According to workcompcentral's newsletter, 2015-08-27, California's Division of Workers Compensation has ordered that as of 1 September 2015 "clinical neuropsychology will no longer be a recognized medical specialty." This decision by DWC was approved by the Office of Administrative Law on 8/12/15. The ruling means that "the elimination of the specialty designation for clinical neuropsychology" goes into effect on September 1st.
Clinicians, particularly psychologists with specialized training in neuropsychology, will at first blush be astonished that the authority of the DWC can be used to ease the way for medical malpractice. On second look clinicians have observed that the workers comp system is rigged against fair hearings for injured workers, for instance, nearly 90% of Utilization Review (UR) denials are upheld by anonymous Independent Medical Reviewers (IMRs).
Keep in mind that MPNs (Medical Provider Networks) pre-select their own clinicians and then step aside as disproportionate numbers of their own clients get denied treatment by the mandatory UR panels created by SB 863 and which usually have links to insurance companies. The MPNs step aside when IMRs such as Maximus slavishly confirm the treatment denials.
In the case of neuropsychology, we know that psychologists with special training in traumatic brain injury (TBI) are uniquely qualified to make diagnostic and treatment decisions about TBI. In fact, Assemblyman Devon Mathis, R-Visalia, co-author of AB 1542 along with Assemblyman Ken Cooley, D-Rancho Cordova, testified in favor of AB 1542 before the Senate
Committee on Labor and Industrial Relations to the effect that while general psychologists deal with mental injuries neuropsychologists are specially educated and trained about TBI.
Assemblyman Mathis' credentials include a Purple Heart for TBI sustained during an IED attack in Iraq in 2008. The point of Mathis' testimony is that the best recommendations for diagnosis and treatment for him and for injured workers who sustain TBI on-the -job is through adequate diagnosis and work-up that requires TBI expertise. Anything else, in this writer's opinion, amounts to inferior treatment. It can now be argued with reasonable medical probability that DWC has in this case imposed a restriction that arguably can be stated to suborn malpractice by advocating and in fact eliminating NeuropsycheQME as a separate and distinct clinical specialty.
That is why it's obligatory to make sure that AB 1542 which would protect neurospsyche as a designated specialty makes it through the legislature where it's already passed the Assembly 79 to 0 and then persuade the the governor to sign the bill into law.
Then we'll need to know whence the misguided direction arose that convinced Director Christine Baker to file a letter in support of eliminating neurospyche as a specialty and to combine it with the more general classification of psychology absent recognition of specialized TBI education and training. One will also need to ask if there is a need for re-education and restructuring within DWC.
This author previously addressed this issue in an editorial reprinted by workcompcentral, 2015-05-20, "Does Somebody Want to Sabotage Neuropsychological Evaluations?" This issue deserves continuing investigation and reporting.
References
Workcompcentral, "QME Rules Take Effect Tuesday," 2015-08-27
The Weinmann Report, www.politicsofhealthcare.com, 4/24/2015
CSIMS, "Comments on DIR Director Christine Baker's Opposition to AB 1542, 8/12/2015
Department of Industrial Relations, letter by DIR Baker, 7/29/2015
Voters Injured at Work, Support letter for AB 1542, Jesse Ceniceros, VIAW president
Brain Injury Association, Support letter for AB 1542, 8/03/2015
California Neurology Society, Support letter, Steve Cattolica, Legislative Advocate, 6/04/15
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