BWC turns Incidents into Allowed Claims for State Fund Employers
The BWC is now allowing incident only reporting as claims even when the employee has not sought medical treatment or in which medical treatment is rendered. It’s time for state fund employers to review their reporting requirements and determine which claims are reportable.
Additionally, state fund employers need to once again carefully review all the paperwork they are seeing and dispute those claims in which no medical treatment is sought or given. The threshold for allowance is that the injury must be in the course of and arising out of employment, without medical verifying that it was in the course and scope of employment the claim should not be allowed.
Changes, Changes and NOT Always for the Better!
State Fund Employers Forced to Act Like Self-Insured
Employers for Efficiency’s Sake
Have you seen these new letters that the BWC is sending out requesting that state fund employers either agree or disagree within a three (if received by fax) or seven day (if received by mail) timeframe?
Guess what? If you disagree some of the BWC examiners are sending them straight to hearing without securing a BWC file review or independent medical examination. So within seven days, a BWC claims examiner can theoretically move the C-86 motion off his or her desk and send it directly to the Industrial Commission.
When a state fund employer does not respond within the request letter time frame, orders are being sent out indicating that the employer did not respond, and the medical submitted by the claimant is sufficient to allow the condition. While we are assured this is not being done on every case, employers need to know that these request letters need a timely response
Additionally, state fund employers need to be aware that if they dispute a condition, they can no longer rely on the BWC in every case to perform either a file review or an independent medical evaluation. From a practical standpoint, employers need to be aware that in disputing a condition they may be required to pay for file reviews and/or independent medical evaluations in the absence of those that were once provided by the BWC as part of and paid for by their premium.
OSBA Webcast: Basics of Workers’ Compensation
Lisa Patterson will be a key speaker at the OSBA Webcast: Basics of Workers’ Compensation
on Friday, April 25, 2014.
Topics will include:
- overview of the Ohio Workers’ Compensation system
- what is compensable
- available benefits
- the Administrative hearing process
- managing a claim
- settlement considerations
- judicial review
Please click on the link below to sign up for this informative seminar!
Dayton B2B “The Post-Recession Battle” by Ria Megnin
Large, small legal firms vie for post-recession clients in a shifting landscape influenced by
niche focus, technology, graduation rates. In recent years, the business landscape for legal
firms has also faced significant upheaval. That’s visible in the rise of smaller, independent firms
with 10 or fewer staff members, “boutique” firms that focus on one or two areas of law.
“When you go to a boutique law firm, you’re getting someone with the same experience as a big
firm attorney, and you’re dealing with that attorney one-on-one,” said Patterson.
Please see the attached for the complete article.
Dayton B2B The Post-Recession Battle March 2014[smallpdf.com]
Lisa Patterson, OSBA CLE speaker on March 19, 2014
Lisa Patterson will speak at a webcast for the Ohio State Bar Association on
March 19, 2014 from 1:00-2:00 p.m. on the topic
“Managing a Workers’ Compensation Claim – Employer Perspective.”
Please copy and paste the link below if you would like to register for this informative webcast:
http://osba.inreachce.com/Details?resultsPage=1&sortBy=&category=beeb39f6-5874-434d-9b0f-1a84495bc232&groupId=a0b61cb9-096d-4fe0-a42c-4439536919a6