Limiting Unnecessary Conditional Payment Disputes
Mandatory reporting to Medicare is now common practice with all workers’ compensation claims. As part of this reporting, the insurer must indicate whether it has “ongoing responsibility for medicals” or “ORM.” ORM is when the Responsible Reporting Entity (“RRE”), the insurer, assumes obligation to pay for medical benefits associated with a work injury. An ORM […]
Supreme Court Clarifies Benefits for PTSD/Occupational Injury Claims – A Right to Benefits End When the DSM-5 PTSD Criteria No Longer Apply
In a March 8, 2023 decision, the state Supreme Court clarified the right to workers’ compensation benefits for an occupational disease, mental impairment/Post Traumatic Stress Disorder (PTSD) claim. The Court confirmed that the right to benefits ends when the injured worker no longer meets the DSM-5 requirements for a PTSD diagnosis. In Chrz v. Mower […]