Archives for February 2012

Given a deadline to return to work, now what?

This is one of the most frequent questions I get from my clients, because it is a frequent tactic used by insurance companies to either: 1) cut off your benefit checks in accepted cases, or 2) show that you are capable of working in denied cases. If you don’t already have an attorney, and you have been given a request or demand that you return to work, now is probably a good time to seek counsel. The decision whether or not to go back to work can have a huge impact on the course of your workers’ compensation claim.

If you have an accepted case and are being paid weekly indemnity checks (typically 2/3 of your Average Weekly Wage), then there are only two ways that an insurance company can stop payment of these checks. The Industrial Commission can order that payments are stopped by granting a “Form 24” application, or you can return to work. Some of the things you need to consider before making this decision include:

  • Is the position offered “suitable“? You will need an attorney to help you determine this.
  • Do you want to do the job they are offering you?
  • Can you medically do the job they are offering you?
  • Do you want to return to work for this employer?
  • Can you afford to keep living off of your weekly indemnity checks?
  • Do you anticipate that the employer is offering you this job merely so they can fire you after you return?
  • Do you have personal knowledge of how your employer has treated other workers in similar situations?

In a denied case, you will not be receiving any type of indemnity checks from the insurance company. You may or may not have accepted a position with another employer that falls within your medical restrictions. You will be feeling a lot of pressure to accept the position offered. Again, tread lightly here and seek the advice of an attorney.

As mentioned before, the decision you make here will have a huge impact on your case. If you have received a request to return to work, I suggest you contact a workers’ compensation attorney to help you decide what to do.

The Workers’ Comp Doctor: What to do on that first visit…

I just finished up a report on what to do and what not to do on that first trip to the dreaded workers’ comp doctor. Here’s a quick overview/summary of my recommendations:

  • Be nice, even if you don’t like the doctor
  • Be prepared with notes explaining exactly how you were injured – explain this to the doctor. Rinse, and repeat.
  • Do like your parents taught you – don’t lie or exaggerate your symptoms. Workers’ Comp doctors have a way of knowing.
  • Don’t say or do anything that you don’t want the Industrial Commission to find out about.
  • Order your records after the visit to insure that they accurately reflect your visit.
  • Talk to the doctor about their opinion with regards to return to work restrictions.
  • Don’t let the doc have a meeting with the nurse without you.
  • Don’t talk bad about the nurse or Workers’ Comp carrier in front of the doctor.  You can call me and do that.
  • Even if you hate the doctor, don’t lose your temper. Again, call me and shout all you want.
  • Don’t get treated for an unrelated condition while you are seeing the Workers’ Comp Doctor.
  • Don’t tape the visit, unless you are being sent to an IME – in which case you probably need a lawyer. Feel free to call me.
  • If you decide not to tape your IME, make notes of the visit.

If that is too much for you to read – remember to be nice, keep notes, don’t lie. That’s about it. Questions? My number is (919) 460-5422.

What is Fair?

What is fair? Today’s post is a bit off the beaten path. I’m on the “legal documents” committee of my homeowner’s association.  Basically, our committee’s job is to review all the legal documents for our HOA (bylaws, covenants, articles of incorporation, etc.) Exciting stuff, right? Well the whole point of this little exercise is that some of the homeowners in our community are charged higher homeowners dues than other members. The homeowners that pay higher dues live in million dollar homes, while the homeowners that pay less live in “regular” homes.  I fall into the latter camp.

Fortunately, we have legal documents that govern how our dues are calculated and what we pay.  It is very difficult to change these documents. Thus the question – what is fair? Is it fair that I pay less in HOA dues than someone in a million dollar home? Is it fair that I have access to the same amenities and community property that they do? I knew what I was getting into when I bought my house – so yes, I think it is very fair. Trying to change the rules now, after I’ve bought my house – that’s not fair.

What in the world does this have to do with Workers Compensation law? Everything. You took a job with an employer. You work hard for them and they pay you a wage which may or may not be fair. You work for the same company, year after year, and then the unthinkable happens. You get injured on the job.

What is fair? Fair is an employer that does what they are supposed to do under the law. They (or their insurance company) pay you for your time out of work, they provide you with medical treatment, and they do all of this promptly so that you can get better and get back to work.

Unfortunately, all too often the employer is the million-dollar homeowner. They are completely fine using you as an employee, and as soon as you are injured and unable to work, they want to change the rules. They will either deny your claim outright, they will pay your medical bills but refuse to pay for your time out of work (forcing you to go back to work before you are physically able), or they’ll pay you, but payments will be consistently late and unpredictable.

I bring this up now because election season is quickly approaching. Last year, we had a tough battle with the insurance companies that tried to shred our workers’ compensation system under the guise of “getting North Carolinian’s back to work”. Fortunately, we had a Governor with veto power who was able to keep lawmakers from taking things too far. This year, the governor’s race is up for grabs. Pat McCrory is a million-dollar homeowner who wants to change the rules, make it easier for insurance companies to justify denying your claims and make it more difficult for you to prosecute your case, if you need to. Simply put – that’s not fair.

We have a good system in place. It’s a fair system. Let’s keep it that way.

 

 

Who does your nurse really work for?

In some Workers’ Comp cases in North Carolina, the case and employee will be assigned a Nurse to help coordinate benefits, schedule doctor’s appointments, and basically make sure that the medical treatment is progressing as it should.  The nurse is supposed to be employed by an independent company, such that they are not unduly influenced by the insurance companies.  Most nurses that I’ve dealt with are great to work with, and I’ve generally had very few problems. The purpose of this post is not to bitch and moan about how the rehab nurses are really working for the insurance company, however…

Today I received a call from a new nurse on a case.  The old nurse had been taken off the file – for reasons unknown to me (again, I’m not going to speculate that she was doing too good of a job for MY client, as opposed to doing what the insurance company wanted her to do).

That being said, when I returned the call, the number went straight to the insurance company, and my newly assigned nurse has an extension at the insurance company.  (Although she does “technically” work for an independent agency – for all I know her office is next door to the adjuster’s office).

So next time you (injured worker) start up a conversation with your rehab nurse about the status of your condition and your case in general, just remember who they are really working for.  Just my 2 cents for the day.  That’s all.