Posted by Fran McCracken on Mar 09, 2023 in Articles, Legislation, Recent News, Workers' Compensation
The Division recently adopted changes to Rule 11, W.C.R.P., which governs the Division Independent Medical Examination process. These changes took effect on March 2, 2023. Unfortunately, some of the changes to Rule 11 have the potential to substantially increase the cost of Division IMEs to all our clients. As such, we wanted to advise you of the potential for increased fees associated with the Division IME process.
There are two primary changes to Rule 11, with the potential to exponentially increase the cost of a DIME. The first is to Rule 11-4(B)(3), which involves changes to the already cumbersome preparation of the Division IME packet. The new Rule provides the DIME packet shall not include any duplicative (as opposed to simply duplicate) records. It further requires, for all inpatient medical records, the records be individually indexed, and Bates’ stamped as admission notes, discharge summaries, operative reports, diagnostic tests other than blood tests, and “all other inpatient medical records from the same inpatient stay”. Ensuring removal of all “duplicative” records, and the additional detailed indexing requirement for inpatient hospitalizations, could potentially lead to additional time spent preparing the DIME packet. Failure to strictly comply with the Rule in compiling the packet can result in the Division IME physician imposing additional fees to perform the examination.
The second change to the DIME Rule more likely to impact the expense associated with a DIME is the addition of Rule 11-5(A)(3), which provides for additional record review fees if the DIME packet exceeds specific page counts. Unlike the old Rule 11, which provided for set Division IME fees depending on the age of the claim, and the number of body regions to be evaluated, the new Rule requires additional fees for “excessive” records. Under the new Rule, if the medical records exceed the page counts below, additional record review fees will apply:
$1,000 DIME 500 pages
$1,400 DIME 750 pages
$2,000 DIME 1,000 pages
The additional record review fees are calculated at the rate of $1 for each page that exceeds these page counts.
Of course, not every Division IME will increase in cost, but we wanted to apprise you of the Rule changes that could affect your claims. As always, please feel free to contact any of the attorneys at Brown Gren Abraham & McCracken about the changes to Rule 11, W.C.R.P., or with any other question you may have.