When a dispute arises between an Applicant’s Attorney (AA) and a claims adjuster (even if trivial in the grand scheme of things), AA may issue a notice of deposition to the adjuster. While we would like to believe that such notices are not issued out of spite or harassment we can only speculate. One thing …
Subpoenas, Medical Releases and Public Records: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
Do you know when to use a subpoena versus a medical release or public record? Once again, our blog will discuss yet another topic where education is not readily available. Today we will quickly go over the major differences in obtaining records through subpoenas, medical releases, and public records. As a procedural tip be certain …
C&R Rescission: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
Our blog today concerns a developing trend at the appeals board where settlement agreements designed to forever close claims are now being set aside, resulting in the files being reopened with litigation resuming. This trend is growing at such a rate that employers now need to employ additional protections to preserve their C&R settlements. For …
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Inconsistent Testimony: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
It is quite common for an employee to file a claim for Unemployment Insurance benefits (UI) after an employee is laid off; however, to receive up to 26 weeks of UI benefits the ex-employee must certify under the penalty of perjury they were available for and capable of working every day. During the 26 weeks …
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Employer Civil Liability: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
In California, an injured worker’s exclusive remedy against an employer for injuries arising out of an industrial accident is subject to the provisions of the Workers’ Compensation Act, found within our state constitution at Article XIV, Section 4, which provides that any dispute between the worker and their employer over the worker’s entitlement to benefits …
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Lost Disability Checks: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
A mystery waiting to be unraveled sometimes arises when an injured worker reports a disability check as missing, and the check in question is identified as having been cashed or otherwise negotiated. The stakes are raised when a large settlement check turns up missing but cashed. We dedicate today’s blog to this scenario, since it …
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Suing Yourself: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
It never ceases to frustrate us when we see employers suing themselves in workers’ compensation. We are not talking about a few employers, but rather dozens of companies suing themselves, often without even realizing it. Our readers are probably asking, “Why would a company sue itself and how could it do so without realizing it?” …
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Calculating the Life Pension: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
We believe with a high degree of certainty that very few claims professionals have ever received instruction on how to calculate a weekly life pension (LP) rate. Most claims professionals, including judges and attorneys, rely on the Disability Evaluation Unit (DEU) to do the calculations for them. Today we will show you how to double-check …
Subrogation Waivers: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
Most employers are aware of the concept of subrogation. California Labor Code §3852 specifically allows employers to seek recovery against third parties for reimbursement of workers’ compensation benefits paid due to an industrial injury attributed to third party negligence. Specifically, LC §3852 states: “Any employer who pays, or becomes obligated to pay compensation, or who …
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Beware Your Own Witness: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
Today’s blog discusses witness testimony at the Appeals Board, particularly testimony offered when compensability of an industrial injury is in dispute. More frequently than one might anticipate, an employer is caught by surprise when their own witness completely changes their story on the witness stand. Employers naturally feel duped when this occurs and can’t understand …
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Home Health Care Attendant: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
When dealing with a catastrophic injury it is not unusual for a claims administrator to hire a home health care attendant to look after the injured worker. Some severely injured workers require constant care and cannot be left alone. For the most part, claims administrators have no objection to engaging a medical management company to …
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DNA Evidence in Work Comp: A Sixty-Second Seminar in Workers’ Compensation Claims Handling
In death benefit claims dependency is a threshold issue, and when paternity is uncertain, it can be a major one. For example: we are aware of a case where a decedent’s ex-girlfriend sought death benefits on behalf of her minor child. DNA testing became necessary as the child’s birth certificate was deemed inadequate proof of paternity. …
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