As part of the Grand Bargain, we have in the workers’ compensation system a process known as the exclusive remedy. What has been traded for is a quick and easy way to address injuries received in the occupational space. Consequently, we have a system that takes us out of the court system to receive proper benefits for those injuries. Exclusive remedy is doctrine and in return, employees cannot sue their…
A significant issue facing workers’ compensation professionals is rising medical costs. We all deal with escalating expenses, and there are a number of vendors who have offered various solutions to limit this escalation. The question becomes what can that workers’ compensation professional do to mitigate the expenses? Understanding that there are multiple methodologies to mitigate rising healthcare costs, one of the first steps noted is prevention. Candidly, that is well…
By definition, fraud is the intentional intent to use deceit, trickery, or other nefarious means to deprive another individual of their inherent money, property, or legal rights. The majority of injured individuals were legitimately injured while furthering their employer’s interests. However, we all know that there are those individuals who feel they are entitled to something to which they are not, and as such will employ various tactics to pad…
All too often, we see a diagnosis of a “sprain/strain” relative to the lumbar or cervical spine. There is a huge difference between the two, and the treatment may overlay initially, however, in the long run, the interventions can become quite different as will the length of duration. Thus, it is imperative that the exact diagnosis be objectified and the injury be limited to what actually occurred. The major difference…
