Category: Workers Compensation Resources

By Posted on Posted in Author, PDRater, Road Warrior, Workers Compensation Resources No Comments Tagged with , , , , , , , ,
THIS is how you do an expedited hearing

I obtained two walk through settlements yesterday morning.  I’m feeling pretty good.

Oh, did I forget to mention one was in Santa Rosa and the other in Oakland? ((Photo courtesy of brian.stein))

What has four eyes and smells like burning rubber?

Me

By Posted on Posted in Blogging, Links, Medical Provider Network, Medical Treatment No Comments Tagged with , , , , , , , , , , , , , , , ,
spine injury cure
Utilization Review Certified: 1 Fun Size Bag

A few weeks ago I posted about how swearing can reduce pain. ((Photo courtesy of Daneen_vol)) If you thought that was unbelievable, read on:

Researchers at University of Rochester Medical Center have apparently found that the dye in blue M&M’s can lessen the secondary effects of spinal injuries. ((Via Slashdot)) Those mice that received the injections of this blue dye recovered the ability to walk, and those without the injections did not.  The only side effect reported was, I kid you not, that the mice turned blue.

You can’t make this stuff up.  Anyhow, here’s the first ten jokes that occurred to me after reading that article:

  1. The blue M&M’s replaced the tan M&M’s in 1995 when it was discovered the tan ones caused spinal injuries. ((You remember the tan ones, don’t you?))
  2. Not to be outdone, Skittles researchers report their candies allow you to pee unicorns.
  3. The WCAB has now issued another en banc opinion that the office candy jar constitutes the rendering of first aid.
  4. *Disclaimer: This study was funded by The Great Pumpkin, the Easter Bunny, and the Mars Corporation.
  5. It has now been discovered that the members of the Blue Man Group are impervious to spinal injuries.
  6. …and that’s why the Smurfs have the lowest workers’ compensation premiums on the Cartoon Network.
  7. Researchers also found that it was the blue dye in Viagra, not sildenafil citrate, that helped with erectile dysfunction.
  8. The legislature has amended Labor Code 4604.5(d)(1) to allow a maximum of 24 ounces of M&M’s per industrial injury.
  9. “Your honor, under Braewood v. WCAB (Bolton), Defendants must authorize the blue M&M’s in order to treat the underlying industrial condition.”
  10. The Governor has added a new ballot measure that would replace the California MPN system with a new M&M based system.

I think the last one is my favorite.  :)

By Posted on Posted in Insurance, Medical Provider Network, Medical Treatment, PDRater, Workers Compensation Resources No Comments Tagged with , , , ,
medical provider network maze
MPN's - a-maze-ing!

One has to wonder which would have given Kafka a bigger headache – MPN’s or voice mail message systems.  ((I think I dislike voice mail message systems more…))  ((Photo courtesy of marcelgermain))  Finding a medical provider within an MPN is no walk in the park.  ((Heck, I’m a defense attorney and I’m not crazy about Medical Provider Networks.))

I get frustrated when I need to find a medical provider within an MPN.  If I’m very lucky, I get lost in a maze of badly laid out pages or meaningless search screens.  If I’m not so lucky the MPN website has changed, moved, or no longer exists.

Anyhow, I wanted to extend a “thank you” to all the users of this website who help me maintain my Medical Provider Network website page.  It seems like just about every week some kind person sends me a new MPN website link or updated MPN password.  ((Once an insurance company sent me their updated MPN page!))

By Posted on Posted in 2005 PDRS, Case Law, DFEC Rebuttal, Ogilvie, Workers Compensation Resources No Comments Tagged with , , , , , , , , , , , , , , , , , , ,
Ogilvie for Dummies
Ogilvie for Dummies

UPDATE: DOWNLOAD THE MATHEMATICAL PROOF AS A PDF!

Get ready to stop paying people to do Ogilvie calculations, recycle your Gearheart/Gerlach handouts, and delete your Frost Excel spreadsheet. ((Sorry Jeff, Mark, Mark, and Ray!))  We’re about to go all “Beautiful Mind.”

Yesterday while at the Oakland WCAB an Applicant’s attorney mentioned he noticed an interesting trend in the Ogilvie formula.  ((Thank you “S”!  Unfortunately, he did not want to be named.)) ((Man, I *wish* I could take credit for this observation.)) He said that whenever he does an Ogilvie calculation for someone with a 100% earnings loss and a modest WPI, the WPI is always increased by 18.  ((Not multiplied by 18, but an addition of 18.))

