subsequent Injuries Benefits Trust Fund (SIBTF) claims than for standard workers' comp claims. The ...

CA: Sedgwick Hits 359,626 Violations (and Counting)

Sedgwick Claims Management Services, Inc. is routinely non-compliant with California workers' comp payment laws and regulations. Among its violations: repeatedly faili...

Zurich's MPN Violates CA Law (Again) - Tesla Should Be Asking Questions

To ensure injured workers' access to care, California has laws governing Medical Provider Networks (MPNs). Zurich Insurance North America continues to treat those laws as opt...