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Medical provider information

Topics on this page include
General information

Medical treatment information
Managing injured workers' claims
Disability rating
Retraining and return to work information

General information

Educational conference - the largest workers' compensation educational event in the state. Normally held in February and March in both Northern and Southern California, speakers from the Division of Workers’ Compensation and the private sector will address the most current topics and issues confronting claims administrators, medical providers, attorneys, rehabilitation counselors and others involved in workers’ compensation.

Certified Health Care Organization
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Frequently asked questions (FAQs) about MPNs

Memo to health care providers interested in joining an MPN acrobat image version

Current list of approved medical provider networks by name of applicant acrobat image version
Current list of approved medical provider networks by approval date acrobat image version

Information on reporting requirements for primary treating physicians

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Medical treatment information

Independent bill review

Independent medical review

Medical treatment utilization schedule

Submitted utilization review plans acrobat image version
This is a list of the groups that have sent actual utilization review plans to the Division of Workers' Compensation. The list does not contain the names of individual employers that might be covered by these plans. The plans have not been reviewed by DWC staff.
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Reporting suspected medical care provider fraud pursuant to Labor Code section 3823

Information for employers, physicians and insurers concerning first aid treatment for workers' compensation injuries

Employer and physician responsibilities for lead-exposed workers requiring medical removal protection acrobat image

Official medical fee schedule

e-billing

Standardized paper billing

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Managing injured workers' claims

Injured on the job? Need to know your rights?
¿Se há lesionado en el trabajo? ¿Necesita saber sus derechos?

Glossary of workers' compensation terms for injured workers
Glosario de términos de compensación de trabajadores para trabajadores lesionados

Workers' compensation reference materials
Libros de referencia de compensación de trabajadores
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Disability rating

Most workers fully recover from job injuries but some continue to have medical problems. Permanent disability (PD) is any lasting disability an injured employee experiences, which results in reduced earning capacity after maximum medical improvement is reached. If an injured employee’s injury or illness results in PD they are entitled to PD benefits. Check out our fact sheets and guides page and click on fact sheet D for more information on PD.

For injuries occurring on or after Jan. 1, 2013, there will be a new method for calculating an injured employee’s PD rating. A QME or treating physician can no longer increase an injured employee’s PD by adding impairment in the form of sleep disorder or sexual impairment unless such impairments were a direct result of the injury. In addition, no increase in an injured employee’s PD on account of a psychiatric injury is allowed unless the physical injury was catastrophic or the injured employee was the victim of or a witness to a violent crime

Permanent disability rating schedule - 2005 acrobat image
This schedule is effective for dates of injury on or after Jan. 1, 2005. This schedule will also be used to rate permanent disability in injuries that occurred before Jan. 1, 2005 when there has been either no comprehensive medical-legal report, or no report by a treating physician indicating the existence of permanent disability, or when the employer is not required to provide a notice to the injured worker under Labor Code section 4061.

Permanent disability rating schedule - 1997 acrobat image
This schedule is effective for dates of injury on or after Apr. 1, 1997

Permanent disability rating schedule - 1988 acrobat image
This schedule is effective for dates of injury on or after Jul. 1988

Answers to practitioners' questions about applying the permanent disability rating schedule

Medical report reference materials icrobat image
For cases rated under the 1997 or earlier rating schedules

Commutation templates and instructions .zip file
Templates and instructions to facilitate the calculation of life pension and permanent disability benefit commutations. When properly used, the templates assure that calculations are done in accordance with commutation calculation methods and tables that went into effect Jan. 17, 2001. The regulations and tables can be found in section 10169 and 10169.1 of Title 8, California Code of Regulations.
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Evaluation protocols - for injuries rated under 1997 permanent disability rating schedule and prior

Cardiac
Foot and ankle
Immunologic
Neuromusculoskeletal
Psychiatry
Pulmonary

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Retraining and return to work information

Getting employees back to work after an injury is one of the most important things you can do for them and their employers. Workers who return to the job as soon as medically possible have the best outcomes: They recover from their injuries faster and suffer less wage loss. You, the employer, the injured worker and the claims administrator should communicate openly and frequently for the best results.

An employer who qualifies for any of the existing return to work incentive programs will need to send information about work restrictions provided by you.
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April 2013