Proposed Regulations by the Calif. Division of Workers Compensation to Fine URO Called "Toothless Tiger" Approach to Dire Problem

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Accreditation of utilization review organizations demanded by injured worker activists

Advocates for California workers' compensation claimants are demanding accreditation of so-called utilization review organizations (or UROs) in response to recent proposals to toughen up penalties for URO slow authorizations by Carrie Nevans, the acting director of the California Division of Workers' Compensation (DWC).

"The DWC Audit Unit just doesn't have the manpower to follow-up on complaints submitted by injured workers to investigate UROs for untimely approval of medical benefits," said Larry Nign, an advocate for injured workers.

According to Nign he has posted a letter received by a workers' compensation claimant denying medical treatment requests submitted two years prior to the letter date. "If that isn't slow, I don't know what is," he said.

"Untimely utilization review is at the core of my federal appeal in the Ninth Circuit," said Barbara Clark (Clark vs. John Rea, 06-16333, U.S.C.A. 9th. Cir.), who is suing Nevan's boss John Rea, the acting director of the Department of Industrial Relations (DIR).

"I sent fifty (50) letters to the DIR and DWC about untimely and improper utilization review. I even spoke on the same Senate panel with Carrie Nevans in May to address this issue, still nothing has been done," she said. Clark believes all UROs handling workers' compensation claims should be mandated to be accredited by the national Utilization Review Accreditation Commission (see http://www.urac.org).

For more information on the issues see:

http://www.MyStateFundStory.com , http://www.AlmostBroken.com , http://www.BarbClark.org

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CHRISTINE PIETZ

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