In national news:

Sedgwick, a national third party administrator, has agreed to pay $1,129,600 to settle allegations of Labor Code violations in its California claims handling. This final settlement stems from an investigation of the company by the state Workers’ Compensation Appeals Board (WCAB) after an injured worker died of a post-surgery MRSA infection after being denied hospitalization by a Sedgwick adjuster. According to a WorkCompCentral report, Sedgwick faces 75 “mandatory administrative penalties” from the WCAB Audit and Enforcement Unit (as part of the settlement) due to violations of Labor Code Section 4610, which governs utilization review. The adjuster on the MRSA death case is at the center of the settlement terms. The WCAB says that she denied treatment or refused to authorize treatment requests under her own authority, without consulting a medical professional or sending the requests to UR. The claimant died on May 2nd, 2008 and Sedgwick didn’t make any payments on the claim until after the fact, on June 23rd, 2008. Sedgwick began handling workers’ comp claims for state of Louisiana employees last year, taking over from F.A. Richard and Associates in a divisive July 2015 appeal of the contract award. The company does not admit wrongdoing in this settlement.

Read full coverage via WorkCompCentral (paid content) here. Read the settlement agreement in full here: DWC Sedgwick Settlement

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