Greetings, As our workforce ages in Florida, we will continue to see an increase in PTD claims. (Here’s a link to two great studies on the workforce aging and population in Florida). http://edr.state.fl.us/Content/presentations/population-demographics/DemographicTrends_11-6-13.pdf https://datausa.io/profile/geo/florida/#intro I often get questions about some of the terms and nuances of PTD. Here are a few terms/issues I see most […]
Greetings, I probably get 2-3 questions a day from clients to help them make a determination on whether an accident or injury c an be denied or if it is compensable. (Keep those questions coming!) In laymen’s terms, an accident is the event, the injury is the result. We often use the terms interchangeably as […]
Greetings, this tip is on everyone’s favorite topic, math. For the first few weeks of a claim, it can be difficult to obtain the correct information regarding the AWW and post-accident earnings to pay benefits correctly. This can create hodge-podge of underpaid weeks and overpaid weeks once the info is received. Per the statute, any […]
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 […]