Medicare Set-Asides: Fundamentals on Protecting Medicare’s Interest
Medicare’s federal funds assist in covering a wide range of healthcare costs for adults age 65 and older, as well as for younger persons with specific needs and applicable benefits. The Medicare Secondary Payer (MSP) Act directs the Centers for Medicare and Medicaid Services (CMS) with protecting Medicare’s future interest in cases involving Medicare beneficiaries […]
What Constitutes a Timely Denial Under LC 5402(b)?
Generally, an employer must deny a claim within 90 days to avoid a presumption that it’s compensable. Labor Code 5402(b)(1) states, “If liability is not rejected within 90 days after the date the claim form is filed under Section 5401, the injury shall be presumed compensable under this division.” Once the presumption attaches, it can […]
Creative Strategies for Workers’ Compensation Claims Settlement
Creative Strategies for Workers’ Compensation Claims Settlement Let’s face it – Workers’ Compensation claims can be challenging. You know how difficult it can be to get to compromise and release – between managing client and injured worker expectations and handling negotiations, it can be a real struggle to get all parties on the same […]
Creative Strategies for Workers’ Compensation Claims Settlement
by Staff March, 2023 Let’s face it – Workers’ Compensation claims can be challenging. You know how difficult it can be to get to compromise and release – between managing client and injured worker expectations and handling negotiations, it can be a real struggle to get all parties on the same page. What if you […]
Requesting Consulting Physicians Within an MPN
Labor Code 4616.3(c) establishes a process that allows injured employees to obtain second and third opinions from physicians within a medical provider network. It states, “If an injured employee disputes either the diagnosis or the treatment prescribed by the treating physician, the employee may seek the opinion of another physician in the medical provider network. […]
The Pregnant Workers Fairness Act: Impacting Employers
The Pregnant Workers Fairness Act (PWFA) was signed into law on December 29, 2022, and goes into effect on June 27, 2023. What is this new law all about and what are some of its impacts? To answer these questions, a summary of the new law is presented along with three very important related topics, […]
Revisions to Medical-Legal Evaluation Regulations
California 2023 Employment Law Updates: Key Changes to Medical-Legal Evaluations The Division of Workers’ Compensation (DWC) introduced important updates to medical-legal evaluation regulations, effective February 2, 2023. These updates, detailed in the DWC’s official announcement, aim to improve scheduling processes and accessibility. Key Changes to Medical-Legal Evaluation Regulations Extended Time Limits for QME Appointments […]
Crush Your Career Goals with Professional Development
by Staff February, 2023 It’s never too late to get started on your career and professional development. You can take steps today to get closer to achieving your goals, no matter what stage of life or career you’re in. By investing in your own professional growth, you are equipping yourself with the tools and knowledge […]
2023 California Employment Law Updates
2023 marks the end of COVID-19 emergency regulations and the implementation of permanent COVID requirements. While several of the new 2023 laws relate in some way to COVID, businesses can expect a return to more non-COVID related requirements. Employers must implement wage transparency policies and implement an expansion of CFRA and sick leave policies by […]
Striking a Qualified Medical Evaluator and the Mailbox Rule Revisited
In represented cases in which a panel of qualified medical evaluators (QMEs) is required to resolve a disputed issue, Labor Code 4062.2(c) states, “Within 10 days of assignment of the panel by the administrative director, each party may strike one name from the panel.” Pursuant to Messele v. Pitco Foods, Inc. (2011) 76 CCC 956 (appeals board en banc), it […]
