Once Again, Adjusters Save the Day
By Robert Warne - January 2, 2003On Nov. 17, 2003, Insurance Commissioner John Garamendi addressed members of the press regarding a number of topics that included the implementation of AB 227 and SB 228.
Garamendi explained how carriers hold the key to what kind of savings would ultimately be realized from the reforms effective Jan. 1, 2004.
“The ball is in their court,” Garamendi remarked about carriers writing workers’ compensation policies in the state.
The impact of the reforms will be the greatest if the carriers do their part and the Legislature provides the necessary clean up language for the bills. Once this is in place the judges will follow, according to Garamendi.
But in order for the industry to perform, carriers and TPAs must teach their adjusters the American College of Occupational and Environmental Medicine guidlines, he explained.
The guidelines the commissioner referred to are contained in ACOEM’s 2nd edition of its Occupational Medicine Practice Guidelines: Evaluation and Management of Common Health Problems and Functional Recovery in Workers.
The significance of the guidelines is that AB 227 and SB 228 stipulate that ACOEM Practice Guidelines shall be “presumptively correct on the issue of extent and scope of medical treatment.”
So what may seem like a daunting task to the rookies, for those steeped in California claims, there hasn’t been a Jan. 1 in recent years when adjusters haven’t had to grab the bull by the horns to deal with the pressures associated with the latest legislative tweaks. So as far as 2004 goes, it looks like it will be business as usual. | 
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