The Division of Workers' Compensation (DWC) monitors the administration of workers' compensation claims, and provides administrative and judicial services to assist in resolving disputes that arise in connection with claims for workers' compensation benefits.
Workers' compensation is the nation's oldest social insurance program. It was adopted in most states, including California, during the second decade of the 20th century. The workers' compensation system is based on a trade-off between employers and employees.
The Division of Workers’ Compensation (DWC) monitors the administration of workers’ compensation claims, and provides administrative and judicial services to assist in resolving disputes that arise in connection with claims for workers’ compensation benefits.
Workers’ compensation is the nation’s oldest social insurance program. It was adopted in most states, including California, during the second decade of the 20th century. The workers’ compensation system is based on a trade-off between employers and employees. Employees are entitled to receive prompt, effective medical treatment for on-the-job injuries or illnesses no matter who is at fault and, in return, are prevented from suing employers over those injuries.
Unlike most social insurance programs, workers’ compensation benefits are not administered by a government agency. They are administered primarily by insurance companies and those employers secure enough to self-insure their workers’ compensation liability.
The Division of Workers’ Compensation has adjusted the fee schedules for hospital outpatient departments and ambulatory surgical centers to conform to Medicare payment changes that will take effect June 1. The attached order outlines the adjustments, which address changes due to the Centers for Medicare & Medicaid Services’ fiscal year 2017 inpatient prospective payment system and outpatient prospective payment system final rules. The new rates will apply to visits and procedures rendered on or after June 1. For more information, visit www.dir.ca.gov/DWC/OMFS9904.htm#6 or contact DWCFeeSchedule@dir.ca.gov.
A new report from the Department of Industrial Relations (DIR) Division of Workers’ Compensation (DWC) addresses the department’s continuing implementation of independent medical review (IMR), the dispute resolution process that uses medical expertise to obtain consistent, evidence-based decisions. IMR is one of the most significant components of SB 863, Gov. Brown’s landmark 2012 workers’ compensation reform. The report charts the program’s progress following its implementation in July 2013. In the second and third year of IMR, DIR and DWC took steps to reduce the average number of days to complete IMRs (from 56 days in late 2014 to 10 days by mid-2015), made program enhancements and began to collect and analyze data to improve decisions and outcomes for injured workers. More information is available at www.dir.ca.gov/DIRNews/2016/2016-106.pdf.