California Workers' Compensation/ California Work Comp/ Work Comp law/ Temporary Disability Overpayment

It is not unusual for a disagreement in opinion between that of the injured workers' treating physician and a qualified medical evaluator (qme) or an agreed medical evaluator (ame) as to the duration of an injured workers' temporary disability period. If a qme or ame opines that an injured worker should have reached permanent and stationary status or the injured worker should have been returned back to work earlier than the period that the treating physician has kept the injured worker on disabled status, it is very likely that an insurance company will claim that an overpayment of disability benefits. The insurance company will then seek to take credit for any "overpayment" against any recovery or permanent disability indemnity that an injured worker may be entitled to. There is a specific set of case law that apply to overpayment claims by insurance companies. You may be able to argue against the insurance company's entitlement to any credit or return of alleged overpayment if the insurance company failed to object to a treating physician's continued disability determination. There is also a line of cases that adversely hold against retrospective determinations of an ame or qme as to the disability/ TTD period of an injured worker (see e.g. JcPenny v. WCAB). If you are an injured worker facing a claim for disability overpayment, please give our office a call @ (714) 360-0100 to speak with one of our attorneys.