Q2 – 2021 – October 14, 2021
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Research COVID-19 Claim Data as of June 14. Data though mid-June showed the steady downtrend in COVID claims that began in January of this year was continuing, with only 522 COVID-19 claims with May injury dates (1.3% of all claims reported at that point for May). That was less than half of the 1,222 COVID claims reported for April, less than one third of the 1,810 claims reported for March, and more than a 98% decline from the record 42,861 claims reported for December, before COVID vaccines became available. Despite the sharp decline in COVID-19 claims, from March 2020 through May 2021 COVID cases have accounted for 18.7% of all Calif WC claims, and within that time frame there has been a notable shift in the distribution of COVID-19 claims by industry with health care workers accounting for a declining share of all COVID-while public safety/government, retail, and transportation workers’ shares increased. The number of COVID death claims rose by 45 in May, bringing the total since the pandemic began to 985. Executive Briefing (6/18/21) (members only) California WC Direct Written Premium and Rankings of the 25 Largest Insurers for 2020. CWCI’s review of the NAIC data on California workers’ compensation direct written premium for 2020, including the rankings of the 25 largest WC writers in the state. The data show that total DWP, driven by the ongoing decline in insurers’ average charged rates and relatively flat payroll levels, fell by 11.4 percent in 2020, dropping to an 8-year low of $10.11 billion, as all but two of the state’s 25 largest insurer groups collected less premium in 2020 than in 2019. Bulletin (5/27/21) (members only) The Impact of Senate Bill 335: A Preliminary Analysis. A CWCI report examines SB 335, a bill that would cut the amount of time claims administrators have to investigate job injury claims and increase employers’ liability for medical benefits during the investigation period by 70%. The analysis concluded that despite the intent of SB 335, it is unlikely that claims adjusters can unilaterally expedite much of the investigation process, which requires a coordinated, cooperative effort on the part of all parties. Reducing the investigation period by half and increasing employers’ liability for medical treatment benefits during the investigation period by 70% is likely to generate unintended consequences. Decreasing the investigation period to 45 days would actually reduce access to medical treatment and would likely increase the number of provisional denials. Provisional denials due to lack of cooperation or available documentation, the inability to schedule a panel qualified medical evaluator, and other issues will likely trigger more litigation as well as increases in allocated and unallocated loss adjustment expenses related to the investigation process. As a result, recent improvements in the overall health of the California workers’ compensation system in reducing litigation, flattening medical inflation, and reducing expenses could be jeopardized. Executive Briefing (5/19/21) (members only) Impact Analysis Report (5/6/21) (public) Bulletin (5/6/21) (members only) News Release (5/6/21) (public) COVID-19 Claim Data as of May 17. The May 17 update to CWCI’s COVID-19/Non-COVID-19 App showed COVID-19 claim numbers continued to fall, as the DWC recorded 1,078 COVID-19 claims with April injury dates – only 2.6% of all claims from that month, and the lowest monthly total since February 2020. The COVID claim count showed a precipitous decline from January-April 2021 as COVID vaccines became widely available, while much of the state’s workforce continued to work remotely. CWCI’s updated projections estimated there would ultimately be 43,866 COVID-19 claims for December; 22,329 for January; 4,132 for February, 1,968 for March, and 1,455 for April. In 2020, the total projected monthly claim volume, including COVID claims, hit a low of 34,654 claims in April, the first full month following the governor’s stay-at-home order, while CWCI’s updated projection estimated that there would ultimately be 52,363 claims for April, up 51% from a year earlier. However, for the 12 pandemic months spanning May 2020 – April 2021, the differential was much smaller, as CWCI projected 680,941 total workers’ comp claims, up 3% from 658,698 claims projected for the corresponding period from a year earlier. Executive Briefing (5/19/21) (members only) Q1 2021 IMR Data. CWCI’s review of Q1 2021 independent medical review outcomes shows there were 33,043 IMR letters with decisions on 52,332 primary medical requests, so total letter volume