Over the course of 35 years representing injured workers, I have heard some whoppers – Employers’ questionable tactics that make even my jaw drop. With all the insurance company generated blather about “employee fraud” incidences of employer fraudulent tactics abound. Workers beware of the following:
Recorded statements taken by worker’s compensation carrier adjuster while employee is under medication or in the hospital still suffering from the injury. Questions such as “It’s true you had (low back pain, arm pain, fill in the blank pain, etc.) before your work injury, correct? You’ve had lots more pain from (your motor vehicle accident, sports injury, etc.) than you’re experiencing from your work injury, correct?
Employer “channeling” a work to its “Return to Work Clinic” (doctors on company payroll whose opinion is “like some athletic coaches, ‘rub some dirt on it and get back in the game’.”
Telling employees to take sick leave rather than claim worker’s compensation.
Telling employees to file medical bills under their group insurance, not worker’s comp.
Nurse Case Manager who initially befriends the employee but later makes every attempt with the worker’s doctor to prematurely return the worker to the job before a healing occurs.
Today’s post comes to us from our colleague Rod Rehm of Nebraska.
Selecting and hiring a good lawyer is critical in dealing with a legal problem. Lawyers are increasingly limiting the types of cases handled in an effort to provided better representation. The Internet is a common starting point for consumers to locate and select lawyers who have the right kind of knowledge and experience for their problem. I recommend the following steps for selecting a lawyer.
1. Check with family, friends, neighbors, or others whom you trust and respect to learn if they know of a lawyer or law firm who they would recommend for the kind of problem you are dealing with. This approach is the traditional way to find a professional and often leads to a good attorney-client relationship with satisfactory results.
2. Consult a general-practice lawyer you know and ask for recommendations. This approach gives you the advantage of having someone who knows area lawyers help you find the right mixture of knowledge and expertise.
3. Internet searches will turn up a large variety of lawyers who handle the kind of problem you are experiencing. Read several of the websites with a careful eye for the following:
a. Is the firm A-rated by the leading peer-rating organization Martindale and Hubbell? The ratings are very good indicators of how the firm is regarded because they come from judges and other lawyers who work with the firm.
b. Do the members of the firm appear to be actively involved in organizations dealing with your kind of problem? Are the lawyers officers or board members of such groups? Have the lawyers been speakers at seminars? This kind of activity shows the lawyers are interested in improving and protecting the law for people with your kind of problem and respected by other lawyers and judges. Here are some examples of law organizations. For employment matters, see the National Employment Lawyers Association (NELA) (please link to www.nela.org). For workers’ compensation organizations, see the Workers’ Injury Law and Advocacy Group (link to www.wilg.org). For other personal-injury matters, see the American Association for Justice (link to www.justice.org). For general trial-attorney needs, see the American Board of Trial Advocates (link to www.abota.org).
c. Do the lawyers from a firm belong to any organizations indicating that they have been honored or selected for membership based on knowledge and experience?
d. Do the lawyers appear to belong the bar associations in their area? Have they served on any committees, sections, or governing bodies?
4. Go to www.martindale.com and use the lawyer search. You can search for lawyers by city, state, and specialty. Lawyers are rated as follows. AV® Preeminent™ is the highest rating, followed by BV® Distinguished™ then Distinguished. We recommend only A-rated lawyers if they are available. One way to get the best of the best is to limit the search by checking the box “Featured Peer Review Rated.” The website is very user friendly.
5. Contact the lawyer or lawyers you focus on, and talk to the lawyer. Learn how the lawyer interacts with clients. The following are some questions that might be helpful: Do you feel comfortable talking with the lawyer? Are they Internet users? Will you have a specific team of people working with you? How do they charge? Can you have Skype conferences or do they have other face-to-face conferencing options through the Internet? Will retainer documents be required and available for review before an appointment?
These suggestions provide a framework on how to locate and evaluate an attorney to help you. The references we refer to are industry standards, so they not subject to as much manipulation as other online approaches, such as reviews, testimonials, or video recommendations on lawyers’ websites.
Today we have a guest post from our colleague Leonard Jernigan of North Carolina.
The Occupational Safety and Health Administration (OSHA) says that “falls from portable ladders are one of the leading causes of occupational fatalities and injuries.” A few weeks ago a gentleman came to see me who had orthopeadic surgical wires and metal bars sticking out of his arm (for those who are not too sensitive, click here to see the photo)
He had fallen from a ladder about 15 feet and landed squarely on his hands and broke both arms. No one was holding the base of the ladder and the ladder was more than 15 years old. Wires and metal bars were now holding his bones in place, and workers’ compensation benefits were holding him financially in place. However, since he was only making $11 dollars an hour his weekly compensation benefits were small. As you probably know, the Workers’ Compensation Act does not provide money for pain and suffering, or lost income from other jobs (think about the man who takes on two jobs to maintain a higher standard of living for his family; if he is hurt while working at one job, he is only paid for the income loss at that job, not both).
