Off The Record: TRR Workers’ Comp Proposed Decisions
Christopher: I’m concerned about these notice of proposed decisions that we’re receiving regularly. And, I’m concerned that unrepresented claimants are not sure what they’re receiving, and they don’t appreciate the consequences of these decisions, which, although they’re on paper, it’s just the same force and effect as if you had gone to a hearing. And it can have a big impact on your case.
Bill: You’re talking about the proposed decisions that…
Bill: Yeah. You know, clients will get these, you know, very regularly. And, you know, they could be dealing with anything from a medical bill that’s been contested to a decision concerning disability. And, if you don’t pay close attention to these things and they go unattended, it really could have some negative consequences for the claim. And, we usually review these every morning when the decisions come in. We get them via email and we print them out and review them and distribute them to the attorneys and the paralegals. But, there has been one issue going around lately about the rates for partial disability and total disability and the discrepancies there. It’s really important that you keep an eye on those I think.
Christopher: I am regularly seeing incorrect decisions issued concerning medical bills, where the decision will say, “We’re ruling this $750 medical bill for treatment that’s already been rendered in favor of the insurance company, as there is no evidence that the condition that was treated is related to the accident,” when a cursory review of the file and the medical records shows that it clearly is. So, if 30 days goes by, and no one’s object to that, the doctor’s not going to get paid. And that has a cumulative effect on the system in general. So it really, if people are getting these decisions and they don’t know what they mean, they should come to an attorney and have them reviewed carefully.
Bill: Yeah. We keep an eye on our own clients, of course. But, if you’ve gotten a decision that you don’t understand, it’s really worth your while to give us a call.