RateFast Podcast: Attorneys in Workers’ Comp: A Historical Perspective

This article is a transcriptions of an episode of the RateFast podcast, which you can listen to by searching “RateFast” in iTunes or the iOS podcast store.

Truly, it’s not ideal to have to hire an attorney for a work comp claim. Work comp attorneys however, are hired when the events of the claim are not ideal.

Originally workers’ compensation was supposed to simplify the process of an occupational injury or illness. As industry got more complex, corporations got bigger, and fraud was more and more common, attorneys became a necessity.

We spoke with attorney Phil Walker about his over 30 years of experience with workers’ compensation, how far it’s come, and where it appears to be going.

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What Are The AMA Guides? A Brief History and Explanation

It is important that physicians have a framework that they can use to show stakeholders the results of their examinations of a worker’s injury. The framework the physician uses is the standard used by the entire state so that they can agree or dispute the results within the language of the framework.

This framework is the AMA Guidelines, a book divided into several editions that is used in most states to measure permanent impairment as a result of injuries. This is a quick primer intended to give a little information to those unfamiliar with the Guides.
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RateFast Podcast: How Spinal Injuries in Stack Up in Work Comp

This article is a transcriptions of an episode of the RateFast podcast, which you can listen to by searching “RateFast” in iTunes or the iOS podcast store.

Physicians have a number of different diagnostic tests requiring special machines, that they use to determine the severity of an injury. It’s not always necessary to throw a patient into an MRI machine when they come in complaining about back pain, however. Sometimes an effective treatment plan is enough to ensure that a potential injury gets better, instead of getting much worse.

We talked to Dr. Christian Athanassious regarding the intricate details about, and differences between, bulging and herniated discs. In our podcast, Dr. Athanassious helped to shed light on the steps that a spine specialist takes to determine the severity and treatment of discs in the spine.
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Gender Bias, Lawmakers, Semantics, and Workers’ Comp

In October, governor Jerry Brown vetoed the bill AB 570. This bill would have made an amendment to Labor Code Section 4663, saying “No percentage of an apportionment in the case of a physical injury occurring on or after January 1, 2018, shall be based on pregnancy, childbirth, or other medical conditions related to pregnancy or childbirth.”

This is the third year in a row that a bill rolling back apportionment laws when considering pregnancy and childbirth has been written, and then vetoed.

The amendment that AB 570 proposes is simple enough, but the politics surrounding the decision to veto the bill are more complex. Bear with us, it’s not all black and white.

This story begins in the early 2000s.
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RateFast Podcast: How Bad Is It, Doc? First Aid vs. Recordable Injuries

This article is a transcriptions of an episode of the RateFast podcast, which you can listen to by searching “RateFast” in iTunes or the iOS podcast store.

Not all work-related injuries require a workers’ compensation claim. The severity of an injury marks the difference between a recordable injury (opening formal claim that involves follow-up visits and an impairment rating), and the simple application of first aid.

Most first aid injuries can be recognized and treated on the spot, but the doctor always has the full authority to determine whether or not to open an injury claim. Read on to learn about how this decision is made.
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The Las Vegas Shooting and Why Police Officers Were Denied Workers’ Comp

Acting in the face of imminent death merits a huge deal of honor, but as several courts in California have shown, it doesn’t obligate a county to supply workers’ compensation benefits.

The story

On October 1st, a lone gunman fired rounds of ammunition into the crowd of a festival with tens of thousands of attendees. This was the deadliest mass shooting conducted by an individual in the United States at the writing of this article.

The Las Vegas police who responded to the scene were quickly joined by off duty Los Angeles police officers who were attending the festival. Along with hundreds of others, some of these L.A. police officers incurred injuries from the shooter.

Returning to Los Angeles, the officers—having responded and been injured in the action—filed for workers’ compensation benefits. A few days later, their requests were denied.
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Common Objections to Workers’ Comp Reports: Apportionment

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 claims adjusters.

Welcome to the final in our series of posts about red flags in impairment reports, and how to ensure that your reports are not objected to by an insurance company. In our previous posts, we have covered incomplete history of symptoms, unchecked Activities of Daily Living (ADLs), accounting for prior injuries, incomplete examination, and complications with diagnostic tests.

In a perfect world, the long road of a workers’ compensation claim would end in a healthy patient with a 0% WPI, an fairly compensated primary treating physician, a satisfied claims adjuster, and no involvement with an attorney. But it’s rarely this simple.

Apportionment is an attempt to objectify something that cannot be measured with tools, which opens up the possibility for disagreement. As we’ve learned from our other blog posts in this series, disagreements between PTPs and the employers’ insurance can cause slowed claims, delayed treatment, and could result in the need for an attorney.
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