Nobody likes being fooled, especially when done maliciously. Although the Board will act to protect itself from being deemed a willing participant to a fraud, it is less likely to act when the victim is an employer, insurance company or a TPA. Therefore, please consider today’s blog as a public service announcement to warn our …
Where’s Your Evidence? A Sixty-Second Seminar in Workers’ Compensation Claims Handling
Today we are going to tell you an incredible story about three newly-hired workers with physical and psych injuries, who each testified at the Board as to the nature of their industrial accident. The first injury resulted from a car crash. The second occurred from a fall off a ladder, while the third happened when …
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Unnecessary Insurance: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
Let’s begin today’s blog with an easy question. Does your company own or lease any motor vehicles, including cars, trucks, vans or busses? Many businesses require employees to use company vehicles when working. Of course, we all know California law requires motor vehicles on a public roadway to be insured for liability. However, additional coverages …
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Serious & Willful Misconduct: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
Whenever a catastrophic injury occurs, it is quite common for an applicant’s attorney to seek a penalty against the employer by filing a Petition for Serious and Willful Misconduct (S&W). This is just their way of trying to squeeze a little extra money out of the employer. Unfortunately, many employers do not fully understand exactly …
Credit Rights: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
When an industrial accident is caused by a third party, an injured worker has the right to seek workers’ compensation benefits against the employer, as well as pursue a tort action against all responsible individuals. If the injured worker thereafter receives a settlement in a third-party case, the employer is entitled to a credit against …
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New and Further Disability: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
It is a common practice for applicant attorneys to calendar cases years in advance to reopen for new and further disability. It’s just something applicant attorneys automatically do shortly before the five-years statute of limitations is scheduled to expire. The purpose of today’s sixty-second blog is to share some quick defense tips when handling reopened …
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Blaming the Claims Adjuster: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
Have you ever noticed how everyone seems to blame the claims adjuster whenever anything goes wrong in a file? It’s amazing how often it occurs. Let’s start with an injured worker who blames the adjuster for their injury, as if the adjuster somehow caused the accident. We know in reality the adjuster had nothing to …
Exceptions to the $10,000 Rule: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
Pursuant to LC 5402(c) an injured worker is entitled to up to $10,000 in medical benefits when compensability of a claim is on delay and/or under investigation. However, this entitlement is not automatic. There are conditions and exceptions to the $10,000 Rule. First of all, a DWC-1 Claim Form must be on file before even …