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Select a state from the dropdown menu below to scroll through the state specific archives for updates and opinions on various workers’ compensation laws in your state.
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The Division announced
its health care provider PBO assessment methodology on July 26th. The memo states that one of the assessment
measures will be whether the provider explained how the work injury prevents
the injured employee from working in any capacity.
This is a perennial problem where the provider checks the “complete inability
to work” box but doesn’t explain how the injury prevents the injured employee
from returning to work:
Division Rule 129.5 requires the doctor to explain how the claimant’s injury
prevents them from working in order for the report to be considered complete.
Carriers are not required to reimburse doctors for incomplete work status
reports. In addition, the failure to provide a complete report may also
constitute an administrative violation.
Requiring providers to explain why the claimant can’t return to work in any
capacity may cause providers to consider more closely whether the claimant
could be working with restrictions. Doing so may facilitate early return to
work which benefits the injured employee and the employer.
Copyright 2022, Stone Loughlin & Swanson, LLP