Allow us to begin today’s blog with a quick history lesson. It was the year 2002. The California Department of Insurance was literally swamped with complaints from employers concerning the cost of workers’ compensation insurance. In addition, injured workers complained about poor claims adjuster performance, while physicians squawked about medical bill reviewers improperly applying the state’s …
Education Certificates: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
Of all the affirmative defenses in workers’ compensation, by far the most difficult for an employer to successfully litigate is intoxication. This defense is comprised of three elements, all of which must be proven by the employer. The purpose of today’s blog is to review the requirements to successfully raise an intoxication defense as it …
Intoxication: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
There is no more awkward situation for a claims adjuster than to need to seek the reimbursement of overpaid temporary disability benefits from a “pro per” injured worker. Many insurance companies and TPA’s require claims handlers to request refunds even though that actions often prompt the worker to retain legal representation. By requesting a $25 …
TD Overpayments: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
For those who supervise or manage a claims department we ask that you take an informal survey of your staff to determine how many of them have ever attended a WCAB hearing. We believe you will be surprised to learn that very few have ever ventured to the appeals board, and that consequently, most claims …
The Best Laid Plans: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
When comparing the job requirements of today’s workers’ compensation claims adjuster to those of yesteryear, the difference is like night and day. Thirty-years ago, a claims adjuster was a jack of all trades. Adjusters of that era would handle all types of comp claims. An adjuster’s inventory consisted of med-only, indemnity and death cases. In …
Today’s Claims Adjuster: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
It seems incomprehensible but for the past twenty years our workers’ compensation system has failed to acknowledge a paradox that exists regarding death benefits. The purpose of today’s blog is to explain the paradox to allow our readers to decide on the interpretation of their choice. We believe it is safe to state that most …
The Death Benefit Paradox: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
In today’s world of workers’ compensation, it is common for claims administrators, insurance companies and law firms to use an out-of-state mailing address, which may result in a misunderstanding of our state’s mailbox rule and how it applies to extend response time. With that said, we will dedicate today’s blog to provide a timely discussion …
The Mailbox Rule: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
Have you ever heard of the “Wimpy Syndrome”? It occurs every few years when our state legislature considers workers’ compensation reform. The Wimpy Syndrome is named after a fictional cartoon character prominently featured in the original Popeye the Sailor comic strips of the 1930’s. J. Wellington “Wimpy” is a gourmet of the finest hamburgers money can buy, …
The Wimpy Syndrome: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
Hello and Happy New Year’s wishes to our friends, clients, and colleagues in the workers’ compensation claims community! F&B is proud to publish the 100th edition of our “60 Second Seminar” series of workers’ compensation educational blogs, providing practical, succinct, and timely information for use by insurers, claims administrators, employers, and brokers! It is also …
New Laws of 2024: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
Every workers’ compensation claims examiner has likely been told that an injured worker may not collect temporary disability and state disability insurance (SDI) benefits at the same time. We can confidently state that every examiner who received such training was given inaccurate information, as it is perfectly legal under certain circumstances for an injured worker …
Collecting TD and SDI: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
For years, it was a common practice for employers to require a resignation before settling a workers’ compensation claim by Compromise and Release (C&R). However, all that changed on 1/1/2020 when Assembly Bill 749 was enacted, amending Code of Civil Procedure § 1002.5(a), prohibiting mandatory resignation as a condition to the settlement of an employment dispute, …
Requesting a Resignation: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
When it comes to invoices from medical providers and other vendors, the standard rule in workers’ compensation claims administration is to pay what the administrator believes is owed and object to the balance. Unfortunately, the balance often becomes a point of contention resulting in a lien being filed with the Workers’ Compensation Appeals Board, and …
Lien Tactics: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
