Just received a Form 24 – What now?

In North Carolina’s workers’ compensation system, many injured workers think that they can handle their case on their own, especially if the case is accepted by the insurance company (meaning that you are receiving weekly benefit checks and medical treatment from the insurance company). Unfortunately, many of these same workers don’t realize the mistake they have made (by not hiring a workers’ compensation lawyer) until their benefits have already been cut off.

One of the biggest threats to an injured workers’ benefits in North Carolina is called the Form 24. Under the North Carolina Workers’ Compensation system, once an insurance company accepts a claim, there are only two ways that they can stop paying benefits to the injured worker: 1) if the worker returns to work, or 2) if the Industrial Commission approves their Form 24 application.

What most workers don’t realize is that the fight to defend against a Form 24 begins long before the insurance company submits this application to the Commission. And unfortunately, once an unrepresented worker receives the Form 24, it is often already too late to do anything about it.

In order to be successful on a Form 24 application, the insurance company must have a legal basis for asking the commission to turn off benefits. Here are some examples of legally sufficient reasons that the industrial commission may grant a Form 24:

  • The injured worker has failed to comply with their medical treatment (a workers’ compensation lawyer will help you stay on track)
  • The injured worker has refused an offer of suitable employment (only a workers’ comp attorney can advise you on whether the job offered is “suitable”)
  • A doctor (usually one hired by the insurance company) has returned the worker to full duty work (a lawyer can help you request a second opinion from another doctor)

Getting an attorney involved early in the process, before the worker receives a Form 24, can greatly increase your chances of defeating this insurance company tactic, and more importantly, keep your benefits from being turned off.

FAQ – What if my workers’ comp check is late?

One of the most frequent calls I receive from my workers’ comp clients is that their workers’ compensation check is late. Unfortunately, (and I don’t believe that this is the client’s fault), the calls I receive are from the same client’s again and again. This means that the same insurance companies are routinely late in processing their weekly workers’ comp checks.

Is this surprising? Not at all. If you think about it, the insurance companies job is to make being on workers’ comp as difficult as possible. That way, when the time comes to try and settle your case, you will be thinking in the back of your head about all those late checks and how you just want that to be over. When your weekly workers’ comp check is late, it puts you and your family in financial jeopardy. I understand that the injured worker depends on these checks to pay their bills and feed their family. A check that is a week late can have devastating effects on an injured worker and their family.

Unfortunately, the insurance companies know this, so they will do everything they can to push the limits of the law.

What can you do if your check is late? If it is a routine occurrence, I recommend that you hire a lawyer. If nothing else, you would then have someone you can call when the check doesn’t come in and they can bother the insurance company until you receive your check. If the check is more than 14 days late, then you are entitled to a 10% penalty on the amount that is late by more than 14 days.

So, in a nutshell, here is what you do if your check is late:

  1. Determine whether there was a holiday that would have delayed the mail.  This frequently is a cause of late checks.
  2. Look to the history of your payments. Is this an isolated incident, or a more frequent problem. You may want to keep a log of your checks and the dates you received them since your case was opened.
  3. If this is an ongoing problem, or if checks are longer than 14 days late, you need to contact a workers’ compensation lawyer.
  4. Once you have a lawyer, contact them. My office will call the adjuster once or twice a day until the client receives their check or we receive verification that the checks have been paid on time.

 

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.

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.

Is Workers’ Comp my only recourse if I’m hurt at work?

I get asked, on quite a regular basis, whether my client’s can recover for pain and suffering if they are injured in a workplace accident.  Unfortunately, the answer is usually no (99.9% of the time, we’ll leave the 0.01% for another day). One of the problems with workers’ comp is that an employee is generally  limited to receiving medical treatment for their injuries and 2/3 of their Average Weekly Wage (AWW) for the time they miss from work.

However, in exchange for giving up the right to seek pain and suffering, a worker is given (theoretically) a streamlined system in which benefits are paid quickly in an administrative setting, and the worker is not forced to go to court and prove that the employer was negligent.  The workers’ comp system is a no fault system in North Carolina, which means that the employee is entitled to benefits even if the employer was NOT negligent, so long as the employee suffered an injury by accident.

