Medicare and Workers Compensation

Medicare is like the mob. They’re protecting their turf. Some have chosen not to pay heed to their warnings. They have given us warnings. Non compliance is everywhere. Medicare ain’t playing. It’s mandatory. Know the facts, be proactive-start compliance efforts early. #LSlaw

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Williams v Department of Corrections

This August 31, 2012 1DCA opinion reversed Judge Winn's JCC decision. In this case, the timeline is important. In short, the timeline was: A PFB for PTD benefits was filed on January 25, 2011. The carrier received the PFB on January 28, 2011. On February 16, 2011, the carrier accepted the claimant as PTD (18 days after receipt of the PFB). The very next day the carrier issued a $2,000 advance that had previously been requested by the claimant. Finally on March 10, the carrier issued a check paying the claimant PTD benefits minus the $2,000 cash advance.(the first installment of PTD benefits was made 41 days after the PFB was received by the carrier.) Claimant's counsel filed for attorney fees asserting as grounds that the carrier initially denied the claim but ultimately accepted the claim. The JCC denied fees concluding that the advance paid was a discharge of liability from the date thereof until such advance is recouped by offset against subsequent benefits

2 Billion overspent on WC prescription drugs

Here is an interesting article on the cost of prescription medications and the extra moneys that workers compensation insurance companies are spending. I've been harping on this same issue for years. There has to tighter control on the medications that are paid for insurance companies. Click here to see the article

Hit Products v Sakiba Krivdic

This April 12, 2012 1DCA decision affirmed a JCC decision of Judge Remsnyder. This case shows the relative ease that a claimant can get an initial $2,000 advance. At the JCC level, the claimant was awarded a $2,000 advance because there was competent substantial evidence to support that the Claimant had been unable to return to the same or equivalent employment. The employer/carrier disagreed with the JCC ruling and appealed. The first DCA affirmed the JCC's ruling concerning the advance. The 1DCA held that there was competent substantial evidence to support the JCC’s finding that the Claimant has been unable to return to the same or equivalent employment,and was eligible for an advance of $2,000 under § 440.20(12)(c), Fla. Stat. (2010). FYI Under 440.20(12)(c), there are 3 requisites for an award of an advance of $2,000 or less: 1: The Claimant has been unable to return to the same or equivalent employment with no substantial reduction in wages;or 2: The claiman

Luks Santaniello's Florida Workers Compensation blog

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