Form C-8/8.6 Regarding Unanswered Questions

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Latest post Wed, May 30 2007 8:41 AM by MJZ203. 8 replies.
  • Sun, May 27 2007 4:44 PM

    • MJZ203
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    • Joined on Fri, Feb 6 2004
    • Posts 45

    Feedback [*=*] Form C-8/8.6 Regarding Unanswered Questions

    I requested twice copies of an updated C-8/8.6 from the Insurance Carrier. On the very top of Form C-8/8.6 it states in bold print " ANSWER ALL QUESTIONS FULLY-TYPEWRITER OR COMPUTER IS REQUIRED.
    This insurance carrier left the following questions blank;

    Question 9- County Where Injury Occured?
    Question 12- Date First Payment Made?
    Question 13- Date Most Recent Payment Made?

    PENALTY PAYMENT TO CLAIMANT;
    LESS a. Fees to representative:
    b. Reimbursement to:
    c. Other (specify ): PRIOR PAIDS

    Question 16- Have benefits been paid in full in accordance with an award of the WCB? ( ) Yes ( ) No, if "NO" check and complete items a-c, as appropriate:
    a. Claimant Returned To Work. Date of Return
    b. There is a change in condition and/or earnings ( a medical report or other supporting documentation must be attached )
    c. Payments stopped or modified for other reasons. ( Explain below or attach explanation/documentation)

    I have contacted this insurance carrier and requested a fully completed Form C-8/8.6. The insurance carriers response is when insurance carrier A, merged with carrier insurance B ( current carrier ) claims some files were thrown out in error and can offer no other explination and can not fully complete the Form C-8/8.6.

    Please, if anyone has been in a similar situation can you tell me if there is a way to get a fully completed Form C-8/8.6?

    Thank you for any assistance.





  • Sun, May 27 2007 5:22 PM In reply to

    re: Form C-8/8.6 Regarding Unanswered Questions

    C-8s are rarely accurate, and there is no penalty for filing an incomplete C-8. There is a penalty for failing to file--but what the carrier files is not required to be complete.

    Some of the questions might be relevant if the carrier is stopping or modifying payments. Because it sounds as if neither is the case, a judge would not see the need for the information. An earlier C-8 from the original carrier may show the earliest payment, for instance; I expect you know the county where the incident occurred. I would expect the new carrier should know when the most recent payment was mailed (if you're still receiving payments), but that is usually relevant when there is a penalty claimed for late payment of an award. With no such claim, the carriers would not usually complete that item.
  • Mon, May 28 2007 8:18 AM In reply to

    • MJZ203
    • Not Ranked
    • Joined on Fri, Feb 6 2004
    • Posts 45

    Feedback [*=*] re: Form C-8/8.6 Regarding Unanswered Questions

    Please explain if C-8s are rarely accurate it raises another question on the accuracy of the dates and the total award as stated on the C-8.

    I failed to mention that IC "A" did modify my award, however failed to include supporting evidence/documentation prior to or following the modification. I also previously received a penalty from IC A. I have obtained the WCB Court Transcript and it fails to mention the reason based on WCB Laws which would justify the modification. The Court Transcript states " We (the lawyers to the WC Judge) discussed a little of this off the record. I was not present, and my former attorney would not explain on the modifaction. He also made no mention of appeal.

    All of the unanswered questions are clearly stated within my WCB file, with the exception of the modification supported by evidence/documentation.

    It clearly appears there is a double standard. The ICs can file a non Notorized rarely accurate C-8. However a claimant is required to submit a yearly Benifit Affidavit to be signed by the claimant and Notorized.

    Thank you for your input on theses issues.

  • Mon, May 28 2007 10:08 AM In reply to

    re: Form C-8/8.6 Regarding Unanswered Questions

    The carriers frequently file inaccurate, perjurous, and incomplete forms with the WCB. The WCB does not care. For instance, every C-7 (notice of controvery disputing a claim) says on the form that the carrier must attach documentation to support its claim. They never do. Judges don't care, and the WCB doesn't care. If a worker filed a similar document with mis-stated or missing information, the worker is heavily penalized. Not the carrier.

    All to frequently we have the carrier file a C-8 stating that payment was mailed on the certain date. The date is critical, as it may determine whether there is a penalty for a late payment. When the carrier files that document, affirming that the information is correct, and we then produce the envelope that shows the payment was days later, we get the penalty for proving the late payments. But no one seems to care that the carrier filed a fraudulent statement attesting to a certain date of payment. It's viewed as "standard business practice".

    There is a dual standard in WC. If you read over this messageboard, you will see example after example. Understand that is the way it operates. Then figure out how to use that to your advantage. I'm afraid it is waste of time to point out inaccuracies, incompetence, or outright fraud by the carriers--no one seems to care. I keep doing it, and it falls on deaf ears.

    As a recent example, the law provides that IMEs will be paid according to the WCB medical fee schedules. That is done to avoid a carrier being able to purchase an opinion which favors its position. When I happen to come across a bill for an IME (incompetence of carriers in sending it to me) that far exceeds the fee schedules, I send it to the WCB. The response is that the WCB does not monitor IME fees. There is no place where the amount paid to an IME is filed. When you see your doctor, and he/she bills $34.00, it is sent to the carrier, the WCB--and the carrier objects if the bill is for $1.00 more than the fee schedule provides. The IME, however, may bill $2,000--and that bill is not filed anywhere. No one is given notice of how much is paid for IMEs, and there is a reason--it would outrage those who work in the system, and outside the system, to realize how much is paid for these opinions.

