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MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 1 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 2 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 3 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 4 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 5 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 6 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 7 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 8 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 9 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 10 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 11 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 12 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 13 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 14 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 15 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 16 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 17 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 18 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 19 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 20 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 21 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 22 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 23 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 24 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 25 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 26 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 27 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 28 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 29 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 30 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 31 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 32 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 33 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 34 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 35 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 36 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 37 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 38 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 39 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 40 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 41 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 42 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 43 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 44 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 45 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 46 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 47 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 48 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 49 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 50 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 51 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 52 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 53 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 54 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 55 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 56 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 57 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 58 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 59 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 60 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 61 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 62 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 63 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 64 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 65 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 66 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 67 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 68 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 69 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 70 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 71 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 72 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 73 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 74 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 75 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 76 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 77 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 78 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 79 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 80 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 81 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 82 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 83 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 84 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 85 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 86 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 87 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 88 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 89 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 90 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 91 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 92 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 93 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 94 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 95 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 96 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 97 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 98 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 99 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 100 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 101 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 102 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 103 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 104 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 105 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 106 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 107 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 108 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 109 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 110 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 111 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 112 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 113 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 114 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 115 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 116 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 117 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 118 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 119 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 120 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 121 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 122 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 123 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 124 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 125 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 126 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 127 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 128 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 129 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 130 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 131 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 132 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 133 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 134 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 135 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 136 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 137 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 138 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 139 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 140 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 141 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 142 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 143 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 144 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 145 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 146 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 147 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 148 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 149 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 150 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 151 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 152 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 153 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 154 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 155 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 156 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 157 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 158 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 159 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 160 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 161 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 162 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 163 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 164 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 165 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 166 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 167 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 168 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 169 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 170 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 171 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 172 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 173 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 174 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 175 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 176 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 177 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 178 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 179 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 180 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 181 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 182 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 183 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 184 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 185 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 186 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 187 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 188 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 189 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 190 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 191 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 192 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 193 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 194 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 195 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 196 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 197 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 198 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 199 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 200 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 201 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 202 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 203 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 204 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 205 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 206 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 207 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 208 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 209 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 210 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 211 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 212 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 213 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 214 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 215 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 216 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 217 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 218 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 219 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 220 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 221 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 222 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 223 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 224 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 225 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 226 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 227 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 228 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 229 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 230 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 231 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 232 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 233 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 234 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 235 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 236 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 237 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 238 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 239 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 240 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 241 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 242 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 243 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 244 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 245 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 246 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 247 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 248 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 249 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 250 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 251 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 252 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 253 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 254 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 255 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 256 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 257 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 258 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 259 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 260 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 261 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 262 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 263 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 264 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 265 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 266 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 267 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 268 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 269 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 270 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 271 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 272 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 273 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 274 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 275 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 276 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 277 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 278 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 279 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 280 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 281 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 282 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 283 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 284 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 285 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 286 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 287 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 288 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 289 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 290 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 291 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 292 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 293 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 294 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 295 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 296 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 297 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 298 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 299 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 300 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 301 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 302 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 303 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 304 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 305 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 306 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 307 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 308 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 309 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 310 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 311 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 312 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 313 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 314 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 315 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 316 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 317 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 318 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 319 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 320 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 321 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 322 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 323 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 324 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 325 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 326 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 327 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 328 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 329 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 330 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 331 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 332 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 333 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 334 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 335 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 336 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 337 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 338 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 339 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 340 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 341 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 342 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 343 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 344 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 345 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 346 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 347 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 348 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 349 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 350 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 351 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 352 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 353 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 354 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 355 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 356 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 357 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 358 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 359 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 360 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 361 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 362 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 363 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 364 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 365 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 366 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 367 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 368 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 369 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 370 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 371 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 372 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 373 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 374 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 375 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 376 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 377 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 378 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 379 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 380 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 381 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 382 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 383 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 384 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 385 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 386 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 387 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 388 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 389 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 390 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 391 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 392 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 393 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 394 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 395 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 396 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 397 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 398 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 399 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 400 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 401 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 402 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 403 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 404 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 405 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 406 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 407 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 408 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 409 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 410 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 411 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 412 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 413 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 414 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 415 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 416 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 417 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 418 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 419 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 420 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 421 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 422 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 423 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 424 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 425 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 426 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 427 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 428 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 429 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 430 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 431 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 432 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 433 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 434 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 435 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 436 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 437 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 438 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 439 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 440 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 441 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 442 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 443 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 444 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 445 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 446 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 447 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 448 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 449 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 450 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 451 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 452 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 453 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 454 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 455 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 456 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 457 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 458 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 459 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 460 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 461 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 462 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 463 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 464 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 465 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 466 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 467 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 468 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 469 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 470 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 471 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 472 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 473 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 474 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 475 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 476 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 477 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 478 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 479 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 480 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 481 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 482 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 483 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 484 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 485 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 486 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 487 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 488 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 489 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 490 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 491 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 492 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 493 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 494 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 495 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 496 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 497 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 498 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 499 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 500 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 501 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 502 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 503 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 504 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 505 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 506 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 507 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 508 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 509 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 510 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 511 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 512 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 513 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 514 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 515 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 516 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

Page 517 of 519 MEDICAL RULEMAKING WRITTEN COMMENTS NAME OF RESPONSE ACTION TREATMENT 45 DAY COMMENT PERIOD PERSON/ UTILIZATION AFFILIATION SCHEDULE General Comment Commenter states under the proposed regulations, Harry J. Monroe, Disagree. DWC is precluded from None. (Automatic future revisions of the applicable guidelines by Director of automatically adopting future Updates) ACOEM or the Work Loss Data Institute will not Government updates of documents incorporated become part of the MTUS unless the DWC amends Relations into a rulemaking without formal the regulations. Commenter opines in future years this Coventry Health Care rulemaking. If future updates are may become confusing for physicians trying to August 12, 2008 automatically incorporated by determine which guidelines are applicable. reference into the MTUS Commenter suggests the guidelines adopted by those regulations, which have the full respective organizations as of the date of the request force and effect of law, then the for treatment be applicable for review purposes, Administrative Director has unless the DWC has taken subsequent action to deny delegated the power to make the use of a revision. Commenter requests if the DWC regulatory law in California to a declines to take this step, DWC should take whatever private association with no steps are necessary to make all current guidelines limitation whatsoever and with no available on its website. Commenter states this would rational basis for determining what at least help to make sure physicians can locate the policy will be implemented. (1 relevant and applicable guidelines. CCR §20, Kugler v. Yocum, 69 Cal. 2nd 371, 375-377 (Cal. 1968).) On the other hand, with medical advances likely to occur and become current practice, it will be necessary for the DWC to update the MTUS on a regular basis. This update will be accomplished through formal rulemaking. The applicability of the MTUS becomes effective when the regulations are approved through the formal rulemaking process. After the regulations become effective, the MTUS is applicable as presumptively correct until it is updated again through formal rulemaking. If there are changes in the medical evidence as a result of medical advances before the next update, then Section 9792.25 allows both physicians and claims administrators to attempt to

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