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 […]

Rating by Analogy – WCAB Decision for Complex and Extraordinary Cases

The California 3rd District Court of Appeal ruled in a case with only subjective complaints and no objective findings that a worker’s condition does not need to be “complex” or “extraordinary” for a medical evaluator to rate it by analogy to another impairment, if this will yield the most accurate rating. See attached City of […]

DWC Posts RBRVS-Based Physician Fee Schedule and 2014 Updates Effective January 1, 2014

Pursuant to Labor Code section 5307.1(g)(2), the Division of Workers’ Compensation (DWC) has issued an Administrative Director Order posting adjustments to the Resource Based Relative Value Scale (RBRVS)-based physician services and non-physician practitioner services section of the official medical fee schedule (OMFS) to conform to changes in the 2014 Medicare payment system as required by […]

DWC Final Supplemental Job Displacement Benefit Regulations Approved

The Office of Administrative Law (OAL) has approved the Division of Workers’ Compensation’s (DWC) final version of the Supplemental Job Displacement Benefit (SJDB) regulations. OAL approved the SJDB regulations on November 8. Two sections have been repealed (10133.51 and 10133.52, which required the Notice of Potential Right to SJDB Benefit), effective immediately. The modifications to […]