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Workers' compensation insurance carriers, auto insurance carriers, and self-insured employers have a legal right to this request. Should the doctor/therapist performing the independent medical examination conclude that a patient's medical condition is not related to a compensable event, the insurer may deny the claim and refuse payment.
The Pennsylvania Department of Labor and Industry is a cabinet-level agency in the Government of Pennsylvania.The agency is charged with the task of overseeing the health and safety of workers, enforcement of the Pennsylvania Uniform Construction Code, vocational rehabilitation for people with disabilities, and administration of unemployment benefits and Workers' compensation.
An independent medical review (IMR) is the process where physicians review medical cases in order to provide claims determinations for health insurance payers, workers compensation insurance payers or disability insurance payers. Peer review also is used in order to define the review of sentinel events in a hospital environment for quality ...
Workers' compensation or workers' comp is a form of insurance providing wage replacement and medical benefits to employees injured in the course of employment in exchange for mandatory relinquishment of the employee's right to sue his or her employer for the tort of negligence. The trade-off between assured, limited coverage and lack of ...
The topic of workers' compensation fraud is highly controversial, with claimant supporters arguing that fraud by claimants is rare—as low as one-third of one percent, [63] others focusing on the widely reported National Insurance Crime Bureau statistic that workers' compensation fraud accounts for $7.2 billion in unnecessary costs, [64] and ...
The Office of Workers' Compensation Programs administers four major disability compensation programs which provide wage replacement benefits, medical treatment, vocational rehabilitation and other benefits to certain workers or their dependents who experience work-related injury or occupational disease. [2]
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