View
2
Download
0
Category
Preview:
Citation preview
Workers’ Compensation
JeopardyMaking Workers’
Compensation Fun!
Hosted By: Edward R. Carpenter, Jr., EsquireDistinguished Advisors:The Honorable John McTiernanMarla A. Joseph, EsquireChristopher A. DiMeo, Esquire
JeopardyWhat’s your diagnostic?
It’s all in the document
It gets unusual To pay, not pay, or it depends
That settles it
100 100 100 100 100
200 200 200 200 200
300 300 300 300 300
400 400 400 400 400
500 500 500 500 500
This imaging study is considered to be the gold standard for rendering a definitive diagnosis.
To Answer
What’s your diagnostic for 100
What is an MRI? Back to Jeopardy
The analysis of the electrical data for this study may support a diagnosis of carpal tunnel
syndrome.
To Answer
What’s your diagnostic for 200
What is an EMG?
Back to Jeopardy
This temperature sensitive study was thought to detect areas of injury within a patient's body.
To Answer
What’s your diagnostic for 300
What is thermography?
Back to Jeopardy
This study can be used to support a diagnosis of complex regional pain syndrome.
To Answer
What’s your diagnostic for 400
Back to Jeopardy
What is a bone scan?
This diagnostic study could be a central piece of evidence in establishing an intoxication defense.
To Answer
What’s your diagnostic for 500
What is a blood test?
Back to Jeopardy
This popular Bureau document allows an employer to continue investigation of a claim
without prejudice.
It’s all in the document for 100
To Answer
What is an NTCP?
Back to Jeopardy
It’s all in the document for 200
This seldom used document allows for continued payment of medical expenses while concluding the claim.
To Answer
What is a Final Receipt? Back to Jeopardy
It’s all in the document for 300
This unilateral document can stop wage loss benefits on an accepted injury.
• To Answer
What is a Notification of Suspension? Back to Jeopardy
It’s all in the document for 400
This EDI transaction should be filed within 21 days of notification of an accident to properly contest an injury.
• To Answer
What is a SROI-04 (Notice of Denial)?Back to Jeopardy
It’s all in the document for 500
This all-purpose document can be utilized to reinstate or cease the payment of workers' compensation benefits.
To Answer
Back to Jeopardy
What is a Supplemental Agreement?
It gets unusual for 100
An air quality study can be utilized to determine whether there has been exposure to this "growing" source of work-related injuries.
• To Answer
What is mold?
Back to Jeopardy
It gets unusual for 200
A kiss causing this severe medical condition has been determined to be compensable.
• To Answer
What is Hepatitis C?
Back to Jeopardy
It gets unusual for 300
Exposure to this formerly common construction product can result in both workers' compensation and general liability claims.
• To Answer
What is asbestos?Back to Jeopardy
It gets unusual for 400
Continued exposure to bromide in brick mortar may result in this defense not being valid.
To Answer
What is a return to baseline?
Back to Jeopardy
It gets unusual for 500
Stifling this otherwise normal bodily function can result in an award for benefits for an injury to an eye.
• To Answer
What is a sneeze?Back to Jeopardy
To pay, not pay, or it dependsfor 100
An NCP describes claimant’s compensable injury as “low back strain”. The claims representative receives a bill for a lumbar discectomy.
• To Answer
What is it depends?
Back to Jeopardy
To pay, not pay, or it dependsfor 200
An NCP mistakenly states the compensable injury as “right knee” but all medical records from the panel doctor note a left knee injury. The claims representative receives a bill for treatment of the left knee.
To Answer
What is pay?Back to Jeopardy
To pay, not pay, or it depends for 300
A claimant returns to work and the claims representative immediately mails a Notification of Suspension. On the last day a Challenge can be filed, the claimant calls the claims representative and states she is not working but can not find the Notification of Suspension to Challenge.
To Answer
What is it depends?
Back to Jeopardy
To pay, not pay, or it depends for 400In a final unappealed UR Determination, the reviewer concludes that treatment including prescriptions for Percocet were unreasonable and unnecessary. The claims representative receives a bill for Percocet from another doctor.
• To Answer
What is pay?Back to Jeopardy
To pay, not pay, or it depends for 500
Case resolves via a Compromise and Release. Both parties waive the appeal period. Fourteen days after the WCJ approves the agreement, the claims representative finds out the claimant died prior to that approval.
To Answer
What is it depends? Back to Jeopardy
That settles it for 100
A Mandatory Mediation cannot be conducted by this individual.
Answer
That settles it for 100
Who is the adjudicating judge?(See Judge Rules 131.59, 131.59a and 131.59b)
Back to Jeopardy
That settles it for 200
A Stipulation of Fact may resolvea dispute if it's signed and dated
by claimant and counsel and is this.
Answer
That settles it for 200
If it is fair and equitable to the parties?(See Judge Rule 131.91)
Back to Jeopardy
That settles it for 300
A WCJ, before approving a C&R Agreement, must determine this
Answer
That settles it for 300
Does the claimant understandit's full legal significance? (See Section 449(b))
Back to Jeopardy
That settles it for 400
Mediations may achieve a settlement but can also beused to achieve this.
Answer
That settles it for 400
Back to Jeopardy
What is narrow issues?(See Section 401 and 401.1; Rule 131.59)
That settles it for 500
Money paid pursuant to a C&R does not constituteconsideration for this.
Answer
That settles it for 500
Back to Jeopardy
What is a letter of resignation?
Recommended