RAND Corp. published its review of the (1) Technical Quality and (2) Clinical Acceptance of the Occupational Disability Guidelines (ODG) published by Work Loss Data Institute (WLDI). This paper briefly discusses the RAND report. Who Is Work Loss Data Institute...
First Comprehensive Study Evaluating EBM Guidelines in Comp Setting In recent years within the workers’ compensation (WC) arena, proponents of evidence-based medicine (EBM) have contended that managing an injured worker’s care according to established...
Beware of UR and IMR physicians who use MTUS, ACOEM, and ODG guidelines to deny treatment when, in fact, other MTUS, ACOEM, or ODG guidelines do support an RFA from a treating physician In Gonzalez-Ornelas v. County of Riverside , 2016 Cal. Wrk. Comp. P.D. LEXIS...
No material mistake of fact exists when IMR reviewer fails to list the actual reports and records reviewed by the IMR physician In Hacker v. County of San Bernardino-Public Health Department , 2015 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB, in a split panel opinion...
Greater medical consensus could reduce geographic variability A recent study published by the Journal of Occupational and Environmental Medicine suggests that there is geographic variation in the use of medical treatment guidelines that reaches beyond differences...
According to the Department of Industrial Relations Director Christine Baker, “ opioid misuse is a national concern ”. As a result of this “misuse”, the Division of Workers’ Compensation recently posted proposed “ Guidelines...
In Garcia-Picen v. Tight Quarters, Inc., the Appeals Board, in a split panel opinion, held that the WCJ incorrectly determined that the defendant’s UR of a treating physician’s request for authorization to provide viscosupplementation injections to...
Recent noteworthy panel decisions show that the applicant would be wise to present all relevant medical reports and records, and citations to the MTUS, ACOEM, ODG, or other nationally accepted medical standards to the IMR reviewer, and that when a material mistake...
After continued implementation of the 2005 reforms to the Texas workers’ compensation system, and legislative review of the system in 2011, 2013 was a year in which system stakeholders and other interested parties were able to step back and evaluate the current...
By Robert G. Rassp, Esq. The current trend across the country is to require evidence-based medicine for treatment of employees who are injured on the job. Statutory and regulatory mandates are emerging on a state-by-state basis. Stakeholders within the workers’...
By John Stahl, Esq. Phil LeFevre, who is a Senior Account Executive, with the Work Loss Data Institute (WLDI) spent much of a recent webinar entitled “Emerging Trends in Workers’ Comp Treatment Guidelines by State: Has the Fox Been Left to Guard the...