Dietz, Gilmor & Chazen, APC, is proud to announce the establishment of our eighth California Office location.  Ryan D. Greer, Esq., has been promoted to Managing Attorney and will lead the expansion in Orange County.

Orange, CA – 09/24/2018 – Dietz, Gilmor & Chazen, APC, a California statewide law firm practicing exclusively in workers’ compensation defense, subrogation, asbestos, Labor Code §132a, and serious and willful misconduct claims, is expanding its Orange County service in response to client demand.  The office will be led by Attorney Ryan D. Greer.

The new DGC office will open on Monday, October 1, at 2230 W. Chapman Avenue, Orange, California 92868.  This office will serve in addition to DGC’s longstanding Long Beach/Orange County office located at 249 E. Ocean Boulevard, which has served WCABs in Anaheim, Santa Ana, and Long Beach.

Speaking on behalf of fellow firm principals Mark Gilmor and Avery Chazen, Bill Dietz stated, “It is our pleasure to reward Ryan for his tremendous success with the firm while also benefitting our clients with an added physical location for client meetings, depositions, and closer travel to both the Anaheim and Santa Ana WCABs.”

Ryan Greer added, “It is an honor to be provided the responsibility for bringing this expansion to our clients.  We have selected a great location near the heart of Old Towne Orange, and the clients we serve are very excited about it.”

About Dietz, Gilmor & Chazen, APC

DGC was established in 1997 and has now grown to eight California Offices, with 43 attorneys, providing defense for insurance carriers, brokers, third-party administrators, private and public employers, and large self-insured groups.  The firm’s guiding principles are based on providing exceptional customer service and legal representation.  DGC provides the expertise needed to reduce claim costs and achieve prompt case resolution.  Please visit the firm’s website for more information at https://dgcattorneys.com

Media Contacts:                                                                                                                      

Company Name: Dietz, Gilmor & Chazen, APC
Full Name: David Jankosky, DGC Client Services (213-278-1513)
Email Address: djankosky@dgcattorneys.com

On May 10, 2018, Associate Attorney Scott Ashby (DGC San Diego) ended newly-ignited medical spending (averaging over $21,754 per year in medications alone) by way of OAC&R from the San Diego WCAB on a 2015 stipulated case of a now 47 year-old applicant, who had filed a timely Petition to Reopen due to a worsening of her psyche condition.

The applicant had been a stocker and was struck on the back of the head and neck by a falling box containing a microwave. Early symptoms were documented as nausea and dizziness, severe headaches as well as neck and shoulder pain, momentary loss of consciousness with posttraumatic amnesia. Anxiety, sleep disturbance, panic attacks, domestic disputes, repeated cutting behaviors, major depression, nightmares, and borderline personality disorder crept into the applicant’s work injury complaints and history.

Post-award, the parties returned to the AMEs in psychiatry and neurology. By this time, the picture included multiple suicide attempts and psychiatric hospital admissions as well as very expensive migraine and psychiatric medications based on the medical reports and UR decisions. Approved medications included Diazepam, Chlorpromaz, Chlopromazine, Effexor XR, Propronolol, Sumavel DosePro Injections, Relpax, Eletriptam, Zonisamide, and Latuda. Valium was not approved, but applicant paid for it out-of-pocket. Documented marijuana use was also a part of her medical history.

To promote resolution of the claim and reduce the risk of tragedy for all parties, Mr. Ashby assisted the claims examiner in developing a plan to consult with a medical expert and obtain his opinion about the use of the extensive neurological and psychiatric medications. The respected specialist who was consulted confirmed the reasonableness of the current treatment, and advised that it was “…very likely…” to continue for life, given all comorbidities and home life stressors.

With $229,972 in medical payments already (TD and PD were only $8,226 and $24,035 respectively), the consultant’s opinion laid to rest any doubt that the claims examiner’s Future Medical Outstanding Reserve of $1,032,789 would most probably be spent, given the applicant’s relatively young age. The risk of her possible death also hovered.

Again for the benefit of all parties involved, Mr. Ashby and the claims examiner were steadfast in their persistence with the applicant attorney that the legal guarantees and closure provided by a structured settlement (as opposed to continued litigation) could at the very least ameliorate one lingering stressor in the applicant’s life and hopefully provide a boost to her psychiatric condition. Mr. Ashby worked collaboratively with the applicant attorney to make sure the settlement offer was communicated clearly and in the right vein.

The following Structured Compromise and Release agreement was reached: $205,000, guaranteed in the form of $1,110.02 payable monthly to applicant for the next 20 years of life beginning on 07/01/2018; $60,000 up-front cash payable to the applicant; and $35,000 up-front cash payable to applicant attorney.

OAC&R and Walk Through Appearance Sheet: Click here

Structured Annuity Settlement Addendum – Paragraph 9: Click here

Outstanding Medical Reserves and Settlement Evaluation: Click here

Compromise and Release Document – WCAB SDO: Click here

A Discussion Regarding California Code of Regulations, Title 8, Sec. 9785.

The latest submission to the DGC website (available also using AskDGC@DGCAttorneys.com), came from a client who asked:  “Is there a Labor Code Section to support an adjuster stopping TD benefits based on no recent medical report?  When should an adjuster stop TD benefits if there is no medical evidence?”

Our response noted that there is supporting legal authority for an adjuster to halt TD benefits, and shared a few of the more common situations where one should, if appropriate for strategic management of a claim, keeping in mind each claim is unique and managed under various client guidelines.

For instance, in accepted claims where initial eligibility for TD benefits is a pending issue, 8 CCR §9785(d) indicates that the “…primary treating physician shall render opinions on all medical issues necessary to determine the employee’s eligibility for compensation…”  Thus, since a medical report is necessary for determination of TD entitlement, then the absence of a report addressing the issue would render entitlement indeterminable by the adjuster.

At any point in the life of a claim, an adjuster can proactively ask the PTP for information necessary to administer the claim (such as disability status and work restrictions), and the PTP has 20 days to respond per 8 CCR §9785(f)(7).   If the PTP then fails to respond, TD benefits can indeed be stopped, if appropriate to the claim circumstances.

Moreover, 8 CCR §9785(f)(8) requires the PTP to provide a PR-2 Report (or narrative containing the same information) every 45 days when there is continuing medical treatment, even if there is no change in the claimant’s medical condition.  The PR-2 Report format (8 CCR §9785.2) essentially requires the PTP to address TD status every 45 days, including how long the claimant will be off.  If the last report is over 45 days old, an adjuster can schedule an appointment with the PTP and send the claimant a request to attend, along with a Notice of Intent to Suspend TD benefits.  If the claimant fails to attend, then TD benefits can be suspended, per Labor Code §4053.

Keep in mind that none of the aforementioned applies if there is an Order for continuing TD payments.  Also, under Labor Code §4053, for accepted claims, “suspending” TD benefits means those benefits will be withheld, and if the claimant later comes into compliance, those benefits will be payable, along with TD benefits restarting.

California Code of Regulations, Title 8, §9785: Click here

California Labor Code §4053: Click here

AskDGC! Disclaimer:  Click here