was down 15.2% from the corresponding period of 2020 (though the pandemic didn’t really get started until mid-March of 2020) while the number of decisions within the letters was down 10%. The sharp decline in IMR letter volume that started in April 2020 began to narrow by September, though monthly letter volume remained lower than the year-earlier figures through March of this year. As has been the case since IMR first took effect, 90% of denied or modified treatment requests submitted to IMR were upheld by the IMR physician, with the overall uphold rate for the first quarter of 2021 coming in at 90.7%. Rx drug requests were still the #1 medical service request submitted to IMR, but in Q1 2021, they accounted for 36.7% of IMR decisions, so their share has continued to dwindle since peaking at 49.9% in 2015. Executive Briefing (5/19/21) (members only) 2020 Insured Experience.WCIRB’s report on Q4 2020 insured experience noted that between CY 2019 and 2020, Calif WC DWP declined by $2 billion, or 13%, from $15.9 billion to $13.9 billion, primarily due to decreases in average insurer charged rates, as payroll levels were relatively flat, while the average charged rate per $100 of insured payroll fell 9% from $1.95 in 2019 to $1.77 in 2020, for a net decline of 40% since the 2014 peak. Given the ongoing decline in premium rates, the WCIRB projects the AY 2020 combined ratio, including COVID-19 claims, will jump by 7 percentage points, from 95% to 102%, which would be 23 percentage points higher than the low point in 2016. But excluding COVID-19 claims, the WCIRB projects insurers’ combined ratio for 2020 will be 96% — more in line with the 2019 combined ratio. While overall claim volume (both indemnity and M-O claims) fell well below the year-earlier level when the pandemic hit and Gov. Newsom issued the statewide stay-at-home order in the 2nd quarter of 2020, the WCIRB notes that indemnity claim volume in the 3rd and 4th quarters rose to level that were higher than in the last half of 2019, as more than 16,000 COVID-19 indemnity claims were filed through December 31, 2020. Executive Briefing (5/19/21) (members only) COVID-19/Non-COVID-19 App Updated With Claims Data Reported As Of 05/03/2021. CWCI updated the COVID-19/Non-COVID-19 Interactive Claims Data App, including data on claims from March of AY 2019 through April of AY 2021 reported to the DWC as of May 3. Those claims included 144,116 COVID-19 claims reported from January of last year through May 3 of this year (914 of which were death claims). The claim count for the 14 months ending April 30 showed 715,591 workers’ comp claims of which 143,872 (20.1%) were COVID-19 claims. Updated monthly figures showed that after peaking at 42,365 claims in December 2020, the number of COVID-19 claims plummeted, with monthly totals as of May 3 falling to 21,295 in January; 3,842 in February; 1,707 in March; and 752 in April. More claims from those months were still being reported, but the pace had slowed and CWCI’s ultimate claim projections also showed the sharp decline in the first 4 months of 2021, with estimates showing the COVID-19 claim count would be 22,277 for January; 4,126 for February; 2,014 for March; and 1,316 for April. That would put COVID-19 claim counts will be well below figures from a year earlier when the governor first declared the pandemic and ordered non-essential businesses to shut down and non-essential workers to shelter at home. Executive Memo (5/11/21) (members only) CWCI IMR Findings for 2020 Confirmed by the DWC. DWC’s annual report on the Independent Medical Review (IMR) process describes IMR activity in 2020, the 8th year since the program was implemented. Maximus, the organization under contract with the DWC to administer the IMR program, received 184,100 IMR applications, and issued 136,740 Final Determination Letters addressing one or more medical disputes. (This tracks with the letter count noted in CWCI’s Research Update report on IMR published April 1). In the first half of 2020, DWC notes that IMR activity slowed as the pandemic hit, but IMR volume picked up in the second half of the year. On average, in 2020 it took Maximus 8 to 12 days from the receipt of all medical records to issue a decision letter, well within the statutory timeframe. Executive Briefing (4/30/21) (members only) COVID 19 Claim Data as of April 23. The April 23 update to CWCI’s COVID-19/Non-COVID-19 Interactive Claim App included data on California work injury claims from both the pre-pandemic and pandemic periods, encompassing 1,368,565 claims with dates of injury from January 1, 2019 through March 31, 2021 reported to the DWC’s Workers’ Compensation Information