This article is part of a series about why insurance carriers object to workers’ compensation reports and return them to the medical practice unpaid. This article is intended for medical providers, administrative staff, office managers, as well as insurance claims adjusters. If you’ve been following our series on objections to workers’ comp reports, you know about the importance of including a complete history of symptoms, activities of daily living (ADLs), prior injuries, and examination in your visit note. If you’re covering these bases, then you should be getting payment for your workers’ comp visits! Welcome to red flag #5 in Read More

This article is part of a series on the top reasons why insurance carriers object to a workers’ compensation report and return it to the medical practice unpaid. This article is intended for medical providers, administrative staff, office managers, as well as insurance claims adjusters. We have now covered two reasons that an insurance claims adjuster may object to your impairment PR-4 report: First, due to an incomplete history of symptoms, and second, because of an incomplete activities of daily living (ADLs). It is the intention of the claims adjuster to be skeptical about any and all things that can Read More

There’s a part of the workers’ compensation impairment report that is oft-ignored. The issue is apportionment, which means what part of the residual functional loss of the injury is industrial vs. other things. It’s confusing and hard to understand, and often left out of reports for this reason. As a result, many physicians don’t address it, or if they do it is incorrect and this delays claims. We are of course referring to apportionment. The AMA Guides to Evaluation of Permanent Impairment can be used to understand how multiple conditions are scored and weighted to make apportionment more relevant and Read More