It is a sad but unfortunate fact that catastrophic injuries resulting in serious injury or loss of life do occur in the workplace. Such tragedies are often investigated by Cal-OSHA and may even draw the attention of the local criminal prosecutor/district attorney should the incident be attributed to gross negligence. It is at this time …
Protecting the Employer: A Sixty-Second Seminar in Workers’ Compensation Claims HandlingRead More
Allow us to begin today’s blog by asking a question. Are you aware that certain Labor Code sections have been determined to be unconstitutional? For example, the following two Code sections (which governed the payment of death benefits to the “estate” of a deceased employee) have been invalidated in court: LC 4702(a)(6)(A) LC 4702(a)(6)(B) On …
The intent of today’s blog is to offer guidance on what employers may do when applicant attorney requests a QME panel in a questionable medical specialty for a denied claim. It is not a revelation that workers who lack private health insurance but need medical care will file a claim for workers’ compensation benefits even …
Private Medical Reports: A Sixty-Second Seminar in Workers’ Compensation Claims HandlingRead More
In a recent online publication, a private company announced that it had been 7,969 days since one of their employees had lost time work due to an industrial accident. Admittedly, that’s a safety record to both respect and be jealous of. Although many companies advertise their no lost time accomplishments, none have come close to …
Safety Awards: A Sixty-Second Seminar in Workers’ Compensation Claims HandlingRead More
Whenever an injured worker’s third-party tort claim settles out of court, it is common for the injured worker and the civil defendant to join forces in a mutual attempt to defeat all workers’ compensation liens and credit rights. Some of the tactics used are ingenious. One such tactic is to classify the entire settlement as …
We are continuously bemused at the frequency with which a newly hired applicant attorney will attempt to replace a QME permissibly chosen when an applicant was unrepresented by counsel. The purpose of today’s blog is to warn our clients of the various tactics some applicant attorneys use to avoid a good defense QME report. There …
Replacing the QME: A Sixty-Second Seminar in Workers’ Compensation Claims HandlingRead More
It is common knowledge that most applicant attorneys view Medical Provider Networks (MPNs) as a program created for the benefit of employers. As a result, applicant attorneys do not consider MPN physicians as being unbiased but rather, they believe them to be in “cahoots” with the employer to the detriment of injured workers. After all, …
Pre-Designation: A Sixty-Second Seminar in Workers’ Compensation Claims HandlingRead More
California’s workers’ compensation system provides several legal presumptions that greatly impact benefit entitlement; however, notwithstanding that, some claims professionals are uncertain as to what a “presumption” is. A legal presumption is defined by Black’s Law Dictionary as “a legal inference, or assumption that a fact exits. It is based on the known or proven existence …
Legal Presumptions: A Sixty-Second Seminar in Workers’ Compensation Claims HandlingRead More
Today we are offering something different. Instead of a blog focused on a singular workers’ compensation topic, we’re offering up four true claims stories, each of which we believe will either elicit a smile or a knowing nod of the head from you, our dear readers. Up in Smoke: On his very first day at …
True Claim Stories: A Sixty-Second Seminar in Workers’ Compensation Claims HandlingRead More
As strange as it may seem, the rules under California’s workers’ compensation act pertaining to “first aid injuries” are becoming more and more complex. Instinctively thought of as minor injuries which could be handled directly by the employer without the necessity of reporting an injury to their workers’ compensation insurer or requiring formal claims administration, …
First Aid: A Sixty-Second Seminar in Workers’ Compensation Claims HandlingRead More
At a recent WCAB hearing, a judge was asked to approve a petition for commutation to enable an applicant to pay off a large credit card debt that was accruing interest at an annual rate of 22%. The applicant testified he could never get financially ahead in life as the interest charges alone were greater than …
Commutations: A Sixty-Second Seminar in Workers’ Compensation Claims HandlingRead More
Today’s blog is all about surveillance. Many employers and claims administrators tend to rely on surveillance as a last resort to disprove the existence of an industrial injury/disability, or perhaps to determine if a claimant is employed elsewhere while collecting compensation benefits. Before assigning an investigation, it is important for the claims administrator to develop …
Surveillance: A Sixty-Second Seminar in Workers’ Compensation Claims HandlingRead More
