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  • Eliot Levine

PPD and Fraud

Re: Permanent Partial Disability and Fraudulent shifting of medical responsibility.

A recent change in the Workers’ compensation Law has occurred to the benefit of injured workers. Prior to this change, any worker who is found to have a partial disability was required to make a complete and well documented work search if they want to continue receiving compensation indemnity i.e., weekly payments. (see Axel Case etc.)

Now those cases where the workers compensation board has found the claimant to have a Permanent Partial Disability and has been classified as such ; no do the claimants have to show or produce evidence of a proper work search. It is presumed that the reason for not working or working at a reduced financial level is because of your workers compensation disability. The burden has thus shifted to the carriers to produce evidence otherwise.

It has also come to our attention that some disable workers have run into difficulty obtaining medical treatment or prescriptions filled under their workers compensation case. Neither the claimant, health provider or pharmacy may without the possibility of fraud attempt to shift the billing and payment for desired treatment or medications away from the workers compensation insurance company. The remedy is to litigate causally related care under the workers compensation case once all proper filings have been made by the health provider using the existing Medical Treatment Guidelines as promulgated by the Workers Compensation Board.

Please guide yourself accordingly to protect your interests.

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