Treatment Authorization Requests: Ensuring Proper Compliance with 12 NYCRR 325-1.4

Workers’ Compensation Law Section 13 establishes the obligation of the employer to “promptly provide for an injured employee such medical surgical, optometric or other attendance or treatment… for such period as the nature of the injury or the process of recovery may require.” When requesting authorization for treatment, the provider submits a Board form titled, “Attending Doctor’s Request for Authorization and Insurer’s Response.”  The Board code for the form is
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How To Ensure Your IME is Compliant with Section 137

In order for an Independent Medical Examination (IME) report to be compliant with Section 137 of the Workers’ Compensation Law, a copy of each report must be submitted by the practitioner on the same day and to the Board, the insurance carrier, the claimant’s attending physician or practitioner, the claimant’s representatives, and the claimant themselves in the same manner (WCL Section 137(1)(a)). “If a practitioner who has performed or will be performing
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Timing Negotiations Where Claimant Has a Third Party Action

Clients frequently seek advice on how to resolve workers’ compensation claims. Often, as attorneys, we are in the best position to negotiate a settlement when we have some leverage on issues impacting a claimant’s entitlement to benefits, such as cases where labor market attachment has been raised or a client’s consultant is of the impression that a claimant has no further causally related disability. In short, timing is everything in
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Due Process in the New Jersey Workers’ Compensation System

In an ideal workers’ compensation system, all parties would keep to the letter of the law. However, courts’ rules are oftentimes relaxed within our system and often not followed. In handling any New Jersey workers’ compensation claim petition, employers, employers’ attorneys and claims professionals must be diligent in making sure that employers’ fundamental rights are not violated by this relaxed approach. All parties, petitioners, and respondents have the right to
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Recreational Marijuana and Workers’ Compensation: What Employers Need to Know

With the impending legalization of recreational marijuana in Illinois on January 1, 2020, employers are abuzz about the potential implications on their operations, particularly how legalization impacts alleged work injuries. Under the Illinois Workers’ Compensation Act, employees found intoxicated at the time of an accident are denied compensation if the intoxication was the proximate cause of the injury or if the employee was so intoxicated it constituted a departure from
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Connecticut Legislative Update: Workers’ Compensation Coverage Expanded for Some First Responders

In a rare legislative change to Connecticut Workers’ Compensation Law, Gov. Ned Lamont recently signed into law Senate Bill No. 164 (Public Act 19-17), which expands workers’ compensation coverage for some first responders who experience mental or emotional impairment following certain traumatic events experienced in the line of duty. Specifically, the bill allows for police officers, firefighters, and parole officers that have been diagnosed with Post-Traumatic Stress Disorder (PTSD) to
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Get It Right the First Time: Why You Should Not Skimp on an IME Cover Letter

We have all been there. The workers’ compensation law judge has directed the carrier to produce an Independent Medical Examination (IME) within a specified number of days. Somehow, we managed to get the report completed timely, even after many scheduling attempts, cancellations, or claimant no-shows. Then, your IME consultant failed to address the key questions. We can try our best to have the law judge grant the carrier an opportunity
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The Holidays are Over. Is Your Office Party Injury Compensable?

Employers throw annual parties for the employees to commemorate another successful year. Of course, once the music starts going and the drinks start flowing, the employers are left with an annual headache of a question – are employees that were injured in relation to these festivities covered under Workers’ Compensation? While compensability for office party injuries is a highly fact-intensive determination, claimants usually emerge victorious. Generally, even if the party
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Minor Issues When A Minor Gets Injured At Work

While not very common, if a minor is hired and then injured on the job, the trajectory of this particular compensation claim will be slightly different than the typical workers’ compensation claim. The most significant difference is that a penalty will be imposed against the employer if the employment of the minor is found to be illegal by the Workers’ Compensation Board. Workers’ Compensation Law Section 14-a governs compensation issues
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