System. The app showed that after surging to a record high at the end of 2020, California workers’ compensation COVID-19 claim volume fell dramatically in the first quarter of this year, with the April 19 tally showing that the DWC recorded only 1,577 job-related COVID-19 claims with March injury dates, the lowest monthly total in over a year. The addition of the March claims brought the total COVID-19 claim count for the 15 months since the pandemic began to 142,513 cases, while the total number of death claims reported as of April 19 was 883. Bulletin (4/23/21) (members only) AB 1465 and Medical Provider Networks in California Workers’ Comp. A CWCI analysis of a 2021 legislative proposal (AB 1465) intended to increase injured workers access to medical care by requiring the state to create a medical provider network (CAMPN) as an alternative to private networks that render 90 percent of California workers’ compensation treatment. The report provides background information on the use of medical networks in California workers’ compensation, reviews how the proposed statewide network would be structured, and evaluates the potential for improving injured worker access to care. The analysis includes data on time to initial treatment and injured worker proximity to treating providers for current MPN and non-MPN claims, shows the percentage of injured workers treated within and outside MPNs who meet the states access to care standards, notes the average distances these workers must travel to receive primary care and surgery services, with results broken out for urban, suburban and rural residents, and estimates the cost of building and maintaining the CAMPN. Impact Analysis Report (4/15/21) (public) News Release (4/15/21) (public) IMR Decisions: January 2014 Through December 2020. A CWCI Research Update report documenting the sharp decline in IMR volume in 2019 and 2020, fueled by the reduction in prescription drug IMRs and the economic slowdown brought on by the COVID-19 pandemic in 2020. The report also looks at the distribution of IMRs and IMR outcomes by medical service category, regional distributions, IMR response times, and examines the distribution of pharmaceutical IMRs among therapeutic drug groups. Executive Briefing (4/1/21) (members only) Research Update Report (4/1/21) (public) Bulletin (4/1/21) (members only) News Release (4/1/21) (public) COVID-19 Claim Update. Data from CWCI’s COVID-19 Application, compiled as of March 22, showed COVID-19 claim volume continued to plummet in February, declining 83 percent from 20,389 claims in January to just 3,467 claims in February, and that came after the COVID claim count fell by more than 50 percent between December and January. The December claim count of 42,233 claims represents the record high since the pandemic began. CWCI’s updated projection estimated 43,802 claims for December; 22,836 for January; and 4,507 for February. Total WC claim volume for the 12 months ending in February 2021 was 626,212, down 9 percent from the 12-month total from the corresponding total from a year earlier, though the Institute projected that differential would shrink to just 5 percent as additional claims from the past year are ultimately reported. CWCI’s App contained data on more than 1.3 million claims from the baseline and pandemic periods, including the nearly 139,203 COVID-19 claims reported as of March 22 – 804 of which were death claims. Executive Briefing (4/1/21) (members only)
Statutory/Regulatory Cal/OSHA COVID-19 Temporary Standards. Following a contentious public hearing on June 3 Cal/OSHA adopted and sent to OAL amended emergency temporary standards (ETS) to protect workers from COVID-19, including requirements for face coverings, physical distancing, prevention programs, exclusions from work sites following contact with someone who has COVID-19, and COVID protection measures when employers provide employee housing and transportation. But facing criticism that its standards conflicted with DPH’s COVID-19 standards for the general public — esp. DPH’s new mask rules – on June 9 Cal/OSHA withdrew the COVID ETS that it had approved days earlier, and two days later issued and approved amended regs removing the mandate that fully vaccinated employees wear a mask indoors if unvaccinated employees are present; the physical distance requirement in non-outbreak settings; and adding requirements that employers make N95 masks available to unvaccinated employees if requested and document employees’ vaccination status in order to relax any rule related to fully vaccinated workers. But the revised ETS was still subject to a 10-day OAL review, so even though the state lifted most of its