Links

• Workers' Compensation Appeals Board
• Commission on Health and Safety and Workers' Compensation
• Department of Insurance
• Employment Development Department
• State Compensation Insurance Fund
• More

Under the direction of an executive medical director, the Medical Unit performs a variety of services related to delivery of medical benefits in the workers’ compensation system. It establishes policy and guidelines for the treatment and evaluation of injured workers. The unit examines and appoints physicians to be qualified medical evaluators (QMEs), who in turn examine injured workers to help determine the level of benefits they receive. It also certifies and oversees groups -- medical provider networks (MPNs) and health care organizations (HCOs) -- that provide care to injured workers. The unit reviews utilization review (UR) plans and handles UR complaints and investigations jointly with the Audit Unit. It also assists the DWC administrative director with other issues affecting providers in the workers' compensation system, such as setting medical fee schedules, and undertakes medical care studies

Adapting the RBRVS Methodology to the California Workers’ Compensation Physician Fee Schedule

Managed care

• Medical provider network (MPN)
  
• Utilization review (UR)
  
• Health care organizations (HCO)

Med-legal programs

• Qualified medical evaluators (QME)
  

Official Medical Fee Schedule

• Official medical fee schedule (OMFS)

Mailing Address: DWC - Medical Unit P.O. Box 71010 Oakland, CA 94612	Street Address: DWC - Medical Unit 1515 Clay Street, 18th floor Oakland CA 94612
Telephone Number: 510-286-3700 or 800-794-6900

PLEASE NOTE: ALL PACKAGES, CERTIFIED MAIL AND PRIORITY MAIL MUST BE SENT TO THE STREET ADDRESS ONLY

May 2008