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SELECTED INDICATORS IN WORKERS’ COMPENSATION:  A REPORT CARD FOR CALIFORNIANS

Late First Payment of Temporary Disability or First Salary Continuation Notice When Salary Continuation is Paid in Lieu of Temporary Disability

Of the randomly selected audited claims with TD payments or first notice of salary continuation, the following percentage for assessable penalties for late-paid first payment of TD or late first notice of salary continuation is:

200437 Audits passing the PAR standard:24.59%

20045 Audits passing the FCA standard:39.51%

20046 Audits failing all standards:           53.68%

2005 35 Audits passing the PAR standard:26.31%

2005   8 Audits passing the FCA standard:32.36%

2005   2 Audit failing all standards:            46.99%

Late First Payment of Permanent Disability, Vocational Rehabilitation Maintenance Allowance, and Death Benefits

Of the randomly selected audited claims with PD, vocational rehabilitation maintenance allowance and death benefits payments, the following percentage for assessable penalties for late-paid first payment of PD, vocational-rehabilitation maintenance allowance, and death benefits is:

200437 Audits passing the PAR standard:12.03%

20045 Audits passing the FCA standard:32.10%

20046 Audits failing all standards:           40.80%

2005 35 Audits passing the PAR standard:15.83%

2005   8 Audits passing the FCA standard:23.88%

2005   2 Audit failing all standards:            26.15%

Late Subsequent Indemnity Payments

Of the randomly selected audited claims with subsequent indemnity payments, the following percentage for assessable penalties for late subsequent indemnity payments is:

200437 Audits passing the PAR standard:20.39%

20045 Audits passing the FCA standard:45.27%

20046 Audits failing all standards:           26.10%

2005 35 Audits passing the PAR standard:21.82%

2005   8 Audits passing the FCA standard:35.84%

2005   2 Audit failing all standards:           27.42%

Failure or Late Provision of Agreed Medical Evaluator/Qualified Medical Evaluator Notices and Notices of Potential Eligibility for Vocational Rehabilitation

Of the randomly selected audited claims with requirement to issue the agreed medical evaluator/qualified medical evaluator (AME/QME) notice and/or the notice of potential eligibility for vocational rehabilitation, the following percentage for assessable penalties for failure or late issuance is:

200437 Audits passing the PAR standard:24.16%

20045 Audits passing the FCA standard:31.39%

20046 Audits failing all standards:           57.08%

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