I ran a number of test calculations on this theory and it appeared to be right.  My calculations show that up to a WPI of 44 the increase appears to always be 18.1, but the last “0.1” always gets rounded down.  However, appearing to be right just isn’t good enough for me.  And, because I am just truly that nerd, here’s the fully mathematical proof:

Let’s break down the calculations at the heart of Ogilvie:

  1. Earnings Loss ((PIESSE = Post Injury Earnings of Similarly Situated Employees)) ((PIEA = Post Injury Earnings of Applicant))
    1. = (PIESSE – PIEA) / PIESSE
    2. = ($1.00 – $0.00) / $1.00
    3. = $1.00 / $1.00
    4. = 1
    5. = 100%
  2. Individualized Proportional Earnings Loss
    1. = (WPI / Earnings Loss) / 100
    2. = (WPI / 100% )/100
    3. = (WPI / 1) / 100
    4. = WPI / 100
    5. Thus, for any WPI less than 45 and a total loss of earnings, the Individualized Earnings Loss will always be less than 0.450 in Table A.
  3. DFEC Adjustment Factor
    1. = ([1.81/a] * .1) + 1
    2. = ( (1.81 * .1)/a) + 1
    3. = (.181/a) + 1
    4. = 1 + (.181/a)
  4. Ogilvie DFEC Adjusted Rating
    1. = WPI * DFEC Adjustment Factor
    2. = WPI * (1 + (.181/a) )
    3. = WPI * (1 + (.181 / Individualized Proportional Earnings Loss) )
    4. = WPI * (1 + (.181 / (WPI / 100) ) )
    5. = WPI * (1 + (.181 * 100 / WPI ) )
    6. = WPI * (1 + (18.1/ WPI ) )
    7. = WPI * ( (WPI/WPI) + (18.1/ WPI ) )
    8. = WPI * (WPI + 18.1/ WPI )
    9. = WPI * (WPI + 18.1/ WPI )
    10. = WPI + 18.1
  5. Conclusion
    1. If you have an Applicant with a 100% post injury earnings loss and a WPI of 44 or less, you should rebut the FEC and arrive at an adjusted WPI that is equal to the original WPI plus 18.1.

Therefore, I propose a new Ogilvie formula that will be easy for anyone to remember:

  • Step 1: If the injured worker has a 100% earnings loss and a WPI of 44 or less, add 18.1 to the WPI and round down.
  • Step 2: If the injured worker has less than 100% earnings loss or a WPI of 45 or higher, go to Step 3.
  • Step 3: For heaven’s sake, just make your life easier and use the calculators here at PDRater.com.

What do you think?  Leave a comment or drop me a line.

By Posted on Posted in Medical Treatment, Workers Compensation Resources No Comments Tagged with , , , ,
A new prescription for pain
Let's hear it for workers' compensation reform!

Researchers at the Keele University in England recently discovered that people report less pain when swearing. (Via Slashdot) And…cue the workers’ compensation jokes:

    1. Depositions:
      • Q: Mr. Smith, what else helps alleviate your pain?
      • A: [DELETED]
      • Q: Counsel, maybe we should go off the record for a moment…
    2. Court reporters:
      • “I need to get the spellings for a few words…”
    3. Interpreters:
      • “Uh, could you translate that again?”
    4. Trials:
      • Judge: Madam reporter, would you please read that back…
    5. Appeals:
      • WHEREFORE the above and foregoing, Defendants respectfully pray that this Board grant reconsideration and find Applicant refused reasonable prescribed medical treatment and should therefore be denied temporary disability benefits.
    6. Legal research:
      • “$ This search is outside your research plan.”
    7. Medical treatment:
      • “Actually, a telephone conference with my doctor should be sufficient.”
      • “Where do I look this up under the ACOEM guidelines?”
      • “Just how the crap am I supposed to write the damn utilization review appeal for this one???”
      • “I’m sorry, doctor, I must have read this prescription wrong…”
      • “Why is this doctor prescribing a speech therapist for a back injury?”
      • “By the way, your nurse case manager is Andrew Dice Clay.”
    8. “Although my level of disability was lowered after SB 899, I sure find that talking about it helps.”
    9. “In other news, researchers in Nevada have found that gambling, hookers, and dry weather also reduce pain.”

      I’m not really a workers’ compensation attorney, I’m really just a failed comic.

      (Photo courtesy of Mike Licht)