    Get used to the fact that the WC system is not fair, not just, and is not likely to change in the near future. Figure it out so that you can use it to your best advantage. If you get upset over the unfairness and inequity, it will drive you crazy.
  • Mon, May 28 2007 4:16 PM In reply to

    re: Form C-8/8.6 Regarding Unanswered Questions

    Well said!!!!
  • Mon, May 28 2007 10:52 PM In reply to

    • 6years
    • Top 500 Contributor
    • Joined on Thu, Aug 10 2006
    • Posts 111

    Feedback [*=*] Scott.....Cost for an IME

    I had an IME a few years back, while waiting for my turn, a nurse came out and gave me some forms to fill out. I noticed on the last page ( not sure if I was supposed to see or look at it ...but I did ) there was the Dr.'s bill for the IME. A little over $2,100. At that time I was just amazed on how much an IC would pay for a exam that took 3 minutes. I thought I was special or IC was buying a report in their favor point blank. I thought for sure seeing that price, I needed to prepare myself for a good defense for a WC hearing. After reading post..... I'm not special after all, I guess they really pay all that money for IME's regardless. Unbelievable. p.s. That IME went in my favor.

  • Tue, May 29 2007 7:04 AM In reply to

    Note [#=#] re: Form C-8/8.6 Regarding Unanswered Questions

    Hi Scott,
    Very well put however I can not honestly say that the entire WCB is as described in your post.
    I've dealt with them as well and although I've found similar instances especially in my own case... I've also found workers at the WCB to be very helpful in getting things done. I believe the entire experience could be based on the approach.
    If you go at them like a bear then expect to hit a rock wall. If you approach them with a somewhat intelligent yet helpless child tone you will probably get further then if you were to constantly be pointing out errors along the way.
    Besides the entire idea here is to have the WCB assist with the case. Realizing up front that the Carrier's for the most part in most cases lie through their teeth and would fib to the Lord's Face when confronted would be a huge step in not getting flustered over every single thing they write, especially what their IME"s write as the IME is being paid to write what he puts down on paper not what he see's when he is supposedly examining you!
    It's all in the approach and everyone should view it that way. I've waited over 2 weeks for a check that was due on the 15th I never got it until the 1st of the following month and was told it was because the clerk at the carrier's office was on vacation but the Social worker at the WCB assisted in getting them to cut that check before the clerk returned from vacation so there is help out there with the WCB; one just has to take a breath and approach it properly and calmly at least that's my opinion I'm sure others feel differently.
    Blessings to everyone for a speedy recovery...!
  • Tue, May 29 2007 8:24 AM In reply to

    re: Form C-8/8.6 Regarding Unanswered Questions

    Bobbie, I could not agree with you more. There are many well-intentioned folks who work at the WCB. They are helpful, and courteous.

    But if you ask the social worker how much an IME was paid for a report, the social worker won't know. That's not part of the system. The social worker works within the system, and can only provide assistance within that framework. My concern is the framework.

    When the WC law was reformed in 1996, there were specific changes brought about to end the abuse of the IME process. One of the changes in the law was to require that IMEs be paid the same as attendings--pursuant to the medical fee schedule. This was done to avoid the situation where an IME is paid $2,000 for an opinion, and an attending is paid $200. The power of the dollar meant that carriers could go shopping for the opinion which would serve its purposes. When I ask the WCB how that provision of the law is enforced, I find that it is not enforced. No one reviews the fees of the IMEs. Everybody reviews the fees of the attendings--objections are filed all the time for lack of authorization, for the fee being too high, for treatment of a non-established body part, etc., etc. No one reviews the IMEs. No one passes on the appropriateness of the fee. They just are not reviewed.

    What does that mean? Well, those very charming and helpful folks at the WCB have no way of knowing how much an IME cost; they have no way of rejecting an IME as being too costly, or as examining outside the parameters of the established sights of injury--as the IME reports are not reviewed at all.

    My problem is not with the folks at the WCB--the workers who are doing their job, and frequently doing more than their job. My problem is the policy decisions which are made by the power-brokers at the WCB.

    But . . . perhaps you could get a different response with a different approach. Perhaps a worker requesting the WCB review of IME fees would get somewhere. I have been unsuccessful, and have been told that there is no system/program/method used by the WCB to review IME fees, nor are the carriers or IMEs required to report the amount of the fees to anyone. It's a cozy secret between the carrier and the IME.
  • Wed, May 30 2007 8:41 AM In reply to

    • MJZ203
    • Not Ranked
    • Joined on Fri, Feb 6 2004
    • Posts 45

    Feedback [*=*] re: Form C-8/8.6 Regarding Unanswered Questions

    Good Morning Mr. Clippinger,

    I can not find enough words to thank you for your response. I truly appreciate your wisdom. All I can say is I wish both you and this great web site were available at the start of my workers compensation claim.

    mjz203
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