The California Department of Industrial Relations, Division of Workers’ Compensation’s new Medical-Legal Fee Schedule (MLFS), which took effect on April 1st, 2021, will significantly increase the cost of medical-legal evaluations, and may have a wider impact on contested claims than initially indicated. The regulations apply to all evaluations taking place on or after April 1st, 2021, and include new multipliers that can further increase the cost of exams and evaluations.
Joanne Thomas recently participated in a new webinar series by The Transitions, offering her thoughts on mentorship in the workers’ compensation industry, and how leaders can develop and nurture talent within their organizations.
Ensure that you have legally valid apportionment for an evaluator’s report that finds medical apportionment. The doctor has to state how and why he finds apportionment and his or her opinion must be predicated on reasonable medical probability and substantial medical evidence.
Hootan Melamed, the pharmacist whose kickback scheme resulted in losses to insurance carriers of between $9 million and $20 million, has been sentenced to a 6 month jail term, and must repay $1.4 million in an asset forfeiture. The judgment requires Melamed, who entered a plea agreement in November of 2020, to turn himself in and serve his sentence by October 1st, 2021.
The California Department of Insurance (DOI) has announced that Angel Maces, a San Jacinto landscaper, has been arraigned for felony insurance fraud for falsifying symptoms following a work-related injury. Mr. Maces received over $42,000 in workers’ compensation benefits that he did not deserve.