Filing a DWC audit complaint (LC §4622)
Step 1 — Open the generator and enter the bill details
Open the audit-complaint generator (/wizard/audit-complaint). The left panel is a form you fill in by hand — bill number, billed amount, service date, the date the bill was submitted, claims administrator, claim number, and patient name. The fields ship pre-populated with example values (a Sedgwick claim for patient "Jane Doe") so you can see the shape of the document, but they are not pulled from any bill in your account; overwrite each one with your real facts. As you type, the complaint on the right re-renders live, so you're always looking at the actual document you'll file.
Step 2 — Read the day count off the submission date
The wizard computes days elapsed straight from the "Bill submitted" date you entered and shows it as a badge, e.g. Day 74 of 60. Once you cross 60 days the badge turns red; before that it stays in the warning color. That overage is the legal basis for the complaint — 8 CCR §9792.5(a) requires the EOR within 60 days of receipt, and LC §4622 and §129.5 authorize the Audit & Enforcement Unit to act when it doesn't arrive. Note the count reflects the date in the form, not a live timer on a bill, so make sure the submission date is the one you can actually document.
Step 3 — Copy the complaint and email it to the DWC Audit Unit
The rendered complaint is addressed to the Department of Industrial Relations, Division of Workers' Compensation, Audit & Enforcement Unit, under the heading "Failure to issue Explanation of Review within 60 days." It lays out the statement of facts and the relief requested under LC §129.5 — an Audit Unit investigation of the payer's pattern of 60-day violations, administrative penalties up to $5,000 per violation, and an order to issue the overdue EOR within 14 days with interest under LC §4603.2(b)(2). Use the Copy button to grab the full text. Then file it yourself: as the note at the bottom of the page states, DWC audit complaints are submitted to DWC.AuditUnit@dir.ca.gov with the full bill packet attached, once the 60-day EOR window has lapsed. Mindbill drafts the complaint; sending it to the Audit Unit is a manual step you do.
When a claims administrator simply sits on a bill and never issues an Explanation of Review, you have a different remedy than a Second Review: a complaint to the DWC Audit & Enforcement Unit. Under 8 CCR §9792.5(a) the payer owes an EOR within 60 days of receipt, and Labor Code §4622/§129.5 give the Audit Unit teeth — penalties and forced payment with interest. Mindbill's audit-complaint generator drafts that complaint for you: you enter the bill facts, it renders the formal document, you copy it, and you file it yourself with the Audit Unit. It's a manual tool — nothing is submitted on your behalf and nothing watches the calendar for you — so this walkthrough shows what to fill in, how to read the day count, and exactly where the finished complaint goes.