(A Humorous Look at the Intersection of Brackets and Claims Adjusting) I might not walk in your well-heeled shoes (or well-worn loafers) as a claims adjuster, but I see you. You are out there balancing a mountain of case files while your co-workers argue over which 13-seed is destined to wreck everyone’s bracket. So, from […]
Death benefits under California’s workers’ compensation laws can be a complex area for employers and claims adjusters to navigate. Understanding how the Labor Code treats “total” and “partial” dependency is vital for accurate benefit calculation, appropriate benefit distribution, and overall claims resolution. Below is an overview tailored to those who regularly handle claims—focusing on the […]
Introduction When a California law enforcement officer sustains two separate workplace injuries—especially if those injuries overlap in time—how should Labor Code § 4850 “leave of absence” benefits be applied? That is the question at the heart of Agaiby v. City of Culver City (2024 Cal. Wrk. Comp. P.D. LEXIS 382), a recent Workers’ Compensation Appeals […]
Introduction A recent panel decision out of the California Workers’ Compensation Appeals Board—Robasciotti v. Maxim Healthcare (2024 Cal. Wrk. Comp. P.D. LEXIS 365)—provides important lessons on how multiple impairments may be combined or “added” when rating an injured worker’s permanent disability. In particular, it underscores the continued importance of the “Kite doctrine,” which allows for […]
1. Apportionment Pitfalls and Documentation Key TrendMany recent WCAB decisions have emphasized the need for clear, well-supported medical opinions on apportionment. Panels repeatedly admonished parties where physicians simply assigned percentages with inadequate rationales or failed to distinguish non-industrial from industrial factors. Adjusters often faced delays and higher litigation costs when an inadequate physician report triggered […]
In a recent panel decision, the Workers’ Compensation Appeals Board (WCAB) offered a cautionary tale for claims administrators and insurance carriers on how a seemingly straightforward denial can inadvertently fail to trigger the one-year statute of limitations (SOL). Although Bracy v. State of California is not binding precedent, it provides valuable insights into best practices […]
