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Tuesday, October 1, 2013

IMR: What Was The California Legislature Thinking?

Today's post is authored by David DePaolo, a national leading commentator on workers' compensation with special expertise in the California system, and shared from The Independent Medical Review system was theoretically contrived to contain cost and make the California system friendlier and more expeditious. Quickly enacted, without full debate and comments from stakeholders, the system has become stymied and yet another hurtle in the system. Read David' thoughtful analysis.......

The debate about the big volume of Independent Medical Review requests in California's new system that were recently reported is all over the map.

Some say that the provider, Maximus, is at fault and many support the Division of Workers' Compensation's proposal for new time lines and penalties for various actions and/or inactions.
There's also plenty of blame slinging going on with employer representatives accusing the applicant attorneys, applicant attorneys implicating carriers/administrators, and everyone else pointing fingers at each other.

But Steven Cardinale, co-founder and Managing Director of CID Management, a Utilization Review company, put it best to me in an email when he said, "SB 863 was conceived in such a way as to assure the overuse of IMR."

I have to agree with Mr. Cardinale - none of the participants in the California system is really to blame for the huge volume going to IMR because the law essentially guaranteed that this would...
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