How Medical Identity Theft Affects Claim Resolution

Medical identity theft occurs when a thief obtains treatment using the victim’s social security number or health insurance identification number. Authorities also report arrests of care providers who have stolen medical identities and submitted bills for treatment they never performed.  Cyber-attacks on medical data have produced a market for this kind of information. Treatment  A […]

Teaching Risk Management to an Eight-Year-Old

“Grandma, why did you move my chopsticks?” My extended family was dining on Cashew Chicken, Mongolian Beef, and fried wantons. Without missing a beat I answered, “Well, Ashley, I’m all about risk management. I noticed your chopsticks were sticking out over your lap, and there was a risk you or I might knock them to […]

Get “In Pro Per” Claims Off The Books

You know the claims I’m talking about: the really old claims where the Injured Worker is representing himself/herself. Let’s call them “in pro per”s.  Active in pro pers file one court paper after another, causing the insurer or self-insured employer to fund what seems like a never-ending stream of money to send a representative to the […]

Are You A Rule-Breaker?

Workers Compensation professionals have to know a lot: the California Labor Code, Title 8 regulations, state and federal rules governing health care entitlements. To make things even harder, the rules of this highly-governed road keep changing. Workers Compensation may be the most intricate, heavily regulated area of practice. These rules can constrain the parties’ ability […]

HOW POLITICS DRIVES UP THE COST OF YOUR MSA

For President George W. Bush and Congress to get Medicare Part D drug coverage passed in 2003, they had to make significant concessions to big business, including the drug industry. One of the law’s provisions forbids the government from setting rules for negotiating better drug prices. The “noninterference” section says: In order to promote competition […]

If you like it, then you have to put a ring on it.

If you like it, then you have to put a ring on it. In the mediation context, that means documenting your agreement. It’s a good idea to bring a partially completed Compromise & Release form to the mediation.  The document can be completed and signed on the spot. This is efficient and forestalls buyer’s/seller’s remorse […]

Why Mediations Are Like Diamonds

Anyone shopping for a diamond quickly learns diamonds have four characteristics known as the four C’s: Like a diamond, mediation is incredibly valuable and has its own 4 C’s: Confidentiality Candor Creativity Collaboration Confidentiality Confidentiality is what makes mediation work. Anything said in mediation cannot later be used in a court. If the parties do […]

WHY YOUR WORKERS COMP CLAIM EVALUATION IS WRONG

Contradictory dynamics involving life expectancy affect your large-exposure workers compensation claim evaluations. The industrial injury plus co-morbidities may decrease the injured worker’s life expectancy. But medical advances and heredity may mean your estimate of the injured worker’s life expectancy is too low. The Mortality Table Isn’t the Whole Story Parties typically use a mortality table to compute […]