In August there was an article in the San Francisco Chronicle entitled
“How to practice medicine without a license” By Robert L. Weinmann
Now he has posted a second article entitled “Insurance Industry Sabotages Injured Workers in California”
Dr. Weinmann covers how unqualified individuals are in control of your health and healing and how they get away with it. After reading it I looked up UR or Utilization Review in Webster’s dictionary and found a short but sweet definition:
a critical evaluation of health-care services provided to patients that is made especially for the purpose of controlling costs and monitoring quality of care.
Well it is a bit surprising to see critical and controlling cost in the same breath but let’s not forget they are tracking your care!
It is hard enough to find a good doctor that your insurance will consider but then when you do the companies either chose their mindless drones or often times when referred to a specialist deny findings.
Dr. Weinmann explains that once your workers comp treatment is turned in to insure compliance the company then retains a UR. Each state has its own regulations and they do not have to specialize in your type of referred treatment or even a license in that state at times, meaning there is no accountability because they are not susceptible to the Medical Board.
What does this mean for you if you are injured? It means they may suspend, change or deny treatment have no real justification and no responsibility.
Well those of you in California should thank your Governator once again for the veto of AB 2969 - AB 2969 (Lieber) Workers' compensation that would have held these UR doctors accountable.