Did you know? Insurance carriers are responsible for obtaining the signed return-to-work from physicians.

Uncategorized Oct 29, 2019

The physician’s return-to-work form is a requirement and it triggers the Supplemental Job Displacement Benefit to be issued by the insurance carrier. The law says the voucher is due to the injured worker 60 days from receipt of the signed physician’s return-to-work form. However, many doctors are not complying, so the insurance companies are not issuing the voucher.
 
In a recent Decision by District Court of Appeals (*see below), it states that the insurance carriers are responsible for obtaining the signed return-to-work from the physicians or issue the voucher if no valid objection for eligibility. As it stands now, insurance companies are forcing injured workers and/or their representatives to get the form, therefore when doctors are not filling them out, the voucher benefits are delayed or simply never issued.
 
The solution here is for the insurance company to comply with the law and to obtain the form themselves or issue the voucher. Attorneys can send them the case law. OCC is calling for change in this matter, but it is more potent if attorneys work on it. 

 

*Robert Fndkyan v. Opus One Labs, 2019 Cal. Wrk. Comp. P.D. LEXIS 51 [Petition for Writ of Review denied 6/14/2019, Second District Court of Appeal, Division Four, B296789]
Supplemental Job Displacement Benefits—Physician’s Return-to-Work Forms—WCAB, reversing WCJ, held that applicant was entitled to supplemental job displacement voucher (SJDV) benefits and, contrary to WCJ’s finding, was not precluded from receiving SJDV based on fact that Physician’s Return-to-Work (Physician’s RTW) form was not sent to or received by defendant, when it was undisputed that defendant received qualified medical evaluator’s report, which informed defendant that applicant’s condition was permanent and stationary following his cumulative industrial orthopedic injuries to multiple body parts and that applicant was industrially permanently disabled, and also informed of applicant’s work capacities and restrictions as result of his industrial injuries, and WCAB concluded that, in this instance, defendant had burden to obtain Physician’s RTW because defendant was apprised of applicant’s permanent disability status and work preclusions in qualified medical evaluator’s report, and that to conclude otherwise would impermissibly place form over substance. [See generally Hanna, Cal. Law of Emp. Inj. and Workers’ Comp. 2d §§ 35.01, 35.02; Rassp & Herlick, California Workers’ Compensation Law, Ch. 21, §§ 21.01, 21.02.]

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