COVID restrictions on June 15, the earliest Cal/OSHA’s revised ETS could take effect was June 28 — and until then the original, stricter ETS would remain in place. To address that 11-day gap, after the June 17 meeting Gov. Newsom issued an Executive Order to codify the amended regs so they could take effect immediately. Executive Briefing (6/18/21) (members only) Fed-OSHA Looks to Restore Injury & Illness Reporting Requirements. The Biden Administration, looking to restore Fed-OSHA regs scuttled under the Trump Administration, wants to reinstate 2 Fed-OSHA work injury and illness recordkeeping regs. The Dept. of Labor’s regulatory agenda released in early June included a proposal to require establishments with 250 or more employees to submit injury and illness data from their OSHA Forms 300 and 301 electronically. Currently, employers only need to submit an annual summary of injury and illness data (Form 300A) but not the more detailed OSHA 300 and 301. The proposal would be a return to OSHA’s 2016 Improve Tracking of Workplace Injuries and Illnesses rule, which was modified in 2019 to require only Form 300A. A notice of proposed rulemaking is scheduled to be published by the end of this year. Also of note, the Labor Dept’s latest regulatory agenda has moved OSHA’s standard on infectious diseases into the proposed rule category. Such a standard would aim to protect employees at health care facilities, labs, correctional facilities, homeless shelters, coroners’ offices, mortuaries, and other work sites where workers may face an increased risk of exposure to long-standing infectious disease pathogens (i.e., TB, chickenpox, measles), as well as newer infectious disease hazards such as SARS, MRSA, and COVID. A notice of Proposed Rulemaking should be published in December, about 6 months after OSHA issued its emergency temporary standard on COVID-19 focused on health care workers. Executive Briefing (6/18/21) (members only) June Update on WC Bills. State lawmakers acted on several WC bills to beat the deadline for advancing bills out of their house of origin. Those bills included SB 335 (Cortese), which would have cut WC investigation periods for most claims to 45 days (and to 30 days for first responder claims covered by presumptions); increase employer liability for medical benefits during the investigation to $17,000, and for a subset of claims, increase penalties for unreasonable payment delays. A CWCI analysis concluded that SB 335 was unlikely to expedite claim decisions since the investigation process requires a coordinated, cooperative effort among all parties – not just claims adjusters — and that reducing the investigation period and increasing employers’ liability for medical care until a claim is accepted or denied would reduce injured workers’ access to care and increase provisional denials, likely triggering more litigation and increases in ALAE and ULAE related to investigations. That analysis put the bill in a new light and quashed its momentum in Sacramento. Other WC bills moving forward: AB 334 to extend the skin cancer presumption to Dept. of Parks & Rec and Fish & Wildlife peace officers; AB 284 to extend the PTSD presumption to additional peace officers and employees in certain state departments as well as public safety dispatchers, AB 404 to require the DWC to review the MLFS every 2 years to adjust the conversion factor to reflect changes in Medicare’s Economic Index; AB 872 to extend §4850 benefits to CalFire firefighters; and AB 1465 which called for CHSWC to conduct a study on injured worker access to care in MPNs. Executive Briefing (6/18/21) (members only) 30-day Public Comment on Workplace Mental Health Guideline. CWCI’s comments in response to the §9792.23.8 Workplace Mental Health Guideline: Anxiety Disorders scheduled for 30-day Public Hearing on June 11, 2021. 30-Day Public Comments (6/11/21) (public) CDI Issues 2021 WCAC Data Call, Submission Deadline Extension Requests Must Be Emailed by June 25. The Department of Insurance issued formal notice advising all workers’ comp insurers in the state of their 2021 workers’ compensation adjuster certification and medical bill review data (WCAC-2021) reporting obligations. The annual report is required under Ins. Code §11761 and CCR, Title 10, Chapter 5, Subchapter 3, §§2592–2592.08. As was the case in 2020, the 2021 data call was issued a month later than usual but announced submission deadlines were not automatically extended. According to the data call, insurers must return the WCAC-2021 Acknowledgement of Receipt Form no later than June 11, while the WCAC-2021 Data Workbook and affidavit are due no later than July 6, 2021. The June 11 deadline for submitting the Acknowledgment of Receipt Form was firm, but CDI would allow companies to request a 10-day extension (to Friday, July 16) for submitting the WCAC-2021 data workbook if they emailed their requests with their company name and NAIC number to the designated CDI contact by June 25. Executive Memo (5/24/21) (members only) 1st Forum Comments on Proposed Changes to the Qualified Medical Evaluator regulations. CWCI’s written testimony on the DWC’s proposed changes to the QME regulations. 