How does an insurance company accidentally destroy its own claims department? It’s easy and we have seen it done three times. In all three instances, underwriters were to blame for destroying the claims department. Here is how they did it: First of all, an underwriter’s goal should never be to focus on writing as much …
Piggyback MSAs: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
Today’s sixty-second blog can easily save a company a few hundred thousand dollars in just one workers’ compensation claim. You won’t believe how simple it is. We call it settling a claim with a Piggyback MSA. Before explaining the process, please allow us to first ask two simple questions: Have you ever seen a situation …
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UR and IMR Decisions: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
Under California law, utilization review (UR) is designed to address requests for medical services as submitted by primary treating physicians on RFA forms. For the most part UR either certifies or non-certifies requested services, although at times a response may legally be delayed pending receipt of additional information. When an RFA is certified the requested …
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Benefit Notices: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
Why do so many claims administrators pay such little attention to benefit notices? Most insurance companies and third-party administrators consider drafting and sending out benefit notices to be nothing more than a clerical function, unworthy of an adjuster’s time or review. Consequently, errors are often made with some mistakes being downright cruel. For example: In …
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The Two-Year Rule (LC 4661.5): A Sixty-Second Seminar in Workers’ Compensation Claims Handling
When TD benefits are paid more than two years from the date of injury, the claims administrator is required pursuant to LC 4661.5 to verify if the benefit rate should increase. However, this requirement only applies if the injured worker is a maximum or minimum earner. Exactly how does the two-year rule work? The best …
California Workers’ Compensation Law: Working Light Duty from Home
Introduction: California workers’ compensation law allows injured workers to perform light-duty work at the employer’s facility and elsewhere, including working remotely from home. There are both advantages and disadvantages of working remote which must be considered as more fully discussed below. Also below is a section on applicable case law as well as three recommendations …
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The DWC-1 Claim Form: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
It is reasonably understood in the workers’ compensation industry that an employer is required to provide a DWC-1 Claim Form to an injured worker within one working day of receiving notice or knowledge from any source of an industrial injury resulting in lost time beyond the employee’s work shift at the time of injury, or …
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The Law Firm of Friedman and Bartoumian is Pleased to Announce our Thirty-Fifth Anniversary!
We are grateful to all our loyal clients, valued employees and dear colleagues. Thank you. A lot has happened since we first opened our doors. Please enjoy this flash to the past showing how far workers’ compensation has come in just 32 years. For some this could be history, but for Friedman and Bartoumian, it’s …
The Top 18 Ways Workers’ Compensation Law Punishes Employers for Doing the Right Thing! (Part 1)
#5 DRUG TESTING POLICY Drug testing must be for cause with reasonable suspicion. Simply drug testing due to being involved in an industrial accident is not recommended unless required by federal or state regulations. Over the years many companies have implemented drug testing policies for various safety reasons. Certain drug testing policies are required by …
The Top 18 Ways Workers’ Compensation Law Punishes Employers for Doing the Right Thing! (Part 2)
#11 FORMING COMPANY TEAMS Sponsoring Company Teams Can Lead to Workers’ Comp Liability If an Employee Becomes Injured Even Though Participation is Voluntary. Most employers are often aware that injuries occurring during an off-duty social, recreational or athletic activity are usually non-compensable. However, liability may apply when an employer generously offers to sponsor an employee …
The Top 18 Ways Workers’ Compensation Law Punishes Employers for Doing the Right Thing! (Part 3)
Yes, That’s What You Get For Being Such A Good Employer! #18 PROVIDING A HOTEL ROOM Employees are covered 100% of the time while on overnight business trips! It is not unusual for companies to accept work assignments in other cities, requiring their employees to commute long distances. Depending on the location of the assignment …