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(c) 2016 Jon L Gelman, All Rights Reserved.

Thursday, November 6, 2014

Uncertainty Continues to Dominate the California System

Today's post is shared from David DePaola, After practicing workers' compensation law for nearly 18 years, he founded and grew WorkCompCentral, a respected news and education service in the workers' compensation industry. David discussed a most critical and continuing problem, the delivery of medical care, a continuing experiment in California that continues to remain unsolved.
David DePaola


"The unanswered question is how much was saved by denying unnecessary medical care," the WorkCompCentral story this morning queries, stating that Greg Johnson, director of medical analytics for WCIRB, said the WCIRB simply can't answer that question.

"Honestly, there's no way the WCIRB will ever be able to answer that question because it is not germane to IMR filings - we don't really know that IMR is denying unnecessary medical care. We only know that IMR is upholding Utilization Review denials, which may, or anecdotally more often than we admit, may not, be about appropriate care.

"As I mentioned before, the anecdotal evidence suggests that UR is being used too often for cost containment rather than directing care. And frankly the amount of time it takes to get through a couple of UR denials and appeals, and then IMR review, denial and appeal, is incentive enough not to push for any particular treatment request - it's easier just to go to a general health doctor to get treatment for an ailment of "unknown origin."

Click here to read the entire article.

Read more about California and "workers' compensation:"
Oct 28, 2014
The union's call – and a rebuttal from the California Hospital Association – came as Brown met privately with nurses, public health officials and medical providers to discuss Ebola. Though there are no known cases of Ebola in ...
Oct 18, 2014
California Prop. 46, Inspired By Tragedy, Pits Doctors Against Lawyers. Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org. This story is part of a partnership that includes KQED, NPR ...
Aug 18, 2014
In Southern California the Riverside County DA has executed a search warrant against a workers' comp firm, California Injury Lawyers (CIL). Apparently this is a result of a long investigation into suspected workers' comp fraud ...
Aug 21, 2014
Today's post is authored by Julius Young of the California Bar and shared from workerscompzone.com. This past Friday the California Commission on Health and Safety and Workers' Compensation (CHSWC) met in Oakland.