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  News

Department of Industrial Relations, Division of Workers' Compensation (DWC) Release Independent Medical Review (IMR) Report for 2023 Data
By Lonce Lamonte, adjustercom editor with DWC Newsline - June 20, 2024

The Department of Industrial Relations (DIR) and its Division of Workers’ Compensation (DWC) have posted an annual report on the Department’s Independent Medical Review (IMR) program. IMR is the medical dispute resolution process for the state’s workers’ compensation system that resolves disputes over medical treatment for injured workers. The report describes IMR program activity in 2023, the tenth year since the program was implemented.


The Independent Medical Review Organization (IMRO) administering the program, Maximus Federal Services, Inc., received 175,027 IMR applications, and issued 130,774 Final Determination Letters, each addressing one or more medical necessity disputes. Throughout the year, the IMRO issued decisions, on average, eight to nine days after receipt of all medical records.

This sends a very strong message -- Homeowners insurance company in Florida fined $1M: WPTV - West Palm Beach  May 11, 2024

WEST PALM BEACH, Fla. — Florida regulators issued a $1 million fine to one of the state's largest homeowners insurance companies on Thursday due to how it dealt with claims after Hurricane Ian, making this the second largest fine in the industry in Florida.

News

California DWC Posts Adjustments to Official Medical Fee Schedule (Physician Services / Non-Physician Practitioner Services)
By Lonce Lamonte, editor, with the DWC Newsline - June 18, 2024

The Division of Workers’ Compensation (DWC) has posted an order adjusting the Official Medical Fee Schedule (OMFS) to conform to ch...

Calif Division of Workers' Compensation Announces Plans to Take Corrective Action Regarding E Filer Errors
By Lonce Lamonte, editor, with the DWC Newsline - June 16, 2024

The Division of Workers' Compensation (DWC) has announced its plans to address e-filing practices that result in repeated system er...

California Division of Workers' Compensation (DWC) Posts Adjustment to Official Medical Fee Schedule (Ambulance Services)
By Lonce Lamonte, editor, with the DWC Newsline - June 14, 2024

The Division of Workers’ Compensation (DWC) has posted an order adjusting the Ambulance Services section of the Official Medical ...

Features

The Property Claims Investigation
By Barry Zalma, Esq. CFE - August 9, 2021

Insurers are large organizations with varying levels of authority for the payment of claims. The adjus...

People

Jake Jacobsmeyer, veteran workers’ compensation claims defense attorney who began as an applicants’ attorney, has now joined the law firm of Michael Sullivan & Associates.
By Lonce Lamonte - May 28, 2024

Jake Jacobsmeyer, a veteran California workers’ compensation defense attorney, just l...

 
 

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