1st Forum Comments (5/14/21) (public) 30-Day Comments on the Proposed MTUS Update. CWCI’s written comments on the DWC’s proposed addition of ACOEM’s Covid-19 Treatment Guideline to the MTUS. 30-Day Public Comments (5/14/21) (public) MPN Bill Amended Following CWCI Impact Study. Assemblymember Eloise Reyes, who authored AB 1465, the controversial bill that proposed the creation of a statewide medical provider network (CAMPN) to treat injured workers as an alternative to existing employer sponsored MPNs amended the bill following the release of a CWCI study that found that the CAMPN would increase workers’ comp medical costs and require at least $314 million a year in ongoing administrative and infrastructure expense but would be unlikely to improve access to care. The amended bill deletes language that would have required the DWC to implement the CAMPN by 6/30/22 and added language that would require the Commission on Health and Safety and Workers’ Compensation to conduct a study comparing claims treated inside and outside MPNs. Executive Briefing (4/30/21) (members only) Member Advisory: 2021 WCAC Data Call Delayed. Pursuant to IC §11761 and CCR, Title 10, §§2592 – 2592.08, workers’ comp claims organizations must submit data annually to certify with the CDI that their claims adjusters, including those working for medical billing entities, meet the minimum standards of training, experience, and skill needed to perform their duties with regard to workers’ compensation claims. The Workers’ Compensation Adjuster Certification (WCAC) data call used for this certification has typically issued in April, but last year it was not issued until the end of May due to delays related to the pandemic. The 2021 WCAC data call was not issued by the last week of April so CWCI contacted CDI’s WCAC Data Call Team Leader who advised that the 2021 WCAC Data Call was scheduled to be released May 21. A circular with instructions and applicable due dates will be issued on the same day. The Institute advised that it would issue an alert to members as soon as the information was released. Executive Memo (4/27/21) (members only) 1st Forum Comments on Proposed Changes to the Disability Evaluation Unit Regulations. CWCI’s written testimony on the DWC’s proposed changes to the DEU regulations. 1st Forum Comments (4/7/21) (public) Confusion Over Bill Calling for MLFS Updates. Amendments to AB 404 (Salas) added ambiguous language that appeared to require the DWC to review the newly minted Med-Legal Fee Schedule and adjust the allowable fees based on the percentage change in the Medical Economic Index at least every six months. As originally introduced, the CSIMS-backed bill would have required the DWC to review and update the fee schedule annually, but amended language called for reviews “biannually,” which means twice a year, or semiannually, as opposed to biennially, which means every other year. The principal consultant to the Assembly Insurance Committee noted that the intent was not to require a review of the MLFS every six months or every year, but every two years – which would be biennially. The committee worked with Salas’ office and the Office of Legislative Counsel to submit clarifying amendments before hearing the bill in April. Executive Briefing (4/1/21) (members only) Fed-OSHA Inspections & Enforcement of ERs w/High COVID Risk. Fed-OSHA launched a program in March to expand inspection and enforcement efforts for companies with workers who are at high risk for contracting COVID-19. The “COVID-19 National Emphasis Program” is a response to President Biden’s Jan. 21 executive order on protecting worker health and safety. OSHA announced the program will be in effect for at least a year and will prioritize enforcement of retaliation standards, focusing on “employers that retaliate against workers for complaints about unsafe or unhealthy conditions.” Last year, Fed-OSHA under the Trump Administration encouraged employers not to retaliate against workers who report unsafe working conditions, reminding them it is illegal to retaliate against those who report unsafe and unhealthy working conditions related to the pandemic, but the new Administration