GQ Corner
Q. The above claimant was represented from 9/4-9/10/2019. I just now received a fee order for $300. Do I have any option to not pay as the attorney did not do anything?
A. If you were not paying the claimant benefits when the fee order was received by the carrier, you do not pay the attorney’s fees separately. But other than this, (or in an unsuccessful SIBs quarter dispute) only the claimant can dispute the fees. The fee order has to be complied with when it’s issued, and it is paid out of the claimant’s benefits. If the claimant thinks the attorney did nothing for him/her then the claimant can contact the DWC to dispute the fees and the attorney would pay the claimant back if the DWC agreed the fees should not have been approved.
Q. We are currently paying split death benefits to a son and wife for deceased firefighter, compensable cancer claim.
The son had been enrolled as a full time college student; however, this semester he is not enrolled per his mother. The problem is that I cannot obtain his grades and/or schedule from the Spring semester this year, although his mother claims he was enrolled full time, but did not do well and therefore did not attend the Fall semester. I have made multiple requests for the copy of the Spring schedule/grades as proof he attended last semester, but we have not received anything from either the son or his mother.
Can I go ahead and just amend the death benefit accordingly and pay the full amount to the wife/mother until we hear back from the son? Or do I have to wait until this semester is over in December and amend at that time?
A. If his mother claims he was enrolled in the Spring 2019 semester, I think you have to assume that is true absent proof to the contrary. Particularly since the mother would stand to receive more DBs if he wasn’t enrolled, so there is no reason for her to be untruthful about that. That would mean Fall 2019 (the present) is the first semester you have proof of non-attendance. Under 132.8(b)(1), then, he is no longer eligible as of “the date on which the child ceases, for the second consecutive semester (excluding summer semesters), to be enrolled as a full-time student”. That means his eligibility ends at the end of the Spring 2020 semester, if he isn’t enrolled as a full time student during that semester.
In the meantime, you should continue to try and get records proving if and when he was enrolled. And if you are still convinced he was not enrolled during Spring 2019 (and that the mother/wife is not being honest about that), you can always request a BRC on that issue.
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