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blog updates

CWCI Study of IMR Shows Increasing Growth of System

5/17/2019

 
Link to CWCI Research Update by Rena David and Robby Bullis: "Independent Medical Review Decisions from January 2014 through December 2018".
  • More than 184,000 IMR requests flooded California’s workers ‘compensation system in 2018.
  • Interestingly, requests that were initially approved but modified, comprised a fair proportion the IMR requests.
  • IMR physicians upheld Utilization Review (UR) modifications and denials nearly 90% of the time.
  • The Bay Area and San Diego led with the largest increase in the number of requests and percentage growth respectively.

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Duty of Care Revisited -- all is not well in Hawaii or California

2/5/2019

 
by Dr. Robert Weinmann, MA - January 30, 2019 (Weinmann Report)
​
Duty of Care (King v. CompPartners) was reviewed in this column on 10/16/18.  The case involved the sudden discontinuation by a Utilization Review (UR) physician of patient Kirk King's klonopin. King filed suit based on negligence and malpractice because the UR doctor arbitrarily discontinued his medication and thereby caused him to have four epileptic seizures. Eventually the case went to the California Supreme Court which decided that "the exclusive remedy for disputes arising out of the UR process belongs to the workers comp system."  The case was remanded to the District Court. King was barred from pursuing a tort claim. 

We wrote in this column that the decision protects UR physicians from malpractice lawsuits. But Justice Mariano-Florentino Cuellar wrote in his opinion that it might be time for the California legislature to take a look at the law since it could now be argued that protections in the law for injured workers "may not be set at optimal levels and the legislature may find it makes sense to change them."

It makes no sense that treating doctors are subject to Duty of Care, a protective legal concept that protects patients from cavalier care, whereas by contrast UR doctors, who do not interview or examine the patients, are not. 

It makes sense to change the law so that both UR and IMR (Independent Medical Review) doctors can be brought under the same Duty of Care umbrella as their PTP (primary treating physician) counterparts. Legislative action is now an issue in Hawaii and California.

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