signaled it intends to take a harder line. Executive Briefing (4/1/21) (members only) 2021 COVID-19 Supplemental Paid Sick Leave. SB 95 (Skinner) signed on 3/19/21 by Gov. Newsom, took effect March 29. The new law mandates that public and private employers in Calif with more than 25 employees provide up to 80 hours of COVID-19 Supplemental Paid Sick Leave, subject to a maximum of $511 per day and a total of $5,110 retroactive to 1/1/21. The bill did not specifically address workers’ comp, but because paid sick leave benefits that are specifically available in response to COVID-19 must be exhausted before TTD on a COVID-19 WC claim commences, and because SB 95 made no provision for insurers to recover TD payments for lost time w/in the retroactive period, to avoid double recovery of benefits employers and claims administrators should keep an eye on COVID-19 claims if TD was paid in the first quarter of 2021 or the worker requests retroactive paid sick leave. SB 95 also added new qualifying reasons for the supplemental paid sick leave, including getting the COVID-19 vaccine and recovering from symptoms related to the vaccine, and required employers to display a poster that the Labor Commissioner issued 2 weeks earlier. If employees are working remotely or do not otherwise frequent the workplace, employers may satisfy the notice requirement by distributing the notice via e-mail or other electronic means. The Labor Commissioner also posted an FAQs page that addresses many of the questions employers may have, including coverage, allowable reasons for taking leave, requirements for requesting leave from an employer, calculating the appropriate amount of leave, recordkeeping requirements, etc. Executive Briefing (4/1/21) (members only)
Legal APPLIED MATERIALS V. WCAB. In the latest confirmation that there is no “alternate path” to a finding of total disability under Fitzpatrick, the Court of Appeal overturned a WCAB finding of 100% disability for an injured worker who claimed psychiatric injury (PTSD) after she became involved in a sexual relationship with the PTP for her underlying orthopedic industrial injury. The Award was based on a psych QME finding that applicant was totally disabled because she was unable to work due solely to PTSD, and under Hikida, the entire disability was the result of industrial medical treatment. Because the QME used an incorrect legal standard, the Court of Appeal reversed and remanded for further proceedings. CWCI acted as amicus and obtained publication of this decision. Significant Decision Summary (6/2/21) (members only
Other CWCI 2021 Case Law Update Program Now Available as an On-Demand Webinar. On May 18, CWCI presented its 23rd Annual California Workers’ Compensation Case Law Seminar as a live, on-line event. The Institute recorded the 5-hour program, and it is now available to members and other workers’ compensation stakeholders as an on-demand webinar. The cost for CWCI members is $189, the cost for all others is $289. MCLE and CEU credits are available to attendees who complete the program. For more information or to register, go to the Seminar section under the Store tab at www.cwci.org. Executive Briefing (6/18/21) (members only) News Release (6/9/21) (public) Minutes from the Legal Committee Meeting. The meeting was held by teleconference on May 13. Ms. Langille announced that the Appeals Court recently decided to publish its ruling in a compensable consequences case, Applied Materials v. WCAB (D.C.): Hikida / Fitzpatrick but given the split nature of the decision, noted that the parties may file an appeal at the Supreme Court (deadline July 10). She also reviewed the ruling in Starstone National Ins. v. Scaffold Solutions, a case involving Subrogation and Representation, that the Executive Committee decided did not merit amicus participation. Mr. Allweiss reminded the group that CalChamber had joined with CWCI in the amicus effort in Applied Materials and noted that other possible amicus cases were believed to be coming up for consideration shortly. The committee heard an update on recent regulatory activity involving the MTUS, Cal-OSHA’s COVID Emergency Treatment Standard, the newly adopted Med-Legal Fee Schedule, QME, and DEU regs. The legislative review covered AB 399, which prohibits MPN contracts from paying less than OMFS and provides for penalties if an MPN fails to meet access standards for a given specialty and fails to authorize treatment outside of the MPN; AB 404 which was amended to authorize (rather than require) updates to the MLFS; SB 788, CAAA’s latest attempt to prohibit consideration of multiple nonindustrial factors when determining apportionment and SB 95 