UR: Money Talk, Injured Workers Walk

As my college buddy ZQ used to say, “JT, money talk, bullshit walk.” In workers’ compensation and Utilization Review (UR), “money talk, injured workers walk.” In workers’ comp, UR is the process where medical treatment recommendations for workers’ comp injuries are either approved or denied.  If they are denied, the UR denial may be appealed […]

Us vs. Them

As a Past-President of a local Chamber of Commerce, I often have heard employers say: “Employees want a paycheck but they don’t want to work. Injured workers abuse the system as much as they can, taking advantage of loopholes to get Workers’ Comp benefits. The California Workers’ Compensation system is skewed too far in favor […]

My Workers’ Compensation Adjuster Requested A QME – What Does That Mean?

QUALIFIED MEDICAL EVALUATOR: Often a workers’ compensation adjuster will request a Qualified Medical Evaluator (QME) to provide a final expert medical report. A QME is supposed to be unbiased.  We always recommend an injured worker seek legal counsel before getting involved in the QME process as some medical reports do not feel unbiased for the […]

Workers’ Compensation: Medical Treatment Denied!

Workers’ comp patients are entitled to medical treatment for their on the job injuries according to the California State Constitution and Labor Code.   But why are Injured Workers treated like second class citizens when it comes to getting medical treatment that their doctors recommend? Legislative changes in 2012 (SB 863) took away Injured Workers’ rights […]

Workers’ Comp IMR: Take As Long As You Want

Independent Medical Review is the appeal process in workers’ compensation for Utilization Review denials of medical treatment.  The IMR appeal goes to an anonymous state assigned doctor who issues a binding, non-appealable decision. Labor Code § 4610.6(d) states that the decision shall be made within 30 days within receipt of the supporting documents.  The purpose […]

Missed the Deadline for RTWSP? It may not be too late!

DIR Issues Notice of Public Hearing on April 15, 2016 for Proposed Modification to Return-to-Work Supplement Program There are timelines associated with obtaining the Return-to-Work Supplement Program (RTWSP) check of $5,000.  At this time an application for the Return-to-Work Supplement (RTWS) must be received by the Return-to-Work Supplement Program within one year from the date […]

Workers Comp IMR

The Court of Appeals in Stevens ruled that workers’ compensation IMR does not violate the California Constitution.  IMR or Independent Medical Review, is the process in workers’ comp where a state-appointed, non-examining, anonymous physician spends less than 15 minutes and gets paid $60 to review medical treatment denials in workers’ comp cases, and issues a […]

Undocumented Workers ARE Entitled to Workers’ Compensation Benefits!!

Many undocumented workers are afraid to apply for workers’ compensation benefits due to their immigration status. What they do not understand is that they ARE entitled to workers’ compensation benefits similar to documented workers.  Undocumented workers may receive medical treatment, temporary disability payments, permanent disability payments and possibly a lifetime medical award. A lifetime medical […]

IMR Unconstitutional?

IMR Unconstitutional?   Workers’ compensation law has never really made sense. Is it workers’ comp, or is it employers’ protection?   Is workers’ comp law here for injured workers, to make sure injured workers get adequate medical treatment and fair compensation so they can recover, get back to work, and feed their families, or is it […]

Time Is Ticking Away For $5,000 Workers’ Compensation Return to Work Supplement Program!

Senate Bill 863 created the Return to Work (RTW) Supplement Program annual fund of $120 million.  This fund is supposed to provide supplemental payments to workers whose permanent disability benefits are disproportionately low compared to earning losses.  If eligible an injured worker will receive payment of $5,000 from the fund. To be eligible for the […]