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Archive | January, 2013

California Department of Industrial Relations Jump Starts Landmark Workers’ Compensation Reform To Protect Workers and Cut Costs

Posted on 08 January 2013 by admin

FOR IMMEDIATE RELEASE
IR #2013-01
January 04, 2013

CONTACT:
Erika Monterroza
Peter Melton
(510) 286-1161

Twitter @CA_DIR
facebook.com/CaliforniaDIR


California Department of Industrial Relations Jump Starts Landmark Workers’ Compensation Reform To Protect Workers and Cut Costs

Oakland, CA— The Department of Industrial Relations and its Division of Workers Compensation (DIR/DWC) today announced new regulations implementing provisions of Senate Bill 863, California’s landmark workers’ compensation reform signed last year by Governor Edmund G. Brown Jr. to save businesses millions of dollars in unnecessary costs while boosting worker protections.

“We are on track to implement the wide-ranging reform which was the result of extensive input by workers and employers,” said DIR Director Christine Baker. “These reforms are engineered to reduce unnecessary costs while redirecting some of the savings to increase benefits for disabled workers.”

Key components of Senate Bill 863, which became law on January 1, 2013, include a 30 percent increase in permanent disability indemnity rates for workers phased in over two years. Other aspects of the bill, including those designed to cut costs for businesses, will now be implemented through regulatory action. Today’s new regulations launch that full rulemaking process with public hearings scheduled to take place by March.
The new regulations, approved on an interim basis by the Office of Administrative Law, improve workers’ compensation by creating an independent medical panel to review injuries, streamlining billing disputes and curbing unnecessary liens. Details of these new regulations include:

Utilization Review, Independent Medical Review
For injuries on or after Jan. 1, 2013, and effective July 1, 2013 for all dates of injury, medical treatment disputes will be resolved by physicians through an efficient process known as independent medical review (IMR), rather than through the often cumbersome and costly adjudication system. If utilization review denies, delays or modifies a treating physician’s request for a specific course of medical treatment for the reason that the treatment is not medically necessary, the injured employee will have the right to request a review of that decision by IMR conducted by a physician. The physician review will be expeditious and based upon evidence-based standards to ensure that injured employees receive timely and appropriate medical treatment.

Qualified Medical Evaluator Regulations and PDRS
The new regulations amend existing rules to clarify that independent medical review is the sole process for resolving disputes regarding ongoing medical treatment issues; limits the number of offices from which a Qualified Medical Evaluator (QME) may conduct evaluations; streamlines the application process for chiropractors; allows for factual corrections of a comprehensive medical-legal report from a QME panel; and amends a number of forms.

Independent Bill Review
Medical service billing disputes for dates of service on or after Jan. 1, 2013, will be resolved through a non-judicial process of independent bill review (IBR). The IBR applies to any medical service bill where the fee is determined by a fee schedule adopted by the DWC. If the medical provider disagrees with the amount paid by a claims administrator on a properly documented bill following a second review, he or she can request an IBR. This regulation will eliminate unnecessary, costly litigation.

Electronic document filing and lien filing fee
Any lien for reasonable medical expenses incurred by or on behalf of the injured employee (except disputes subject to independent medical review or independent bill review) and filed on or after Jan. 1, 2013, is subject to a lien filing fee of $150. For those liens filed before Jan. 1, 2013, there will be a $100 activation fee which must be paid prior to Jan. 1, 2014, or the lien will be subject to dismissal by operation of law.

Self-Insurance and Annual Actuarial Reports
These new regulations will implement SB 863’s requirement for all private self-insured employers and groups to obtain an actuarial report to more accurately establish the organization’s California workers’ compensation liability exposure. The regulations will further define new methods in how the OSIP establishes security deposit collateral requirements based on this additional information.

Interpreter Services
SB 863 amended Labor Code section 4600(g) to state that an injured worker is entitled to the services of a “qualified interpreter” at medical appointments if the injured worker is not proficient in English. These regulations define the “qualified interpreter for purposes of medical treatment appointments” as “…an interpreter who has a documented and demonstrated proficiency in both English and the other language; a fundamental knowledge in both languages of health care terminology and concepts relevant to health care delivery systems; and education and training in interpreting ethics, conduct and confidentiality …” so that employers can furnish, and non-English-speaking injured employees can receive, interpreter services at medical treatment in accordance with the statute.

Supplemental Job Displacement Benefits
Makes modifications reflecting regulatory changes regarding offers of work, notifications and vouchers for retraining workers injured on the job.

