Who must send relevant medical records to IMR?
The reg seems to say two things. Short answer, the insurance carrier is required to.
Under 9792.10.5(b)(1) the IMR reviewer “shall receive from the employee”.
The courts are ruling that claims administrators must send records, see Diane Garibay-Jimenez (ADJ 65552734) June 2015); failure to do so is grounds for appeal:
“The WCAB stated that Labor Code § 4610.5 (l) places a mandatory obligation on the employer to forward all relevant medical records to IMR. Further Administrative Director Rule 9792.10.5 also mandates that [Maximus] receive from the claims administrator all reports of the physician relevant to the employee’s current medical condition…The WCAB went on to state there is no statutory or regulatory obligation placed on the applicant to submit medical records to the IMR organization. Therefore,
“Defendant’s failure to provide the relevant medical records to the IMR organization constitutes grounds for appeal,” –full article here.
Applicants MAY send relevant records to IMR based on the principle of independent discovery, through any copy service of their choosing.
Is Black’s Law Dictionary available in a phone/iPad App?
Yes, click here! Recently, West updated its Law Dictionary App to fit the iPad and the new version comes with quite an impressive set of bells and whistles, well worth the price tag, according to one reviewer.
Must the claims administrator pay for additional sets of records (second sets)?
A. Yes. The regs specifically say that “the claims administrator is liable for one additional set of records. All other additional sets of records are payable by the party ordering the additional set. Click here to see the full list of Q+A on the post-SB 863 fee schedule
How much can a custodian charge for the Release of Information when records are subpoenaed?
This question came from the defense, from applicants, from medical locations, employers, and insurance** carriers, even saw the question blogging around on the internet.California Evidence Code section 1563 explains. Under Evidence Code section 1563, subdivision (b)(1)-(3), and (6), “Reasonable cost,” is ten cents ($0.10) per page for standard reproduction of documents of a size 8 1/2 by 14 inches or less; twenty cents ($0.20) per page for copying of documents from microfilm; actual costs for the reproduction of oversize documents or the reproduction of documents requiring special processing which are made in response to a subpoena; reasonable clerical costs incurred in locating and making the records available to be billed at themaximum rate of twenty-four dollars ($24) per hour per person, computed on the basis of six dollars ($6) per quarter hour or fraction thereof; actual postage charges; and the actual cost, if any, charged to the witness by a third person for the retrieval and return of records held offsite by that third person.
(3) The witness shall submit an itemized statement for the costs 563 states that a location may charge $15.00for the witness fee, as long as the witness is not a party to the action (so, the custodian of records will charge the copy service $15.00, and no more than that).
(6) Where the records are delivered to the attorney, the attorney’s representative, or the deposition officer for inspection or photocopying at the witness’ place of business, the only fee for complying with the subpoena shall not exceed fifteen dollars ($15), plus the actual cost, if any, charged to the witness by a third person for retrieval and return of records held offsite by that third person. If the records are retrieved from microfilm, the reasonable cost, as defined in paragraph (1), shall also apply.
**Some locations have elected to send invoices to a copy service, totaling far above $15.00 for the witness fee and for clerical costs that are not itemized, or simply not reasonable. This practice is not supported by law and should be eliminated. All bills sent to a copy service, by locations in California, must comply with Evidence Code section 1563, and must provide the subpoenaed records within 15 days under Evidence Code section 1560, subdivision (b)(2).
Under the fee schedule, copy services may charge $180 per location generally: overcharging a copy service for the Release of Information results in undue burden on the injured worker and on any law firm who originally requested records.