DWC WARNS ABOUT BAD FAITH LIEN NEGOTIATIONS

DWC WARNS ABOUT BAD FAITH LIEN NEGOTIATIONS:

The DWC has issued a warning about bad faith negotiations. They have stated that the DWC has received complaints indicating that payers are refusing to negotiate liens without proof that the lien claimants have filed with WCAB or paid the activation fee.

SB 863 requires lien claimants to pay $150 activation fee for liens filed after 1/1/13.

The DWC issued a press release on 2/27/13 stating:

“…that some payers have adopted a policy of refusing to discuss negotiating the provider’s liens until the provider of the services demonstrates it has filed a lien with the WCAB and paid the applicable lien filing or activation fee required by the enactment of SB 863.” Further, the DWC stated that such practices are directly contrary to the legislative intent of SB 863 as well as existing law.

This conduct by payers could expose them to sanctions, attorney fees and costs under Labor Code section 5813 as well as other audit penalties under California Code of Regulations section 10109(e).

Public Hearing Set for Medical Provider Network (MPN) Rules

Adelson, Testan, Brundo, Novell & Jimenez (ATB Law) would like to make its audience aware that the California Division of Workers’ Compensation (DWC) will be holding a public hearing to discuss issues and changes connected with the Medical Provider Networks, or MPNs, following the passage of SB 863 last year. The term MPN was coined in 2005 as a way to describe health care providers and groups maintained by insurers and self-insured employers and approved by the DWC for workers’ compensation cases. SB 863 will bring significant changes to the way that MPNs operate in workers’ compensation claims. The DWC hearing will be the first occasion for members of the public to supply recommendations on these MPN changes as part of the state rulemaking process.

The details for this hearing are as follows:

January 31, 2013

10 AM to 12 noon

Elihu Harris State Office Building Auditorium

1515 Clay Street

Oakland, CA 94612

All Employers Should Have a Voice in the Rule making Process

It is hoped that the pending reforms will reduce costs to employers while developing a more navigable workers’ compensation system for all. The DWC is seeking public input on a variety of issues, including new MPN applicants, MPN audits and investigations, and the Independent Medical Review process. Employers will have the opportunity to participate in the formation of regulations for these new processes on January 31, and will also be able to share input on other facets of the law.

Adelson, Testan, Brundo, Novell & Jimenez believes it is important for employers to have a voice in workers’ compensation legislation, and encourages all employers potentially impacted by the coming changes to send a representative to this hearing and voice any suggestions or concerns they may have.

 

Nebraska Follows Other States Covering Workers’ Comp for Undocumented Workers

Adelson, Testan, Brundo & Jimenez (ATB Law) is committed to providing timely and practical information to employers concerned about workers’ compensation, and recent news from the state of Nebraska bears dissemination. The Nebraska Supreme Court recently ruled that illegal immigrants in the state are entitled to the same workers’ compensation disability benefits as legal workers, placing Nebraska among a growing number of states with comparable laws.

In its ruling on Moyera v. Quality Pork International, the Nebraska Supreme Court noted the legal inconsistency in denying workers’ compensation to illegal immigrants when this group is permitted to sue employers under tort law to recover damages in such cases. The Court also stated in its opinion that denying these individuals such benefits could incentivize the hiring of illegal immigrants, as by doing so employers could potentially avoid liability for workplace injuries by hiring illegal rather than legal workers.

Coverage for Illegal Immigrants Varies from State to State

Florida, Nevada, Texas, and Utah already have similar laws requiring employers to cover disability benefits for injuries sustained by illegal immigrants in the workplace. California also requires employers to pay workers’ compensation claims for illegal immigrants. Other states may expressly prohibit illegal immigrants from receiving workers’ compensation; Idaho and Wyoming are two states with such laws on the books. Still other states have ambiguous positions on this issue.

The differences in state laws can create obstacles for businesses with locations in multiple states that may have conflicting laws. The workers’ compensation attorneys of Adelson Testan et al. are aware of the uncertainties this causes for employers, and are prepared to help clients navigate the legal patchwork this situation creates in the following states:

  • California
  • Connecticut
  • Florida
  • Illinois
  • Iowa
  • Missouri
  • Nebraska
  • Nevada
  • New Jersey
  • Oklahoma
  • Pennsylvania
  • Texas

Whether your business requires workers’ compensation defense or workers’ compensation consultation to lower costs and reduce uncertainty, Adelson, Testan, Brundo & Jimenez are available to help. Contact us today to learn more about our firm’s comprehensive workers’ compensation defense services.

 

Adelson, Testan, Brundo & Jimenez Welcomes the First Participants in Their Newly Established ATB Legal Institute

Earlier this month, Adelson, Testan, Brundo & Jimenez (ATB Law) announced the formation of the ATB Legal Institute, a 12-week program in which recent law school graduates will work closely with ATB Law attorneys while receiving classroom instruction. The ATB Legal Institute was created to provide new attorneys with a valuable start to their legal careers by serving as a bridge between their law school education and their entry into the workers’ compensation defense field. Additionally, the ATB Legal Institute will identify selected, promising new attorneys for consideration for careers with Adelson, Testan, et.al.

