Control Costs - Safety Programs - Common Injuries - Best Practices

"Providing the Means to Lower Workers Compensation Rates"

Laws on Workers Compensation

I received a call from the claims adjuster on a workers' comp claim at a company where I was the HR Director. The conversation went something like this:

Mary:  Hello, This is Mary Appleton from ABC Workers' Comp Insurance. I want to discuss claim # 666-666, John Fakem.

Vie:  Yes, Mary, go ahead I have his file at hand.

Mary: I received a disclosure statement for the claimant's AA and with it a 132(a). I suppose you're still taking an AOE/COE position because your DOK was well beyond the DOL
I will send the IW to an AME ASAP, since we can't go the !ME route. What a joke, the AME and the !ME are both QME so why the hassle from the AA?
I'm still waiting for your payroll dept to send the AWE. I expect the State will find him QIW. When that happens the QRR will need aRU91.
I'll be recommending increasing the RESERVES at the QUARTERLY CLAIMS REVIEW. Even though I don't know when he'll be P&S'd and get a RTW order?
We're pushing Voc Rehab in hopes of getting a C&R.
We have his claims history so we may be going for APPORTIONMENT. Although they're tough when it's a CTD. I expect you'll be at the MSC, so I let our lawyer know.
Per your request I'll refer it to our Sill for SUBROSA.
Don't look for a C&R too soon. Your employee is going drag it out. He'll be collecting TD for couple of years and then go on to VRMA. I understand that you'll be paying the premiums on the group health insurance, as well.


Obligation to Inform Employees

Employers must post, in a conspicuous place, a notice about the workers' compensation carrier and who within the company is responsible for handling workers' compensation claims.
Failure to post this notice may be considered evidence of non-insurance. The notice must also include advice about the injured employee's right to receive medical care, to select or change the treating physician, and to receive temporary disability indemnity, permanent disability indemnity, vocational
rehabilitation services and death benefits as appropriate. LC §3550

Failure to post this notice will automatically permit the employee to be treated by his/her own physician for an injury occurring during the period in which the notice was not posted. LC §3550 (g)
Every employer subject to workers' compensation must give each new employee a written notice of the above information either at the time the employee is hired or by the end of the first pay period. LC §3551

If the employee makes the request, an employer must provide him/her with an appropriate form on which to indicate the name of the employee's personal physician. LC §3552
If the employer does not offer two or more certified health care organizations (BCG) for treatment of occupational injuries, the employer must furnish each employee, upon request, with a form allowing him/her to designate a personal physician prior to the date of injury.

If two or more certified care organizations are offered, that form must be furnished at the time of employment and at least annually thereafter, allowing the employee to designate the BCG or a personal physician.

Any such designated physician must be a licensed physician who has previously treated the employee and maintains that employee's medical history. The employer should retain the completed designation forms and a copy forwarded to the employer's compensation insurance carrier.
LC §4600.3

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