RFA

Sedgwick Removes 54% UR Denial Stat From Website
Oct 16, 2024
Sedgwick Removes 54% UR Denial Stat From Website
We knew it was only a matter of time. The question was how much time?Third-party administrator (TPA) Sedgwick Claims Management Services screamed the quiet part out lo...
Liberty Mutual: 23-Month Wait for Surgery in CA
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...
daisyData: CA RFA & Utilization Review 2024 Data
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...
CA DWC to Impose Costly New Reporting Burdens on Providers
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...
Albertsons Employee's Post-Amputation UR Nightmare
Jan 9, 2024
Albertsons Employee's Post-Amputation UR Nightmare
Two days before Christmas in 2022, an Albertsons Companies employee suffered “traumatic amputations” of three toes in a work accident. This worker lived alone on the t...
daisyNews: 2023 Top 10 Articles
Jan 8, 2024
daisyNews: 2023 Top 10 Articles
In 2023, daisyNews tackled the stories, trends, and issues that had the biggest impact on providers who treat injured workers. Below, we share the 10 most-read articles of th...
SCIF Inept UR #7: Truly Unbelievable Incompetence
Oct 3, 2023
SCIF Inept UR #7: Truly Unbelievable Incompetence
Employees, taxpayers, and moral human beings should be outraged by Utilization Review (UR) abuse inflicted on a state employee by the State Compensation Insurance Fund (SCIF)...
SCIF Inept UR #5: EK Health Ignores MTUS, Denies Surgery
Sep 27, 2023
SCIF Inept UR #5: EK Health Ignores MTUS, Denies Surgery
Why is it so difficult to get treatment for a work-related injury? At least in California, most of the answer is a broken UR system that allows insurers to withhold potential...
SCIF Inept UR #4: IMR Rules Favor Insurers
Sep 15, 2023
SCIF Inept UR #4: IMR Rules Favor Insurers
In recent articles, we’ve shared the details of State Compensation Insurance Fund (SCIF)’s denial of continued care for an injured worker on false grounds, and ...
SCIF Inept UR #2: Bungled Medical Records Strikes Again
Sep 12, 2023
SCIF Inept UR #2: Bungled Medical Records Strikes Again
Once again, the consequences of inept Utilization Review (UR) fall on an injured worker.EK Health, conducting UR on behalf of State Compensation I...
UR: An Open Letter to CA Residents
Sep 11, 2023
UR: An Open Letter to CA Residents
Dear California Readers,One of your neighbors experienced a significant head injury while repairing California highways. This individual has diminished cognitive abili...
SCIF: Inept Utilization Review Delays Care for Injured Worker
Sep 6, 2023
SCIF: Inept Utilization Review Delays Care for Injured Worker
We write often about the systemic issues surrounding Utilization Review (UR) in California and the constant struggle of providers to obtain authorization to tre...