That being said, even though the employee may not recover for pain and suffering against their employer, there are instances where the employee may have the ability to sue other parties, or even sometimes, the employer.  Some examples include:

  1. Where the employee was injured due to the fault of some third party.  In other words, if the employee was injured while using a piece of equipment that was designed defectively, the employee could sue the manufacturer of the equipment and any party that was involved in the sale of that machinery.  These are known as “third-party claims”, and sometimes come up during the representation of Workers’ Comp clients.
  2. If the employee was injured at work, filed a workers’ comp claim, and was then let go by their employer, the injured worker may be able to file a Retaliatory Employment Discrimination Act (“REDA”) complaint with the NC Dept. of Labor.  Once you file a REDA complaint, the Dept. of Labor will investigate your claim.  If it has merit, the Dept. may take a number of actions, including suing the employer on your behalf or issuing a right-to-sue letter so that you may sue your employer.  If successful, you may be entitled to triple the amount of wages you lost as a result of the employer’s actions, as well as payment for your attorney’s fees.

 

Anatamy of a Workers’ Comp Case

If you have been injured on the job in North Carolina, you are probably scared (about your health and possibly loss of income/job security), nervous and a little uncertain of what the future will hold.  However, knowledge is power – so the more you know about how the process will unfold, the more confident you will become.  Here is a quick rundown (big picture stuff) of the Workers’ Comp process in North Carolina from A-Z…

  1. You are hurt in an accident at work.
  2.  If you haven’t already, you should immediately report the accident to your employer.
  3. Seek medical treatment for your injuries.  Your employer may have a doctor on-site, or they may direct you to a designated health care provider.
  4. Tell the medical services provider that your injury occurred at work, and give them the name of your employer so that the treatment can be billed as a Workers Comp claim.  (Give the doctor as much detail as possible about how the accident occurred, what it did to your body, what you felt/experienced at the time of and immediately after the accident, and any other details that are necessary for the doctor to adequately understand what happened to you and how it has affected your body.)
  5. Give written notice to your employer of the accident.  The law requires that this notice be given within 30 days of the accident.  It would be prudent to copy the notice and give it to several people, in addition to keeping a copy for your files and to give to your attorney (should you require one).
  6. You can use Form 18 to provide the notice in #5 to your employer.  A Form 18 must also be filed with the Industrial Commission within two years of the accident.
  7. Follow the instructions and restrictions provided by your doctor.
  8. Return to work – hopefully without being out for too long.
  9. In the event that your claim is denied, you should speak with a Workers’ Comp lawyer to help you decide what to do next.  You will probably have to request a hearing and will need the help of an attorney to do this.
  10. If you are out of work longer than 7 days, or get terminated as a result of the injury, you should speak with a lawyer about what to do.

Most people are cleared to return to work after only being out a couple of weeks.  However, if you have sustained a more serious injury that involves a complete or partial disability, then you may be out of work much longer than that.  Since Workers Comp benefits can go on indefinitely, the insurance company will do everything they can to cut off or limit the amount of those checks.  Many people are more than capable of handling their claim on their own – but as with everything in life, the more complicated the claim, serious the injury, or difficult the adjuster is being, the more likely you are to need an attorney to help you.

 

Injured Workers settle case without attorney… Now What?

Injured workers settle their workers comp cases everyday without attorneys – this is nothing new.  But what most people don’t understand is that by signing a settlement agreement without consulting a workers compensation lawyer can cause you all sorts of problems.  Many times, as part of the settlement, your employer will ask you to sign a separate release of any and all claims that you currently have, or may have in the future, against your employer.  For injured workers without an attorney, this is dangerous territory.

There are a number of issues that could potentially come up in this separate release, and if you don’t have a workers compensation lawyer helping you to negotiate this agreement, you could run into several problems later on.  Here are the main issues that we frequently see:

  • The Settlement agreement does not comply with Industrial Commission rules and NC Statutes – making it unenforceable if you have second thoughts
  • You may be asked to give up other substantive law claims against your employer, such as claims of discrimination, retaliation, wrongful discharge, etc.
  • You may be giving up your rights to separate employee benefits, such as ERISA or COBRA benefits.
  • Many injured workers are asked to “resign” their position in connection with signing the settlement contract – this could have a negative impact if you are in the process of applying for, or are already receiving unemployment benefits
  • Often times, we see provisions stating that the injured workers will not file any lawsuits or participate in any lawsuits against the employer.
  • Many releases contain a provision indicating that the injured workers will never again seek employment from the defendant employer.  This can be a problem if you live in a small community where there is one main employer for most of the population, and nowhere else to work

The bottom line is that if you have decided to settle your case without the advice of counsel, there are a number of pitfalls that you can run into when signing a settlement agreement and release.  Consider speaking with a workers compensation lawyer if you have questions about this.  You may contact us at (919) 460-5422 or use our online form.

