The Self-Insurance Exam: A 60-Second Seminar in Workers’ Compensation Claims Handling

//  by 

The California Office of Self-Insurance Plans (OSIP) is the state entity responsible for offering the Self-Insured Workers’ Compensation Claims Administrator examination. Candidates who successfully pass the exam receive a certificate demonstrating their competency to handle self-insured claims. By regulation, every self-insurance adjusting location is required to have at least one person on staff who successfully passed the …

The Self-Insurance Exam: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More

EAMS Case Search: A 60-Second Seminar in Workers’ Compensation Claims Handling

//  by 

Many claim professionals are unaware that our California workers’ compensation system allows the public free limited access to records of the Workers’ Compensation Appeals Board through the EAMS computer database. EAMS is an acronym for “Electronic Adjudication Management System” which has been used by the WCAB since November 17, 2008. It replaced the Electronic Data Exchange …

EAMS Case Search: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More

Requesting an Additional QME: A 60-Second Seminar in Workers’ Compensation Claims Handling

//  by 

Due to the nature of certain industrial injuries, there are times during the life of a workers’ compensation claim when an injured worker may require QME examinations by physicians specializing in different fields of medicine.  For example, a worker with alleged foot, ear and heart injuries will probably require evaluations by a podiatrist, otologist, and …

Requesting an Additional QME: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More

Occupational Adjustment: A 60-Second Seminar in Workers’ Compensation Claims Handling

//  by 

We will begin today’s blog by asking our readers to answer four questions concerning the role an injured worker’s occupation plays when calculating a PD rating. Question #1: If a worker performs two occupations for an employer, which occupation is used when rating PD? Answer: The occupation producing the greater rating is used. Question #2: …

Occupational Adjustment: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More

Terrorism Claims: A 60-Second Seminar in Workers’ Compensation Claims Handling

//  by 

We suspect that many claim professionals have wondered what workers’ compensation law has to say as to employees injured as a result of an act of terrorism. Sadly, injury by that scenario is not that far-fetched. Case in point, the terrorist attack which occurred on December 2, 2015, in San Bernardino resulting in the death …

Terrorism Claims: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More

Accidental Drug Overdoses: A 60-Second Seminar in Workers’ Compensation Claims Handling

//  by 

Sadly, even though opioid prescriptions have significantly decreased over the past two years, the number of drug overdose deaths occurring in the United States each year are at epidemic levels. Overdose death attributed to prescription drugs in 2019 was recorded at a staggering 70,639. In 2020 the number of deaths increased to 91,799, then to …

Accidental Drug Overdoses: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More

Employment Records: A 60-Second Seminar in Workers’ Compensation Claims Handling

//  by 

We are substantially certain that our readers will not be surprised to learn that certain applicant attorneys are known for issuing a dozen or more document production subpoenas in every case they handle. The subpoenas almost always include one which seeks the applicant’s personnel file. These attorneys can’t wait to read what the employer has …

Employment Records: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More

Education Certificates: A 60-Second Seminar in Workers’ Compensation Claims Handling

//  by 

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

Parental Rights in Workers’ Compensation: A 60-Second Seminar in Workers’ Compensation Claims Handling

//  by 

Today we will discuss a topic that we believe has never been presented to claims professionals anywhere in this state.  It’s called “Parental Rights in Workers’ Compensation.” Allow us to begin by asking two questions.  As strange as it may seem both scenarios are possible.  Let’s begin our analysis by examining the first question where …

Parental Rights in Workers’ Compensation: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More

When to Pay PDAs: A 60-Second Seminar in Workers’ Compensation Claims Handling

//  by 

Today’s blog focuses on when permanent disability advances (PDAs) are to be paid. The rules pertaining to PDAs have been somewhat murky ever since the governing law was amended eleven years ago. Prior to 2013, the only statute which addressed the payment of PDAs was Labor Code § 4650(b), which directed that PDAs begin within 14 …

When to Pay PDAs: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More

The EDD Experiment: A 60-Second Seminar in Workers’ Compensation Claims Handling

//  by 

Today’s blog tells the story of a long-forgotten workers’ compensation experiment that occurred back in 2003. It was a time when there was a significant shortage of worker’s compensation adjusters.  Coincidentally, in 2003 our state economy was in a recession with an unusual number of recently laid off and out of work college graduates receiving Unemployment …

The EDD Experiment: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More

Medical Bill Review: A 60-Second Seminar in Workers’ Compensation Claims Handling

//  by 

Allow us to give fair warning that some readers may find today’s blog to be disturbing.  A great deal of needless trouble and frustration is currently occurring due to the inability of a few medical bill review companies to recognize a simple DWC form.  Their actions are causing many problems in workers’ compensation, especially for …

Medical Bill Review: A 60-Second Seminar in Workers’ Compensation Claims HandlingRead More