July 2010

Last February, I wrote about the common misplaced notion that a request for a diagnostic test by an authorized doctor must accompany proof that the test is for a compensable body part.  There is a slew of case law that says otherwise (see Chance v. Polk County Schools). 

But, what if the E/C has an Independent Medical Examination (IME) to counter the recommendation of an authorized doctor? (more…)

For many W/C claims, the hard part is differentiating where the physical injury ends and where the psychiatric injury begins.  Often, the pain associated with a severe work place injury will lead to certain psychiatric impairments: anxiety, depression, paranoia.  However, there are statutory limits to the exposure E/C’s have in claims with mental and nervous injuries.

In a seminal case, the First DCA sifted through the mental and nervous injury statute to decipher what happens when a Claimant suffers a psychiatric injury simultaneously with her physical injury. (more…)

While everyone gets ready for “Comp Camp” next month at the FWCI Convention in Orlando, with all of its catered meals, live music, and open bars, we must not forget that things actually get done at the Convention.  For example, the Division of Administration Hearings (DOAH) has proposed changes to the Rules of Procedure for W/C Adjudications and will be presenting them at a hearing at the Convention on August 18, from 8 am to 9:30 am.

These changes reflect the desire to transfer all legal pleadings to towards e-filing, as well as streamline the mediation process.  However, buried within these procedural changes is a whopper of a rule change that can affect every claims professional and HR person handling W/C files:  

Finally, DOAH is placing a Statute of Limitations on motions for Claimant attorney fees. (more…)

The Association of Workers’ Compensation Proffesionals (WCCP) has a very important post up on their website about potential draconian changes to the Department of Financial Services’ Adjuster Code of Ethics.  Some of these changes do not reflect the real world scenario of a W/C adjuster.

These changes have the potential to expose alot of Carriers and their claims professionals to serious legal exposure.  I encourage you to read the letter, posted by WCCP Executive Director Jim Greer, here.   There is still time to communicate your dissatification with these changes to the Department of Financial Services.

If you are a claims professional and have not joined WCCP, I encourage you to do so.  They provide excellent services, including industry newso, nline forums, job listings, and continuing education programs, including one of my favorites, the Florida Bar Workers’ Compensation Board Certification Forum held in Orlando every April.   The WCCP is kind enough to link to this blog as well. 

You can see my updated posts at their website and Facebook page.

This morning, another attorney in my firm received a request from a Claimant’s attorney for mileage reimbursement for travel to a gym.  The authorized treating physician recommended the gym membership and found it to be medically necessary.  The E/C paid for the membership.

Since I am the “blog guy” in my firm, this attorney naturally asked me to research this.  And, since his initial reaction–and mine–was to deny the request, I thought I would share with you my research. 

What do you want bet that I came up with an answer we didn’t expect? (more…)

Count temporary partial disability (TPD) along with the 5-day rule and the statute of limitations, as an area the First DCA wants to clarify.   And, clarify they did. 

With many Florida employers shedding jobs over the last three years due to the current econmoy, the question of TPD entitlement is becoming an ongoing debate among the defense and Claimant’s bar.  How do you connect Claimant’s wage loss to the compensable injury when the reason for wage loss is the economy?

With Wyeth/Pharma Field Sales v. Toscano, we now have a definitive ruling on the matter. (more…)