The employer has a duty to train and teach its employees how to use a ladder. Many employees (particularly young ones) have no idea how dangerous ladders can be: they assume the ladder will hold the load and will be secure when placed in position, and that it is free of defects, no matter how old. OSHA has a list of safety considerations and these tips can be found at the Department of Labor’s web page (click here for a PDF version).
Click through for a graphic video of a ladder accident published by prevent-it.ca, a website run by the Province of Ontario (Canada)’s Ministry of Labor. Be warned that this mock-up video is a public service announcement intended to teach safety. It is scary and not for the faint of heart. Continue reading Ladder Safety Could Save You From A Painful Injury→
Many people don’t realize that Social Security stopped mailing out annual Statements in 2011, but indeed they did. Citing budget concerns and a little-used ‘emergency’ ruling stating that it’s okay for the Social Security Administration to stop fulfilling one of its legally-mandated functions if doing so could potentially bankrupt the agency or impair its ability to fulfill its primary function, Social Security stopped sending out individual Social Security Statements. In fact, they also ceased fulfilling requests for statements received by mail or telephone, and disabled their online ordering service. The only way you could obtain your Statement was to go down to your local Social Security Office and tell them you had an ‘urgent need’ for the information!
Now, Social Security has (finally!) rolled out online (and IMMEDIATE) access to your Statement, including your earnings history, estimated benefit amounts, and eligibility information. And fortunately, they have made it incredibly easy!
All you need is:
your own personal information (full name, Social Security number, date of birth, mailing address, phone number)
and working email address.
Start at Social Security’s website. On the left-hand menu, go to ‘Get Your Social Security Statement Online’, and follow the prompts. Social Security uses a program called Experian to verify your personal data, so be prepared to answer some interesting multiple-choice questions, including
phone numbers and addresses that you may have used in the past,
dates that you opened specific credit accounts,
or where you send your mortgage payment.
You can also choose an added layer of security, by asking Social Security to send a text message to your mobile device anytime you log in to your account.
Note, however, you are actually setting up a ‘my Social Security’ account – – the same type of account that people RECEIVING benefits have – – not just accessing a Statement. Please be prepared to keep track of your login information, as you not only may need to access your Statement again over the years as new earnings are posted, but you may also one day need this account to set up your own Medicare, Retirement, or Disability benefits. Keep this login information in a safe and secure location, and do not share it with others to maintain your security.
There are strategies that can make worry more manageable.
For the last few weeks we’ve been talking about the very real medical dangers of worry. For injured or disabled workers, worry can add an additional and very significant burden on the body. In this post, we’ll talk about some of the ways that worry can be treated or even avoided.
Much of the time treatments are simply medications that increase GABA. Cognitive therapy is prescribed depending upon insurance coverage. Addressing the physical and mental effects of excessive worry can aid in recovery from an injury or disability and can increase levels of success in vocational retraining efforts. In rare cases, worry and anxiety can become permanent fixtures in a person’s life, and the effects of this condition can result in ratable permanent impairment. But, the greater part of lay and scientific literature lists non-medicine tips to reduce worry, fear and anxiety to a more modulated level, thereby providing some relief from this constant invader that often creates unproductive and hurtful periods in life.
Here, summarized, are six tips cited in the literature to help manage worry without medication:
Separate out toxic worry from good worry: Good worry amounts to planning. Toxic worry is unnecessary, repetitive, unproductive, paralyzing, frightening, and in general, life-defeating.
Get the facts rather than letting your imagination run away. Analyze the problem and take corrective action.
Develop connectedness in as many ways as you can: family, social, information and ideas, organizations and institutions. Never worry alone.
Touch and be touched: in addition to massage therapy, seek out hugs and laughter – being around children or family can help.
Be good to yourself. Exercise, eat well, get enough sleep, meditate, do yoga and be aware of over consumption of substances detrimental to your health, such as alcohol.
Sing, read, cry, do what you love, look for what’s good in life and don’t sweat the small stuff.
The physical reactions to excessive fear and anxiety (worry) initiate a chain or cascade of pathological events by stimulating the amygdala area of the brain (fight/flight response), releasing neurotransmitters to the cortex. There, the fear or anxiety, whether real or imagined, is analyzed in detail and the analysis is returned to the amygdala where, in normal situations, the fear response is shut off by amino-butyric acid (GABA). GAD worriers may not have high enough GABA levels to shut off this pathway. Consequently, there are constant marked secretions of glucocortocoids and catecholamines that increase blood sugar levels. Marked levels of epinephrine and norepinephrine dilate blood vessels in skeletal muscles and other adrenergic (adrenal) stimulations that in turn create modifications in breathing, increased temperatures, sweating, decreased mobility of the stomach, bowels, and intestines, constrictions of the sphincters in the stomach and intestines.
