Red Flag UR Decisions: A 60-Second Seminar in Workers’ Compensation Claims Handling

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When industrial compensability is in dispute, either for an entire injury or for just a body part, claims administrators should act cautiously should a Request for Authority (RFA) be received. The RFA is not to be addressed by utilization review (UR).  Instead, pursuant to Labor Code §4610(l)&(m) and C.C.R. 9792.9.1(b)(1), the administrator should respond within …

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The Wimpy Syndrome: A 60-Second Seminar in Workers’ Compensation Claims Handling

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Have you ever heard of the “Wimpy Syndrome”? It occurs every few years when our state legislature considers workers’ compensation reform. The Wimpy Syndrome is named after a fictional cartoon character prominently featured in the original Popeye the Sailor comic strips of the 1930’s. J. Wellington “Wimpy” is a gourmet of the finest hamburgers money can buy, …

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