 

Flash Fire at Sherwin Williams Plant leads to burned worker

A Flash Fire at the Sherwin Williams Plant in Greensboro has burned a worker, reports CBS News.  The fire happened Thursday morning and burned the worker on his arms and face.

This unfortunate incident was the result of chemical vapors igniting, reports fire investigators, and is yet another reason that workers must be vigilant in maintaining a safe work environment.

The Raleigh Workers Compensation Lawyers at The Hart Law Firm understand how devastating a tragic event such as this can be.  Chemical burns are a serious danger of working in any factory.  When you or a loved one is involved in an accident like this, it is important for you to consult legal counsel about your rights.

The actions you take in the initial hours and days after a workplace accident can have a significant impact on your case and how it gets resolved.  The insurance companies will do anything they can to deny your claim or limit the workers compensation benefits you are legally entitled to – don’t let that happen to you.

One of the first things that this worker or his family must do is inform his employer (Sherwin Williams), in writing, of the accident.  Seems like a pretty simple thing to do, right?  But six months or a year from now, nobody will remember how severe this accident was, and if he failed to write this very important letter, it could be used against him in court.  In a severe workplace accident, such as a flash fire, this very simple step is often overlooked.

After getting appropriate medical treatment, the next thing I would advise this worker to do is contact an attorney to learn more about his rights.  A workers compensation lawyer can help him to navigate this treacherous and complicated claim – and make sure nothing is overlooked.

If you or a loved one was injured in a Flash Fire or Other Workplace Accident, contact a Workers Compensation Lawyer today.

Call the Raleigh Workers Compensation Lawyers at The Hart Law Firm to schedule a free consultation at (919) 460-5422.  Alternatively, you may complete our online contact form and a representative of our office will call you back within 24 hours.

Injured at Work? Have you applied for Social Security Disability Benefits?

If you are injured at work in North Carolina, you should give some serious thought to applying for Social Security Disability Benefits, in addition to filing for Workers’ Compensation Benefits.  Here are a couple of reasons why:

  1. Filing for Social Security Disability will not adversely affect your Workers’ Compensation.  In some cases, you may be entitled to receive more benefits from Social Security than you would from workers comp.
  2. If your workers comp benefits are stopped or delayed, then you will have your social security disability checks to fall back on while your workers compensation attorney works to restart your checks (which can take 3-4 months, or longer).

The bottom line is that if you are injured at work, you may need to rely on several different sources of income to sustain you until you are able to work again.  For many people, workers’ comp is the main source of income, but Social Security Disability is another income stream, along with long term disability insurance (which you may have purchased through your employer, or privately).

One of the frequent questions I get from clients is:

Will I qualify for Social Security Disability Benefits?

In order to qualify for Social Security Disability Benefits, you must meet the following criteria:

  • You must be age 18 or older;
  • You must have worked and paid social security taxes long enough to qualify;
  • You must have a medical condition that has prevented you from working or is expected to prevent you from working for at least 12 months or end in death, and;
  • You must reside in the United States or one of its territories/commonwealths.

At first glance, these seem like easy and straightforward criteria.  However, there are a number of tricks and hurdles that can trip you up along the way.  Most denied claims are due to a technicality that could be prevented.  It is not necessary for you to hire an attorney to assist you in applying for benefits, but talking to an attorney before you apply can go a long way towards getting your claim approved.

It can take a long time and several applications before you are approved for Social Security Disability – if you feel that you may be out of work for an extended time, call our office to inquire about applying for benefits today.

NC Workers’ Compensation Checklist

In looking up some information on Union’s in North Carolina, today I came across a Workers’ Compensation Checklist for you to review and print if you have been injured in a workplace accident.  Some of the important things for you to do include:

  • Prepare a detailed statement of everything you can remember about the accident, including how you were injured and who was there.  Discuss how serious your injuries are and how they affect your day-to-day life.
  • If appropriate, take pictures of your injuries, and describe where you were hurt and what, if anything caused the injury.
  • Keep a copy of the letter you sent to your employer letting them know you were injured. (Review this post if you have questions about this).
  • Keep a list of every doctor you have been to see, including dates of treatment, contact information, and bills that you received from the doctor.
  • Maintain all correspondence from/to your employer and/or your insurance adjuster regarding your claim.
  • Keep track of the miles you drove both two and from medical treatment, receipts for parking and tolls, and other expenses related to the same.
  • Maintain receipts for any other expenses you incur as a result of your injury.
  • Keep copies of all of your workers’ compensation checks and/or pay stubs if you return to work.

Here is a printable and more complete checklist for you to use.