The ATB Legal Institute Provides Abundant Benefits for New Attorneys

According to Kathleen L. Brundo, co-managing partner of Adelson, Testan, Brundo & Jimenez and leader of the ATB Legal Institute, “the practice of workers’ compensation defense law requires a unique combination of legal knowledge, communication and people skills, enthusiasm and insight that generally takes years to develop.” Adelson, Testan, Brundo & Jimenez hopes to advance the development of these skills for recent graduates recruited to the program. The benefits to those recruited to the program include:

  • A salary for the 12-week program
  • Hands on legal experience
  • Mentorship by an individual ATB partner
  • Participation in classes held by ATB partners and senior attorneys

At present, participants will be recruited from California law schools, including Pepperdine, Loyola, and Southwestern, where Ms. Brundo is an alumnus. As Southwestern Law School’s Dean Austin Parrish said of the program, “The ATB Legal Institute serves as a wonderful and innovative model program for helping promising new law graduates transition into specialty areas of the law.”

Adelson, Brundo, Testan & Jimenez Continues to Be a Thought Leader with the ATB Legal Institute

Since its founding in 1996, Adelson, Brundo, Testan & Jimenez has prided itself in bringing innovation to the practice of defending workers’ compensation claims. Whether through community outreach, its continuing education library for attorneys and clients, or its ongoing seminar and event series, Adelson, Brundo, Testan & Jimenez is committed to staying actively involved in the communities they serve. The ATB Legal Institute is the most recent example of how Adelson, Brundo, Testan & Jimenez is seeking to make a difference and give back to the community.

The inaugural class of the ATB Legal Institute will shortly welcome four recent graduates to twelve weeks working with and learning from the partners and attorneys of Adelson, Brundo, Testan & Jimenez. We look forward to meeting these promising individuals, and many future classes of participants through the ATB Legal Institute. For more information, please contact Ms. Brundo at kathleenbrundo@atblaw.net.

 

 

 

Diversity Is Valued Through Inclusiveness at Adelson, Testan, Brundo & Jimenez

Adelson, Testan, Brundo & Jimenez (ATB Law) believes in and supports diversity, not only by recognizing the value of differences between individuals, but also by supporting a culture of inclusiveness within the firm and with our clients.

We believe that any form of diversity helps strengthen an organization and community, but at ATB we take our commitment to diversity a step further and it’s reflected in our wonderful staff. Adelson, Testan, Brundo & Jimenez attorneys, associates and support staff represent a huge variety of different backgrounds and can offer services in all of the following languages:

Afrikaans

French

Korean

Spanish

Arabic

German

Mandarin

Swedish

Armenian

Greek

Marathi

Taiwanese

English

Hindi

Punjabi

Urdu

Farsi

Italian

Russian

Vietnamese

Adelson, Testan et al. also believes that diversity is more than language and culture. Diversity encompasses all backgrounds, beliefs, experiences, and worldviews. We recognize and value all different types of diversity, including that of race, sex, age, sexual orientation, and even personal interests.

One of the ways that we encourage inclusiveness for all groups is through community outreach programs and support. The organizations our firm supports are as diverse as Adopt a Fire Station, Cerritos College Women’s Soccer, and the Southern California Latvian School, just to name three of among over 100 programs to which Adelson, Testan, Brundo & Jimenez has contributed.

Adelson, Testan, Brundo & Jimenez actively supports diversity throughout our firm with our recruitment efforts and by offering internal mentoring programs and diversity trainings. This not only enhances our ability to serve clients but also enables us to connect more closely with them and with the communities in which we live and work.

Our firm embraces diversity in all of its many forms, in our office and in our communities. Adelson, Testan, Brundo & Jimenez believes that on a macro level, diversity makes the world a more enriching place for all. On a more local level, diversity strengthens the community by incorporating different ideas, viewpoints, and backgrounds. And at Adelson, Testan, Brundo & Jimenez, diversity makes us a stronger firm.

 

 

Adelson Testan Brundo & Jimenez Share Worker’s Comp Expertise with Self-Insurers

Recently three attorneys from the Oklahoma City office of Adelson, Testan, Brundo & Jimenez (ATB Law) participated in the annual Oklahoma Self-Insurers Association Conference in Tulsa, OK. Associate attorneys D. Craig Johnston and James Gaston along with managing partner Linda Foreman shared their expertise gleaned over years of counseling self-insured clients in regards to workers’ compensation and insurance claims.

The Oklahoma Self-Insurers Association (OSIA) represents self-insured employers, group self-insurance associations, municipal governments, higher education institutions, public school districts, hospitals, as well as vendors and providers who deliver services and products to self-insurers. OSIA’s stated mission is “to preserve, protect, and promote the rights and privileges of employers of Oklahoma who assume certain risks and liabilities by self-insuring.”

