Utilization Review

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: CHSWC Meeting Highlights Need for Comp Reform

Stakeholders at a recent meeting of California’s Commission on Health and Safety and Workers’ Compensation (CHSWC) did not mince words in describing what needs fixing in the ...

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 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,...

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'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 ...

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 Employers: Who Profits When the CA DWC Ignores the Law?

It's time to confront a fundamental problem with California's workers' compensation system.California employers are paying higher workers' comp premiums, even as rates...

CA DIR to Blow $1.25M On (Another) Questionable Comp Study

The California Division of Workers’ Compensation (CA DWC) is set to waste $1,250,000 in taxpayer dollars on a faulty “study” of non-existent data.The Department of Ins...

Labor: “Predatory” Sedgwick Is “a Menace to Workers”

Labor representatives are finally saying it out loud: Sedgwick Claims Management Services, Inc. is a “menace” to injured workers.Transport Workers Union (TWU) Local 100 isn’t...