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It seems that the DWC is listening.

Recently there has been an outpouring of concern from all quarters in the comp community about the DWC backlog in processing QME panel requests.

Those delays adversely affect employers and injured workers alike. Delays can adversely affect medical treatment and may in fact lead to increased indemnity costs.

The backlog has gotten so bad that workers’ comp judges are being asked to issue orders that panels be issued. One judge told me that the judge will honor such a request but did have concerns since it meant that the DWC would essentially be shuffling the deck of waiting requests.

But as any practitioner knows, some workers find themselves in dire straits as their group medical insurance expires and as they near the end of their eligibility for State Disability. Delays in getting a QME can put the worker in a desperate situation.

Responding to the concerns, the DWC issued a May 20, 2013 newsline, pledging to address the problem by looking at its root causes.

According to the DWC:
“The delays were eliminated in the past through significant amounts of overtime work by DWC staff as well as the use of temporary student assistants. While those efforts were successful in the short-term, they were not sustainable, leading to reoccurring problems in processing QME panel requests for represented injured worker cases.”

What will the DWC do about the problem? Here’s what they say:
“We are conducting a thorough review of the work processes and the applicable regulations, and exploring long-term solutions to reduce the amount of staff time required to process panel requests and make the process more efficient. A technological infrastructure repair is underway.”

It seems that part of their strategy is an assumption that the Independent Medical Review (IMR) process will lessen the volume of QME panel requests.
After all, after July 1, 2013, appeals of UR decisions will not be resolved through use of QMEs. That is a change that will apply to all cases, even cases involving decades-old injuries.

While panel QMEs will still comment generally on the need for treatment, PQMEs (and AMEs) will not be resolving specific treatment disputes.

So there may in fact wind up being less volume of PQME requests, leading to a shrinking backlog.

Meanwhile, here is what the DWC says:
“We are confident that the combination of re-directing resources, implementing new technology and the expected IMR-related decrease in panel requests will result in the permanent elimination of the processing delays. Thank you for your patience during this transition.”

I’m sure that all stakeholders look forward to updates from the DWC on what progress is being made to streamline the process.

Here is a link to the DWC newsline:
http://www.dir.ca.gov/dwc/dwc_newslines … f#zoom=100

Stay tuned.

Julius Young
www.boxerlaw.com
www.workerscompzone.com

Category: Medical treatment under WC

Julius Young

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