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Off to CWCI…

It’s the middle of conference season, with WCRI behind us, CWCI coming Thursday, and RIMS on the horizon.

David Deitz MD PhD will be giving the keynote at CWCI, and it is one I am eagerly anticipating.  David’s a keen observer of the workers compensation space, one of the nation’s leading experts on work comp medical issues, and the perfect choice to provide much-needed clarity on medical cost drivers, evidence-based medicine and the application thereof.

It is also particularly timely as there’s been much discussion of issues surrounding the Independent Medical Review process, the provision (or lack thereof) of medical records, and related issues.

I’m thinking not so much about IMR specifically, but rather the larger question of why the IMR process was put in place, how it has worked or not to date, and what the real issues are. And, of course, how IMR should be modified – if at all.

Unfortunately, there has been a good bit of confusion surrounding IMRs, and the latest WorkCompCentral reporting provides a good example of how complex and multi-faceted this is.  After an initial report that apparently indicated thousands of medical records had not been received on a timely basis, subsequent reports have revealed that many of these missing records likely pertained to cases that are closed.

I’d note that the furor created by the initial report was, while predictable, also premature. As with many “incidents”, both within and outside workers’ compensation, a full understanding of the background, contributing factors, processes involved, and facts of the case often result in a very different view than the original reports seem to provide.

Right now I’m in an airport listening to a Congressional inquiry into the alleged incident involving Secret Service agents, alcohol, and barriers in front of the White House.  Our elected officials are pillorying the head of the Secret Service for not firing/disciplining the alleged offenders, and the Secret Service head continues to try to impress upon our representatives that he can’t do that unless and until the investigative process is completed.

Sorry to see there’s a predilection to rush to judgment in a lot of different settings…

Should be an interesting week in California.

What does this mean for you?

Always good to wait until all the relevant facts are provided before coming up with conclusions…


Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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