OSIA is a member of the National Council of Self Insurers (NCSI), a national organization dedicated to monitoring federal rules and regulations regarding the rights and responsibilities of self-insured employers. To support the mission of OSIA and NCIS, Adelson, Testan, Brundo & Jimenez attorneys shared their knowledge of workers’ compensation defense in relation to self-insurance with the members of the OSIA at their last annual conference held at the Hard Rock Hotel in Tulsa, Oklahoma.

As a national workers’ compensation defense firm, Adelson, Testan, et al. has extensive experience in defending self-insured employers and their third party administrators against workers’ compensation claims in the following twelve states:

  • California
  • Connecticut
  • Florida
  • Illinois
  • Iowa
  • Missouri
  • Nebraska
  • Nevada
  • New Jersey
  • Oklahoma
  • Pennsylvania
  • Texas

There are unique opportunities and challenges presented in defending employers who have chosen to self-insure their worker’s compensation liabilities. With many years of experience, Adelson, Testan, Brundo & Jimenez is especially adept at protecting the legal rights of their self-insured clients. For more information or to schedule an appointment with one of our lawyers, please do not hesitate to contact us today.

 

 

Managing Partner of Adelson, Testan, Brundo & Jimenez Appointed as Connecticut State Chair for CLM

Congratulations to Gerald Davino II, Managing Partner of Adelson, Testan, Brundo & Jimenez‘s Rocky Hill, Connecticut office, for being selected as Committee Chair of the prestigious Claims & Litigation Management (CLM) Alliance. Mr. Davino will be helping lead and launch the Connecticut chapter by heading up membership and working together with others to help plan events in local areas in 2013.

Mr. Davino recently completed the CLM sponsored Litigation Management Institute earning him the prestigious designation of Certified Litigation Management Professional (CLMP). As Connecticut State Chair, Mr. Davino will assist in the development and growth of CLM, strengthening affiliations, fostering communications locally, and creating opportunities for participation.

CLM is a national, collaborative alliance created to promote and strengthen the highest standards of claims and litigation management by bringing together industry experts and thought leaders. CLM values having a diverse membership and is dedicated to serving all individuals and companies involved in claims and litigation management, including risk and litigation managers, insurance and claims adjusters, attorneys, risk managers, and third party vendors.

Mr. Davino joined Adelson, Testan, Brundo & Jimenez in 2005, is licensed to practice in both the state of California and Connecticut, and practices in a variety of civil litigation and workers’ compensation matters. In addition to CLM, he is also an active member of the Connecticut Bar Association and Workers’ Compensation Section, Risk & Insurance Management Society (RIMS) and the Connecticut Farmington Valley Chapter.

What is Valley Fever? Workers’ Compensation Attorney Explains the Basics

As part of Adelson, Testan, Brundo and Jimenez’ ongoing educational seminar series, presented on ATB Law’s YouTube Channel, David Tew, managing partner at our Fresno office, covers workers’ compensation issues and defense strategies related to Valley Fever.

Valley Fever is also known as coccidiomycosis, an infection in the lungs and respiratory system caused by inhalation of Coccidioides immitis, a fungus that grows in soil in areas of the US and Central and South America. Valley Fever generally causes a temporary disability, and in its most common forms is not a cause to be unable to work. In cases where permanent disability does arise from Valley Fever, impairment can range from 0% to 100% disability, and in rarer cases may involve a death benefit.

Avenues of Workers’ Compensation Defense against Valley Fever

Valley Fever must be diagnosed through lab tests to create substantial medical evidence for a workers’ compensation claim. When deposing a worker claiming a Valley Fever injury, it’s also important to determine the symptoms, as Valley Fever’s various forms present with classic symptoms.  In addition, employees who live or visit endemic areas on a non-industrial basis will have difficulty proving industrial exposure, as will those who do not have a greater exposure than that of the general public. There are, therefore, four common avenues of defense against workers’ compensation claims involving Valley Fever:

  • If lab tests show negative results for Valley Fever but these are contradicted by a doctor’s opinion, there is a strong opportunity for defense if an exact copy of the negative lab tests is obtained.
  • Negative symptoms combined with a negative lab test are a possible avenue of defense.
  • Valley Fever can be recurring, and therefore a pre-existing condition that would not be covered under workers’ compensation.
  • Directly compare the employee’s risk of exposure to that of the general public through complete discovery and history of residence, travel, and illnesses, among other factors. If the employee’s risk was not greater than that of the public, the employee may not meet the bar of proving industrial exposure.

As one of the top workers’ compensation defense firms in the nation, Adelson, Testan, et al. is experienced in defending against all types of claims, including Valley Fever. Learn more about Valley Fever, including how it is spread, treatment options, diagnosis, complications, and further defense strategies by watching David Tew’s video seminar on Valley Fever on YouTube.