Last month, the California Senate passed SB 697. This bill, if signed into law, would require the Administrative Director of the Division of Workers’ Compensation to perform a study on whether it would be viable to link payment for workers’ compensation medical treatment to “value of care” instead of the current model where providers are…
What happens when you are severely injured at work but are not deemed 100% disabled from that injury alone – yet can’t find a job because of the injury and other disabilities? For injured workers with prior injuries and a qualifying Subsequent Industrial Injury (“SII”), they may be able to obtain benefits from a Subsequent…
Beginning January 1, 2023, peace officers, fire fighters, and other qualified public servants in the State of California (and the attorneys who represent them) will have new tools to ensure that workers’ compensation claims administrators fairly and timely handle claims involving legal presumptions for these employees. A “presumption” effects the burden of proof. Typically, an…
What is the Supplemental Job Displacement Benefit (SJDB) retraining Voucher A retraining voucher (formally a Supplemental Job Displacement Benefit or SJDB Voucher) is designed to help injured workers retrain for different careers or positions. It is not required in every case. It’s designed to cover the costs of retraining (within limits) if an injury causes…
As my partner Marc S. Wiesner outlined in a prior post, time missed at work due to a workplace injury is compensated by a benefit called Temporary Disability. Per California Labor Code §4653, this in generally calculated at 2/3rds of the injured workers Average Weekly Wage. However, certain employees in the State of California are…
In my first post, we covered issues that arise earlier in a case (AWW, TD, PTPs, WPI, RFAs, UR and IMR). Part II covered some of the common issues (and shorthand) that would come up later in a case (P&S, stips, C&R, MSA, F&A). Though uncommon, there are particular issues that might exist in a…
I know, it’s mind-blowing, isn’t it? Your work comp doctor, who the insurance may have sent you to, requests treatment but the doctor tells you you have to wait. Why isn’t the treatment immediately available? Why can it be denied and you don’t hear about it for days or weeks after? Welcome to the world…
My earlier post covered issues that arise earlier in a case (AWW, TD, PTPs, WPI, RFAs, UR and IMR). Later in a case, you might encounter one or some of the following situations (with their associated acronyms): P&S—Permanent and Stationary A Permanent and Stationary (P&S) determination can be made by a Primary Treating Physician (PTP),…
Imagine being injured so badly at work that your doctor tells you to stay home. Or, your doctor gives you work restrictions and your employer cannot meet them. You should get paid until you can return to your job or another job. Right? While that makes logical sense, unfortunately, few things in a workers’ compensation…
As with many things in law, the answer is, it depends. The more cynical answer is, yes, but the insurance controls the doctors on the list. So, how good is that list going to be? We call these lists Medical Provider Networks or MPNs. Each workers’ compensation insurance carrier, administrator, or self-insured employer (we will…
