WCCA 12 – Medical Benefits in California Workers’ Comp Claims



Learn to confidently recognize and comply with the laws that govern payment of medical expenses and independent bill review. Stand out as a knowledge resource in your organization with your enhanced understanding of medical control issues. Competently handle claims involving utilization review and independent medical review. Effectively handle complex claims. Demonstrate your value to your organization.

Key Takeaways:

  • The scope of medical treatment provided under workers’ compensation, including employer requirements to pay for medical care, Labor Code 4600, and statutory limitations on therapy
  • Learn who is an authorized physician and the role of the primary treating physician
  • Utilization Review (UR) and the new Independent Medical Review (IMR) procedures and processes are presented
  • How to use the medical treatment utilization schedule and how to develop a UR plan and process in accordance with law and regulation
  • Handle SB863’s new IMR process-when and why IMR is used and how to appeal or implement determinations
  • Obtain medical control, including pre-designation of the PTP and medical control in the absence of an MPN
  • How an employer’s failure to furnish medical care can result in liability for self-procured care
  • Medical Provider Networks are discussed in depth, including controlling law, dispute resolution, out-of-network consequences, and transfers in/out of the MPN
  • Understand law and regulation covering the payment of medical expenses and Independent Bill Review
  • Law governing the medical provider’s submission and the employer’s response is reviewed
  • The scope and application of the new IBR rules adopted under SB 863 is presented and the requirements, steps and standards underlying the IBR process
  • Complex issues of liens and lien management


Who should attend:

  • Workers’ compensation claims adjusters
  • Medical only claims adjuster
  • TPA / Self -insured claims personnel
  • Agent/Broker workers’ compensation claims staff



Robert Cornelow

Course Type

Semester Course

Dates & Times

2/23/2021- 4/27/2021
Tuesdays, 5:00pm – 6:00 pm PST

10 classes/weeks


Online – Webinar

SP21: WCCA12 OL Cornelow



Paying by check? Hit “Enroll”,
then “Check”, then for payment
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