Greetings, an issue has come up recently on two of my files where the adjuster settled the file with a claimant directly pro se. The issue is whether the settlement covers “any and all claims”. In one, the claimant alleged he did not think he was settling his other claim. In the other file, […]
Greetings, A JCC just ruled that the E/C took too long after selecting a 1-time change doctor to “provide” the doctor, and thus the claimant was allowed to select their own physician. This is a JCC level decision, and not an appellate decision, but other judges could follow the rationale. (the link to the case […]
Greetings, In the past week, I have had a few issues come up with authorization letters and faxes to medical providers. The language we use matters greatly. I know many times we use the phone to provide the initial authorization, but you should always follow up in writing, email is even fine. To the provider: […]
Greetings, according to the Fla Admin code, medical providers in Fla Workers’ Comp are to use the 1996 Florida Impairment rating schedule to determine impairment ratings. I’ve attached a link below to the actual guides. Often we see issues arise in this area, and if the rating looks off, we should always check. […]
Greetings, An issue often comes up on claims where there is a gap in treatment, resulting in a gap in indemnity benefits. The most common ones I see are: Gap between the initial hospital visit (without restrictions being addressed) and the clmt being seen at a walk-in clinic. Gap between the date of accident and […]
Greetings, I have the pleasure of reviewing my new files over the weekend, so I usually get to read a few initial/recorded statements. And I know in all practicality, adjusters are pressed for time, but in general there are a few things I wish would be consistently asked in all recorded statements: Confirmation of competence […]
Greetings, Despite the return of hourly claimant’s attorney fees, it seems that adjusters are still able to settle some claims directly with the claimant or even the claimant’s attorney. While that is great, we have to make sure all the details are hammered out at the time of the settlement being agreed to…or they are […]
Greetings, As you well know, Florida legalized the medical use of marijuana last year, joining over 30 states that have some form of medical, if not complete recreational, use laws. At a Federal level, marijuana remains illegal as a controlled substance, even for medical use. In 2009, 2011, 2013 and 2014, the U.S. Justice Dept […]
Greetings, DOAH has put out their annual report on WC litigation (Fiscal year July 2016-June 2017), and it’s a nerdy treasure of statistics and reports. This is the first full year of data since the Castellanos decision (April 2016) removing the cap on claimant’s attorneys fees. I’ve attached the link, it’s 230 pages so […]
Greetings, Tis the season for holiday parties and functions, and inevitably, holiday party claims. If its an in-office event during the workday its likely going to be compensable. The events offsite, afterhours or when the workplace is closed are trickier. As a reminder, to be compensable, there are two things that both must apply: The […]