A panel of three Administrative Law Judges – Judge Melodie Belcher, Judge Vicki Snow, and Judge William Cain – addressed the workers’ compensation section of the State Bar on October 15, 2009. A major focus of their presentation was good and bad practice habits of employers, insurers, and attorneys.
The Judges made several useful recommendations.
- File the Forms: All three judges stressed the importance of filing forms correctly, and timely. Remember to file the WC-1 within 21 days of the employer’s knowledge of the accident. A WC-2 must be filed and served upon both the employee and the employee’s attorney if represented, and failure to provide timely notice of suspension of benefits (10 days) can result in additional benefits owed. A WC-3 must be filed within 21 days of the employer’s knowledge of the accident or within 81 days of a claim which was initially accepted as compensable. Failure to file board forms in a timely manner may result in assessed penalties and attorney’s fees against the employer/insurer.
- File the Forms Part II: Filing the proper forms is so important to Administrative Law Judges, they advised that even a form filed after the deadline can avoid penalties and fees, so long as it is filed. The lesson to take from this is to the file the forms, even if they’re late.
- Retain Counsel at the Outset of Litigation: Judges do not like having to track down insurers to determine whether they want an attorney to represent them at an upcoming hearing. They also do not like attorneys asking for a continuance because they are new to the file. Hiring an attorney early in the process avoids this frustration. It also helps protect the employer/insurer’s interests and may lead to a greater chance of success at the hearing.
- Peer Review is for Medical Bills Only: Peer review is a forum to resolve disputes over medical expenses between medical providers and employers/insurers. The Judges correctly pointed out that peer review was not intended to serve as a substitute for an IME or to negate the opinion of the authorized treating physician.