Simply said, constant fear and anxiety result in debilitating amounts of stress hormones like cortisol (from the adrenal glands) and hormones that cause blood sugar levels and triglycerides (blood fats) to rise significantly. This process, if not shut off or modulated, can cause premature coronary artery disease, short-term memory loss, digestive problems, and suppression of the natural immune system. The scientific literature is now implicating constant stress, such as constant work stress or toxic fear and anxiety, in causing large weight gains in the midriff area which can greatly exacerbate orthopedic injuries, particularly of the spine or knees, and can lead to increased incidences of diabetes and cancer.
Worry causes increased mortality and morbidity. It is that simple.
For information on how to treat and avoid worry, check in with us later this week for the next installment in this 3-part series.
Worry is increasingly pervasive in our society as insecurity about the economy and safety, nationally and personally, grows daily. Worry is compounded in the daily lives of those who are injured or disabled, as they struggle with the added burdens of medical costs and loss of income, all of which engenders a bleak outlook on their future.
“At its worst, [toxic] worry is a relentless scavenger roaming the corners of your mind, feeding on anything, never leaving you alone.” This was the description of “worry” by Edward M. Hallowell, MD, in Worry, 1997, with a 2002 introduction. (This study is still considered the “bible” in lay literature and often quoted in scientific research.) Long ago, Dr. Charles Mayo said, “Worry affects circulation, the glands, the whole nervous system and profoundly affects the heart.” Indeed, worry appears to be, at worst, of genetic origins, and to a lesser degree a learned or environmental response.
Hallowell defines worry as two types: toxic worry and good worry. He likens toxic worry to a virus, insidiously and invisibly attacking you and robbing you of your ability to work, your peace of mind and happiness, your love and play. On the other hand, good worry, or adaptive worry, is necessary to avoid real danger and life-threatening situations.
Worry is categorized as part of Generalized Anxiety Disorder (GAD) in most lay and scientific literature. The National Institute of Mental Illness (NIMH) defines GAD as people who go through the day filled with exaggerated worry and tension, even though there is little to provoke it. NIMH literature states that people with GAD anticipate disaster and are overly concerned about health issues, money, family problems or difficulties at work. GAD is diagnosed when a person worries excessively about everyday problems for at least six months. Worry, as part of GAD, is commonly treated with medication and cognitive therapy.
The everyday worry of the disabled or injured worker is direct, with anxiety and fear over money, physical abilities, medical care, vocational options, housing, food, and family disintegration. It does prey upon so many, compounding their physical health problems and environmental lives.
For more on the very real physiological implications of worry, check in next week for the next installment in this series.
Washington State has instituted a new rule that allows a workers’ compensation claimant to be billed by their regular doctor or medical provider for missed appointments. WAC 296-20-101(6) states:
Other than missed appointments for examinations arranged by the department or self-insurer, a provider may bill an injured worker for a missed appointment if:
(a) The provider has a missed appointment policy that applies to all patients without regard as to which insurer or entitlement program may be responsible for payment;
and
(b) The provider routinely notifies all patients of the missed appointment policy.
The implementation and enforcement of the policy is a matter between the provider and the injured worker. L&I is not responsible for the implementation and/or enforcement of the provider’s policy.
This allows the medical provider to bill their patient directly for missed appointment charges. The Department of Labor and Industries and/or Self-Insured Claims Administrator continues to be allowed to bill a claimant for any no-show or late-cancellation charges they incur when a claimant misses and appointment arranged by the agency.
Worry is increasingly pervasive in our society as insecurity about the economy and safety, nationally and personally, grows daily. Worry is compounded in the daily lives of those who are injured or disabled, as they struggle with the added burdens of medical costs and loss of income, all of which engenders a bleak outlook on their future.
“At its worst, [toxic] worry is a relentless scavenger roaming the corners of your mind, feeding on anything, never leaving you alone.” This was the description of “worry” by Edward M. Hallowell, MD, in Worry, 1997, with a 2002 introduction. (This study is still considered the “bible” in lay literature and often quoted in scientific research.) Long ago, Dr. Charles Mayo said, “Worry affects circulation, the glands, the whole nervous system and profoundly affects the heart.” Indeed, worry appears to be, at worst, of genetic origins, and to a lesser degree a learned or environmental response.
