Rule 16 and 18 Proposed Changes

The Division lets us know about proposed rule changes and this change concerns Rules 16 and 18. These are medical matters which are changed just about every year because medical costs keep rising. Rule 18 involves medical billing and Rule 16 utilization review. The proposed rules are posted and then adopted after comments are received and reviewed. Most of this is not very exciting information except for doctors and other providers although at times a claimant or claimant's attorney does have to look at the rules. What a doctor can charge for legal things like testimony, consultations, reports and the like are important to know. Such matters are often the responsibility of the claimant if he or she asks for any of them. So wanting to have the doctor come to the hearing is fine but it is also at a cost to the claimant. So while these rules seem complicated to read and perhaps not that important to claimants most of the time there are situations where a claimant needs to check on what the rule says. For example, in the past there has been litigation on the subject of what is called prior authorization. This area involves a provider getting advance approval for something and when approval is not forthcoming the doctor and perhaps the claimants attorney may wish to dispute it and even seek penalties. What is addressed in Rule 16 on the subject becomes quite important in such a situation.

Retirement is coming soon!

While I shall continue to publish this blog it is just about my time to retire from an active law practice. I am not taking any new matters and only seeking to resolve all the remaining cases that I have. What I can say to all those thinking about and searching for an attorney is whenever possible at least consult with an attorney about your case. The laws and rules involving workers compensation and Social Security disability are quite complex. Thinking it is just common sense and form work is a major mistake. Deadlines are not to be ignored and some matters seem to go against common sense. The reason is that these areas are creatures of statute. Benefits, rights and responsibilities are what the law says they are not what you think it should be. Entire claims can be lost by assuming something that is not so. So it is better to consult to assess what can be done and if you need legal help. Claims that look like small matters or you are told are minor can be worth an enormous sum. Never rely on the accuracy of what you are being told by your employer or the insurer. Just protect yourself and the best way to do that may well be with an attorney. I have nothing to gain here because I am retiring but I know this...wherever possible use an experienced attorney. Even cases where you think the offer to settle is decent may actually be worth much more. Even where all is going along fine so you think you are being taken care of by the insurer please consult with an attorney. Too much may be at stake financially, medically and emotionally to not obtain good legal advice. And do not be afraid to check with more then one attorney. It is your claim and your future that is at stake. As I head into the sunset of my practice I can say that the legal profession has been rewarding not just financially but in making a difference for others. You usually do it one person and one case at a time but you also achieve real results for real people. You also stand up for those injured and disabled just when they are most vulnerable. For me that has been very special. So thanks for allowing me to help. I shall continue however to write and speak up in this blog for as long as I can.