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Tuesday, December 9, 2014

Certain Uncertainty

Today's post was shared by WorkCompCentral and comes from

As the token Californian on the Blogger's Panel at the National Workers' Compensation and Disability Conference in Las Vegas yesterday, I drew fire from moderator Mark Walls, and a bit of derision from my fellow panelists.
"Mark, you know why California is so expensive?" I countered to his question to me about the cost of work comp in California. "Because it's worth it..."
At least I got the most laughter out of the attendees for the session.
But in all seriousness, California's issue isn't that the system is so expensive - as I implied to the audience in my quip to Walls: the state has always ranked high relative to costs.
That's not the issue. The issue is whether the California system delivers adequate and timely benefits to injured workers at a reasonable cost to employers. It doesn't have to be the cheapest, it doesn't have to deliver the most.
It just has to be reasonable, and in order to be reasonable it must be consistent, dependable, reliable; in other words, certain.
Utilization Review (and Independent Medical Review) is one of those things that was intended to bring some certainty to the medical treatment delivery process, but as we have seen that mission doesn't seem to be making it into operations.
Yesterday the Workers' Compensation Appeals Board certified an opinion as "Significant Panel," meaning it can be citable authority, about UR again, reinforcing the concepts discussed in the WCAB's second Dubon opinion about timeliness of a UR...
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