which provides 2 weeks of COVID supplemental paid sick leave retroactive to January 1 for any employee who has symptoms of COVID-19, cares for a family member, or even obtains a vaccination. It was noted that AB 1465, the proposal to establish a state-run MPN was reduced to a study bill following a CWCI impact analysis; while CWCI had also just issued an analysis on SB 335, a bill that would have sharply reduced the time allowed for workers’ comp claim investigations. The committee reviewed examples of how some stakeholders have addressed the new QME regs and Ms. Langille shared recent comments and strategies for applicants’ attorneys presented at the recent CAAA conference. It was noted that WCAB remote hearings would continue for a while, but that trials would be first to return; recent information and tips from the LifeSize training was presented. The committee also discussed practical difficulties associated with the required Declarations under the new MLFS – particularly where records are submitted by someone other than the claims examiner, and the issue of identifying a date of injury in COVID-19 cases. Meeting Minutes (5/13/21) (members only) Minutes from the Claims and Medical Care Committees Meeting. The meeting was held via teleconference on April 14. Discussions included a review of regulatory activity in regard to proposed regs in the following areas (Disability Evaluation Unit regs; MTUS treatment guidelines; MLFS changes effective 4/1/21; QME telehealth and electronic service; Cal/OSHA Covid19 Temporary Emergency Standards; WCAB Rules of Practice & Procedure) and anticipated regs governing the Copy Service Fee Schedule; Utilization Review; QMEs; the Interpreter Fee Schedule; and the Home Health Fee Schedule. Mr. Swedlow and Ms. David provided highlights of recent CWCI research on COVID-19 and treatment access; IMR volume and outcomes through Q1 2021, and the potential impact of two bills: AB 1465 (the CAMPN proposal); and SB 335 which would reduce the injury denial timeframe from 90 to 45 days and increase employer liability to pay for medical treatment from $10,000 to $17,000 during the initial investigative period. Ms. Secia reviewed key provisions of the 2020 DIR and DWC Independent Bill Review (IBR) Report (the new tighter audit standards and issues specific to DWC claim administrator audits. Ms. Langille provided a legal update, discussing the significant panel decision in Gao v. Chevron and CWCI amicus work in Applied Materials v. WCAB, and noting the governor signed SB 95 which guarantees employees of companies with 25 or more employees up to 80 hours of COVID-19-related sick leave. The staff presentations were followed by a guest presentation by DWC Audit Manager Christina Fennimore, who discussed the Compliance process, Target Audits, Annual Audit Performance Reports, and SB 1159, and answered questions from Committee members. Meeting Minutes (4/14/21) (members only) 2021 Case Law Update. CWCI announced it would conduct a live broadcast of our 23rd annual Case Law Update Seminar on Tues, 5/18/21 from 9 a.m. to 3:30 p.m. The Institute’s case law seminar is the longest-running program of its type in the industry. The faculty included defense attorneys Saul Allweiss of the Offices of Allweiss, McMurtry, & Mitchell, and Richard Jacobsmeyer of Shaw, Jacobsmeyer, Crain, & Claffey, and applicant attorney Elizabeth Hudson of the Law Offices of Scot Shoemaker. The sessions were moderated by the CWCI General Counsel, Ellen Sims Langille, an expert in WC appellate law and procedures. Continuing Ed units were offered to attorneys, claims examiners, and hearing reps, and discounted tuition was available to CWCI members. Executive Briefing (4/1/21) (members only) Executive Briefing (3/23/21) (members only) CWCI Med-Legal Fee Schedule Webinar and 2021 Annual Meeting Available Online. In early March, CWCI presented our 57th Annual Meeting and our 1-hour training program on the new Med-Legal Fee Schedule as virtual events. Both programs were recorded and the Institute is now pleased to offer them as free, on-demand webinars to our members who were unable to attend or who would like to view them again. Executive Memo (3/23/21) (members only) Executive Briefing (4/1/21) (members only) CWCI Quarterly Summary. Quarterly listings of all CWCI publications, including publication dates, brief summaries of each topic and the various formats in which the information is available (e.g., research report, Bulletin, Executive Briefing, news release), so users can choose the level of detail they want to view. Listings include live links so users can click into the CWCI website to access specific documents quickly and easily. |