For the Best Defense
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
We believe most claims professionals are aware that there two methods which allow for termination of workers’ compensation death benefits. They are: Inexplicably, a third method for termination of death benefits has also been put into use, a method which is not only illegal but subject to penalty. Various claims administrators are terminating death benefits once …
Termination of Death Benefits: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
Surprisingly, workers’ compensation claims professionals continue to encounter problems administering the three-day temporary disability waiting period. One misunderstanding concern whether the waiting period is applied or waived when an injured worker returns to work on light duty at half-days immediately following an injury. In our blog today we will tackle some of the basic questions …
The Waiting Period: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
It is common for employees to be injured when commuting on company business, and transportation injuries are typically deemed to be within the course and scope of employment. However, an exception exists if the accident occurs during what’s known under the law as a “deviation,” but many claims’ professionals may be surprised to learn that …
Deviation Injuries: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
There is little doubt that offering light duty helps an employer control its workers’ compensation claims cost. Unfortunately, some injured workers would rather remain on disability than return to work. They offer a variety of imaginative excuses for not returning to work, and many often succeed. Employers are usually aware ahead of time which workers …
Offering Light Duty: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
In a previously published blog, entitled “Physicians Who Quit Comp,” we cautioned the claims industry that a campaign was being conducted encouraging medical providers to withdraw from the workers’ compensation system. Specifically, we said: “Currently, an educational campaign is being waged within the medical community where physicians are being encouraged to leave workers’ compensation under …
Why Physicians Quit Comp: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
It is common practice for applicant attorneys to file two applications for adjudication on behalf of an injured worker even when only one body part has been impacted. The first claim will identify a specific date of injury while the other will be for a continuous trauma to the same body part. It happens all …
Companion CT Claims: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
Have you ever asked yourself, “Can medical treatment be streamlined by allowing the claims examiner to authorize medical services instead of involving Utilization Review (UR)”? Under current law examiners may authorize requested medical services but are not allowed to deny or modify treatment requests based on medical grounds. The examiner may only deny or delay …
Streamlining UR: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
Even though many examiners work remotely on a full-time basis, they are still under the threat that an irate and potentially violent injured worker might become aware of their day-to-day whereabouts. Not only does this make the examiner fearful for their personal safety but also for that of their family and co-workers. Memories of a …
Many employers and claims professionals don’t realize that the rules of conventional mathematics don’t always apply to claims for workers’ compensation benefits. For example, in workers’ compensation 25 + 25 does not equal 50, at least not in the context of permanent disability calculations! Allow us to demonstrate. A 25% PD award is worth $29,217.50. …
The Numbers Don’t Add Up: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More
In today’s blog we will explain a legal tactic used by applicants’ bar for over 30 years that has needlessly cost employers untold amounts of money. It is our sincere desire to put an end to this maneuver by bringing it to the attention of the workers’ compensation defense community. In September 1994 Governor Pete …
In general, California’s Workers’ Compensation Act excludes benefits to “volunteers” who are injured while rendering services to a business, on the grounds that they are not “employees.” Having written that, and even though the parties may have agreed beforehand that a worker is a volunteer, the situation often changes once an accident occurs and the …
Volunteers: A Sixty-Second Seminar in Workers’ Compensation Claims HandlingRead More
