DIR, DWC Respond to Concerns Regarding Ongoing Home Health Care

The Department of Industrial Relations and its Division of Workers’ Compensation (DIR/DWC) have received inquiries regarding the denial of previously approved home health care services. Agreed-upon medical treatment must be honored, and California’s 2012 reform law, SB 863, did not change this. Under the 2012 reforms, unless a treating physician provides medical evidence of a […]

DWC Posts Adjustments to Official Medical Fee Schedule (Physician Services / Non-Physician Practitioner Services)

The Division of Workers’ Compensation (DWC) has posted an order adjusting the Official Medical Fee Schedule (OMFS) to conform to changes in the Medicare payment system as required by Labor Code section 5307.1. The Physician and Non-Physician Practitioner Fee Schedule update Order adopts the following changes: • National Correct Coding Initiative April 1, 2015 includes […]

Contact Information for Status of IMR Requests

The Department of Industrial Relations (DIR) and its Division of Workers’ Compensation (DWC) remain committed to improving California’s workers’ compensation system to ensure that injured workers can receive timely and appropriate medical treatment. The independent medical review (IMR) process allows injured workers who have been denied a specific course of medical treatment by a claims […]

DIR Reduces Fees for Independent Medical Review, Independent Bill Review

The Department of Industrial Relations (DIR) is pleased to announce a reduction in Independent Medical Review and Independent Bill Review fees effective January 1, 2015. IMR Fees Any IMR application submitted on or after January 1, 2015 will be subject to the following fee schedule: Standard IMRs Involving Non-Pharmacy Claims* • Fee effective April 1, […]

DWC Files Amendment to Official Medical Fee Schedule with Secretary of State, Posts Adjustment to Inpatient Hospitals Section

The Division of Workers’ Compensation (DWC) has adopted and filed an amendment to the official medical fee schedule (OMFS) with the Secretary of State. The amended regulation reiterates the applicable dates of fee schedule provisions that are declaratory of existing laws; addresses the operating disproportionate share hospital (DSH) adjustments to inpatient hospitals; addresses the inpatient […]

Co-Founder and Past Chair of the CAAA AMA Guides Committee

Medical Legal Experts is physician-owned and operated by practicing AMEs, QMEs & IMEs, so the only stake holders are members. We only accept physicians with honest and ethical reputations who are nominated by peers. “Medical Legal Experts is a leader in Medical-Legal evaluations. The quality of reports, with clear and accurate impairment ratings, makes their […]

Medical Legal Expert Forum

Medical Legal Experts is proud to present the following speaking invitaion events.  If you are interested in having a Medical Legal Experts Meical Expert speak at your organization, please contact us. Date Time Requested Topic Organization City State Onsite Tele Attendee Type1 2015-01-22 10:00 AM Diagnostic & Psychological Testing & Reporting:  Overview and Role in […]

UPDATES: QME EN BANC, HICFA & ICD-10

QME physicians should not expect to see the same previous applicants if they have a subsequent claim of injury or illness. This decision will create opportunities for new QME physicians as they will have opportunities to be selected. However, if the disputed medical issue is related to treatment and utilization review disputes, the applicant will […]

Medical Legal Experts Education Series for Insurance Carriers

Medical Legal Experts Educational Series for 2014. Join us at an event to learn more from our Medical-Legal Physicians.    6/10/2014 10:00 AM Ergonomic Assessments (1hr) Sedgwick Pleasanton CA 20 WC Adjusters 6/10/2014 11:00 AM FCE’s: Functional Capacity Evaluations (1hr) Sedgwick Pleasanton CA 20 WC Adjusters 6/18/2014 10:30 AM Healing Time for Acute Injuries (Sprain, […]

DWC Posted More Reductions in Fee Schedule Effective January 23, 2014

Many of you have started the transition within the California Workers’ Compensation to the RBRVS, today the Division of Workers’ Compensation (DWC) made further changes. These changes include additional reductions for Physician reimbursement rates for treatment of injured workers. The DWC has posted an order adjusting the Physician Services and Non-Physician Practitioner Services section of […]