Understanding Workers Compensation Insurance
Posted by Michele Lewane | Working With The Adjuster/Nurse Case Manager
What Is Workers Compensation Insurance? Workers’ compensation insurance is an insurance policy that represents a compromise between business owners and their employees. In exchange for medical coverage and wage replacement, employees essentially give up their right to sue employers for workplace injuries and diseases. Workers’ Compensation Benefits are just that – an insurance claim – …
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Why is Sedgwick Calling Me?
Posted by Michele Lewane | Working With The Adjuster/Nurse Case Manager
Often times when you experience an injury at work, you will be getting a call from your employer’s workers’ compensation insurance carrier or “TPA”. Sedgwick CMS is one of the largest “TPA’s” in the world and is involved in thousands of work injury claims every year. Companies like Sedgwick CMS and Claims Management Inc. are …
When Can I Get a Second Opinion?
Posted by Lorraine D'Angelo | Working With A Doctor, Working With The Adjuster/Nurse Case Manager
Often, a medical opinion will be needed from a doctor other than the injured worker’s treating physician. There any many reasons why this would be. However, not all second opinions are required to be covered by the workers’ compensation insurance carrier. A second opinion can be needed because your treating physician wants the second opinion. …
What Are ISO Reports
Posted by Lorraine D'Angelo | Claim Denied - Now What?, First Steps, Working With A Doctor, Working With The Adjuster/Nurse Case Manager
We get asked all the time how the workers’ compensation insurance carrier knows about car accidents that injured workers have had in the past that they may not even remember themselves. Insurance Services Office provides information for health insurance companies called ISO Reports. The Insurance Services Office (ISO) keeps a database of all property and casualty …
When Your Workers Compensation Claim Is Under Investigation
Posted by Michele Lewane | First Steps, Working With The Adjuster/Nurse Case Manager
Often times, especially at the beginning stages of a claim, the workers’ compensation claim is under investigation and the injured worker is waiting to hear from the insurance company as to whether or not their claim is approved or denied. This situation can be exasperating when the insurance adjuster does not give the injured worker …
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Is the Adjuster Ignoring Your Phone Calls? Try Email!
Posted by Injured Workers Law Firm | Working With The Adjuster/Nurse Case Manager
One of the biggest gripes injured workers have is that they can never get in touch with their workers compensation insurance adjuster and days or weeks go by with no response. We here at Injured Workers Law Firm know all about this. Adjusters are hard to get in touch with for a reason – maybe …
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The Adjuster Said I Was Overpaid
Posted by Injured Workers Law Firm | Working With The Adjuster/Nurse Case Manager
What happens if the insurance adjuster said I was overpaid? Sometimes, if the insurance adjuster continues to pay benefits to the injured worker when they are not owed. An example of this would be if an injured worker returns to work and is earning their full wages or partial wages but are still receiving a full …
An Insurance Investigator Comes Clean – “One Man’s Opinion”
Posted by Injured Workers Law Firm | Working With The Adjuster/Nurse Case Manager
I just read an article that a workers compensation advocacy group posted that was by a man who spent 30 years as an insurance investigator for a workers compensation insurance company. While it is unclear exactly which state or states he operated in, the insight he reveals is horrifying! The writer talks about how the …
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The Insurance Adjuster Sent Me a Medical Release – Should I Sign It?
Posted by Injured Workers Law Firm | First Steps, Working With The Adjuster/Nurse Case Manager
I get this question from injured workers a lot. They’ve received a Medical Release from the insurance adjuster requesting that they sign it. We like to think that our health information is completely private and protected by the HIPPA laws. However, if you read this article further, you will learn that workers compensation is a …
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HELP!! – The Adjuster Said They Were CLOSING MY CASE!
Posted by Injured Workers Law Firm | Claim Accepted - Now What?, Working With The Adjuster/Nurse Case Manager
Listen up folks – I’m about to let you in on another one of the insurance companies dirty little secrets! I regularly get calls from injured workers in a panic because the insurance adjuster told them their case was being “closed.” Adjusters love to use this threat – “If you don’t ______________ (sign this form, …
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