Hospital outpatient departments and ambulatory surgical centers fee schedule
The statute also amended the official medical fee schedule for hospital outpatient departments and ambulatory surgical centers, reducing the facility fee for ambulatory surgical center services to 80 percent of what Medicare bills for the same services in a hospital outpatient. This change will save an estimated $62 million plus additional savings in system costs. The regulation is effective Jan. 1, 2013.

Extensive information on workers’ rights and employers’ responsibilities as well as information for small business owners can be found on DIR’s website. DIR’s rulemakingweb page includes a quick overview of regulations and is updated regularly.

The DWC, a division within DIR, monitors the administration of workers’ compensation claims, and provides administrative and judicial services to assist in resolving disputes that arise in connection with claims for workers’ compensation benefits. The DIR was established to improve working conditions for California’s wage earners, and to advance opportunities for profitable employment in California. DIR is a department within the Labor and Workforce Development Agency.

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VIAW Newswire 12.31.12

Posted on 02 January 2013 by admin

Record 8.82 Million Collected Social Security Disability Benefits

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NY: On the Street Roundup Two Workers Killed On Job

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VIAW Newswire 12.28.12

Posted on 02 January 2013 by admin

DaisyBill, California’s Only Workers’ Compensation Electronic Billing Solution, Opens Up Additional Client Invitations for January

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VIAW Newswire 12.27.12

Posted on 02 January 2013 by admin

Auto Cricket Corp. Will Pay Nearly $77K in Back Wages To 414 Employees

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California Labor Law and Pregnancy Complications

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Barry-Wehmiller Has A Funny Way of Valuing Its Employees

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Labor Beat Prop. 32 Via Social Media

Leaders of the California unions that spent $75 million to defeat Proposition 32’s union-busting campaign in November discovered something during the bruising battle: 40 percent of likely voters were not watching any Prop. 32-related TV commercials, even though the spots droned on nonstop throughout the fall.

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CA Teachers Fund Reviewing Firearms Holdings

The nation’s largest teachers’ pension fund announced Tuesday that it was reviewing its firearms holdings after determining that its investment in a gun maker was linked to one of the weapons used in last week’s Connecticut school massacre.

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VIAW Newswire 12.26.12

Posted on 02 January 2013 by admin

Injured Colombian Worker on Hunger Strike That Will Stop Only If GM Negotiates

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Bangladesh Garment Factory Fire: Another Triangle Shirtwaist Fire?

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Departure From Strict AMA Guides Rating Justified for Ankle Injury: CA Work Comp Rulings

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SC Mexican Restaurant Agrees To Pay Nearly $391,000 in Back Wages Workers After DOL Investigation

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US: Office Workers’ Tort Action Against Dentist Employer Alleging Sexual Assault

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VIAW Newswire 12.24.12

Posted on 02 January 2013 by admin

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VIAW Newswire 12.21.12

Posted on 02 January 2013 by admin

Employee Termination Because of Facebook Comments Does Not End Workers’ Compensation Benefits

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VIAW Newswire 12.20.12

Posted on 02 January 2013 by admin

EEOC Sues American Tool & Mold For Disability Bias

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VIAW Newswire 12.19.12

Posted on 02 January 2013 by admin

Employers Commend Progress To-Date on Workers’ Comp Reform

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Division of Workers’ Compensation posts lien filing instructions

Posted on 02 January 2013 by admin

Newsline No. 72-12
December 31, 2012
Twitter @CA_DIR
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Division of Workers’ Compensation posts lien filing instructions

The Division of Workers’ Compensation has posted step by step instructions on new lien filing requirements which go into effect January 1, 2013 as part of its implementation for Senate Bill 863.

An “at a glance” guide is included so that those filing or activating liens can refer to easily:

Filing a Lien

How to file a lien for medical treatment expenses and pay the lien filing fee:

  • Anyone filing a lien for reasonable medical expenses incurred by the injured employee and filed on or after Jan. 1, 2013 is required to pay a lien filing fee of $150.
  • The lien must be filed electronically by one of two methods: : E-Form or Jet File.

Activating a Lien

How to activate a lien and pay the activation fee:

  • A $100 fee must be paid for any medical treatment expense lien filed prior to Jan. 1, 2013 in the following situations:
  • A lien claimant files a DOR for a lien conference
  • On or before a lien conference if the lien claimant did not file a DOR
  • To activate and pay for a lien by E-form or JET File use the step by step instructions.
  • All liens will be dismissed as a matter of law if the activation fee is not paid by Jan. 1, 2014.

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