|Newsline No. 58-11||Printer friendly|
|December 14, 2011|
Division of Workers’ Compensation administrative director announces 2012 profile audit review and full compliance audit performance standards
Labor Code §§129 and 129.5, require the Audit Unit of the Division of Workers’ Compensation (DWC) to conduct a profile audit review (PAR) for all adjusting locations of California workers’ compensation claims at least once every five years. Performance of the adjusting locations is measured in five areas of claims administration:
The administrative director annually establishes profile audit review and full compliance audit (FCA) standards in accordance with Labor Code §§129(b)(1) and (2) and Title 8, California Code of Regulations §10107.1. The 2012 standards are based on the audit results of calendar years 2008 through 2010.
Performance standards for 2012
Assembly Bill (AB) 335 directs the administrative director of the DWC in consultation with the Commission on Health and Safety and Workers’ Compensation (CHSWC), to promulgate regulations that will establish a new system of plain-language benefit notices. DWC will be meeting with CHSWC to initiate the process of drafting new “user-friendly” benefit notices and the necessary informational material.
In light of AB 335’s amendment to Labor Code section 4658.5(c), when conducting audits in 2012, the Audit Unit will only review notices of potential eligibility for supplemental job displacement benefits due on or before Dec. 31, 2011.
More information on the performance standards that will be in use for the profile audit reviews and full compliance audits during calendar year 2012 is now posted on the DWC Audit Unit Web site.