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Changes, Changes and NOT Always for the Better!

Thursday, April 3, 2014

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.

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