I reviewed a workers’ compensation claim for a potential client nine months ago. At the time, I told him of several items that I saw as upcoming issues in his case and shared my opinion about why it would be important for us to start clearing those issues off the deck sooner rather than later. Would he be found employable with no services or would he receive just a bit of training to allow him to continue working in his field as a welder but in a lighter-duty capacity? Would the onset of depression be addressed under the claim and taken into consideration when making employability decisions? Would his level of permanent impairment be under-rated through the typical Independent Medical Evaluation (IME) process or would his surgeon be willing to provide a rating that more accurately reflects his limitations? I shared my concerns about his case, explained the process I would recommend for addressing these concerns and discussed the fees and costs to be expected. He indicated he wanted to go forward with representation.
I did not hear from him again, until yesterday. He left me a message asking for help with his claim. I looked at the case this morning before returning his call. He has been found to be employable with no additional retraining, so he will likely not be able to continue with his favored career but, instead, can look forward to his new line of work as a small parts assembler. He underwent an IME that conservatively rated his level of permanent impairment and approved the job analysis for small parts assembly. His attending physician signed the form letter to indicate concurrence with the IME results and, on this basis, the Claims Manager has found him employable and is closing the claim. What about the depression? Not addressed by the IME, so the Claims Manager is construing the attending physician’s signature on the concurrence form letter to mean that he is also not contending that depression is an issue, so she is denying this condition under the claim.
I know there are two sides to every argument, and I know that an employer representative would look at this same fact pattern and see a job well done, but I am a claimant’s advocate, so I share my thoughts from only that perspective. I see a situation where I now have a 15-day deadline for filing a dispute with the Vocational Dispute Resolution Office if I want to argue that Continue reading Why Wait? A Case Study…→
Causey Law Firm celebrated the New Year by welcomingKim Krummeckaboardas of January 1, 2010.
Mr. Krummeck’s practice will focus on workers’ compensation litigation, Social Security disability appeals, Longshore and Harbor Workers’ Act cases, Veterans Affairs benefit appeals and unemployment hearings and appeals, complementing and expanding Causey Law Firm’s areas of practice.
Referendum 67 simply requires the insurance industry to be fair and pay legitimate claims in a reasonable and timely manner.
Please join us in voting to APPROVE Referendum 67 in November.
Dear clients and friends:
Referendum 67 is an important consumer protection measure on the November 6th ballot. If you are forced by your insurance company to file a lawsuit over a legitimate claim you’ve made, and you win, you will get paid for your claim but nothing more for the company’s wrongful delaying or denying your claim. Your own legal costs to recover against the insurer are not recovered.Referendum 67 fixes that by allowing the court to assess penalties against the insurer for that type of conduct. It therefore creates an incentive for insurance companies to treat their policy-holders fairly.Referendum 67 covers claims related to homeowner’s insurance, auto insurance, long-term care insurance, property insurance and small business insurance.
4100 complaints are made annually to the Office of the Insurance Commissioner about illegitimately denied claims, which likely means there are thousands more unreported instances of this kind of behavior by the insurance industry. Ultimately this conduct can lead to denied medical care, loss of a business, and ruined credit for policy holders. Continue reading Approve Referendum 67!→
I think most of us who follow politics can agree that there’s been steady deterioration in the quality of speeches given by major candidates of both parties over the past few years. Speeches that should speak to specific facts and address real issues have become so much vanilla blather, devoid of any real substance. Candidates timidly avoid staking out their positions with any specificity, choosing instead to couch their message in vagueness — or in the case of the right wing, coded language — that allows them to scamper away from any heat the message might engender and to be able to manipulate that message to make it sound a bit different for the next audience.
Some of you may be old enough to remember the speeches of John F. Kennedy in the early 60’s that still resonate as some of the greatest presidential oratory of the 20th century.
When candidates “dumb down” their message so they can triangulate between different constituencies in order to placate, or at least not alienate, certain voters, those messages lose all moral force and any real visionary quality or appeal. Some of you may be old enough to remember the speeches of John F. Kennedy in the early 60’s that still resonate as some of the greatest presidential oratory of the 20th century. If you didn’t hear them in real time, you’ve undoubtedly seen video clips, or read or heard phrases from those speeches that live on. Kennedy’s speech writer at that time was Theodore C. Sorenson, who worked first for JFK while he was a senator and then in the White House. He was a gifted wordsmith about whom pundits have said he and Kennedy were Continue reading Suggested Acceptance Speech for Democratic Nominee→