Summary: Just when you thought the claim by your injured employee was finally over and closed with a voluntary resignation, you still might have to meet with him/her to discuss possible return to work.
We all know that Yogi Berra was right when he said "It ain't over until it's over." That could not be truer than with workers' compensation claims.
Just when you thought the claim by your injured employee was finally over and closed with a voluntary resignation, you still might have to meet with him/her to discuss possible return to work. This is due to the Interactive Process (I/P) rules imposed on you by the Fair Employment and Housing Act (FEHA). You will all remember that failure to enter into an Interactive Process, where there are work restrictions, is a violation of the law itself.
All the plaintiff needs to do is show that you did not meet with him/her in good faith to discuss how you might accommodate the return to their usual and customary job. If you did not do an Interactive Process, then it becomes just a matter of how many zeros go on the check you will ultimately write. I need only point to the over $2.2 million dollar jury verdict against the Auto Club for failure to do an Interactive Process with Mr. Weisinger when his doctor recommended an accommodation and they ignored him.
Well, Yogi's saying is also true when it comes to liens. They are filed for everything you can imagine including medical costs, translators, investigators and even pharmacies. The problem has been that they take on a life of their own and have clogged the system to such a degree that other more important matters such as hearings and trials for claims are being needlessly delayed.
However, there appears to be a light at the end of the tunnel. The Director of Industrial Relations (DIR) and the Administrative Director (AD) for workers comp have been listening. Effective May 23, 2012, new court rules are now in effect that are intended to cut down on the number of continuances a lien claimant may request and reduce greatly the number of documents that can be filed in support of the lien. The intent is to help reduce the huge backlog of unresolved liens which do nothing more then keep claims open.
The new rules require someone filing a lien to request a conference before actually filing a Declaration of Readiness (DOR) for a trial date. Lien claimants will also be limited to only one continuance and of the greatest importance is the judge's ability to dismiss the lien if the claimant fails to appear at the required conference. Finally, there is also a rule that allows the claim to be dismissed if the lien claimant fails to file a timely request for trial after the conference if the claim is not resolved at that time. The bottom line — a quicker resolution to a problem that has plagued the system for too many years.
Stu Baron is a nationally recognized expert on managing workers’ compensation claims. He is both President of Workers’ Compensation Claims Control and a principal in the law firm of Stuart Baron & Associates. Stu has been heavily involved in advocacy in Sacramento. He is quoted frequently by major workers’ compensation and trade journals.
More articles, videos, and podcasts by Stu Baron:
New Laws ... New Responsibilities ... New Opportunities
Are You Aware Of The Independent Employee Act Defense?
SB 863 Valdez Revisited
The Dark Side Is At It Again
Medical Provider Networks – Valdez v. Zurich North America
Insurance Thought Leadership exists to "simplify the complex." The insurance industry is fraught with complexity so our defining vision is to aggregate and deliver best practice solutions from highly respected experts in their field. Insurance Thought Leadership provides knowledge and experience at a time when its needed most, times of sweeping change and market uncertainty.
Whether it's Healthcare, Worker's Compensation, Property & Casualty, Auto, Sophisticated Life Insurance designs, Directors & Officer's, Safety, Risk Control or other Claims Management, Insurance Thought Leadership promises to deliver the most relevant mind share the industry has to offer, thus our defining vision … to "simplify the complex."