Hallowell defines worry as two types: toxic worry and good worry. He likens toxic worry to a virus, insidiously and invisibly attacking you and robbing you of your ability to work, your peace of mind and happiness, your love and play. On the other hand, good worry, or adaptive worry, is necessary to avoid real danger and life-threatening situations.
Worry is categorized as part of Generalized Anxiety Disorder (GAD) in most lay and scientific literature. The National Institute of Mental Illness (NIMH) defines GAD as people who go through the day filled with exaggerated worry and tension, even though there is little to provoke it. NIMH literature states that people with GAD anticipate disaster and are overly concerned about health issues, money, family problems or difficulties at work. GAD is diagnosed when a person worries excessively about everyday problems for at least six months. Worry, as part of GAD, is commonly treated with medication and cognitive therapy.
The everyday worry of the disabled or injured worker is direct, with anxiety and fear over money, physical abilities, medical care, vocational options, housing, food, and family disintegration. It does prey upon so many, compounding their physical health problems and environmental lives.
The physical reactions to excessive fear and anxiety (worry) initiate a chain or cascade of pathological events by stimulating the amygdala area of the brain (fight/flight response), releasing neurotransmitters to the cortex. There, the fear or anxiety, whether real or imagined, is analyzed in detail and the analysis is returned to the amygdala where, in normal situations, the fear response is shut off by amino-butyric acid (GABA). GAD worriers may not have high enough GABA levels to shut off this pathway. Consequently, there are constant marked secretions of glucocortocoids and catecholamines that increase blood sugar levels. Marked levels of epinephrine and norepinephrine dilate blood vessels in skeletal muscles and other adrenergic (adrenal) stimulations that in turn create modifications in breathing, increased temperatures, sweating, decreased mobility of the stomach, bowels, and intestines, constrictions of the sphincters in the stomach and intestines.
The scientific literature is now implicating constant stress, such as constant work stress or toxic fear and anxiety, in causing large weight gains in the midriff area which can greatly exacerbate orthopedic injuries, particularly of the spine or knees, and can lead to increased incidences of diabetes and cancer.
Simply said, constant fear and anxiety result in debilitating amounts of stress hormones like cortisol (from the adrenal glands) and hormones that cause blood sugar levels and triglycerides (blood fats) to rise significantly. This process, if not shut off or modulated, can cause premature coronary artery disease, short-term memory loss, digestive problems, and suppression of the natural immune system. Continue reading 6 Tips To Combat Worrying, Stress & Anxiety→
Last week we shared a post about dealing with medical bills after an on-the-job injury. Our quick answer was that you most likely do not have to pay these bills, depending on your specific circumstances, which we discussed. So, let’s say that you don’t actually have to pay these bills, but you’ve already paid some of them. Here are a few more questions and answers.
What About Everything I Have Already Paid? Can I Be Reimbursed??
Question: My private insurance has covered the cost of my medical care while my workers’ compensation claim was in dispute. I have been making payments to my doctor’s office, too, for co-pay and other charges. Can I be reimbursed? What about my prescription costs?
Answer: Yes, you can be reimbursed for your expenses!
You can be reimbursed for medical expenses, prescription costs, travel expenses (when appropriate) and other costs once your workers’ compensation claim has been approved. In Washington State, though, the Department of Labor and Industries will only make payment to medical providers directly for services rendered, so you cannot receive direct reimbursement for payments to your doctor, physical therapist, chiropractor, etc… These providers will need to submit bills for services under the allowed claim, receive payment for those services, and then issue refunds to you and your private insurance carrier for payments previously made. This can be a difficult process, though, as the medical providers have already been paid, often at a higher rate than what is allowed under a workers’ compensation claim, so they often would prefer to not go to the hassle of rebilling for services they have already been paid for and then make refunds to you and/or your insurance carrier in excess of the workers’ compensation payments.
Prescription costs are easier to have reimbursed. If you have receipts, you can submit a Statement for Pharmacy Services form to request reimbursement. If you do not have your receipts, you can submit this form with a printout from your pharmacy of all filled prescriptions related to the claim. The printout and the form must be signed by the pharmacist to certify that you have paid for the claimed prescriptions. Reimbursement for pharmacy expenses will be paid to you directly.
Similarly, travel expenses can be claimed under certain circumstances. If the travel was at the request of the Department of Labor and Industries, or if travel greater than 30 miles round-trip was needed to see the closest appropriate medical provider, then you can request reimbursement of mileage at the State’s rate and some extra expenses, such as ferry fares, parking charges or meal expenses. The Travel Reimbursement Request form must be submitted using the appropriate code for the type of expense incurred and receipts must be provided to support the reimbursement request. As with pharmacy reimbursements, travel reimbursements are paid to you directly.
