Monthly Archives: May 2012

Medical Bills After an On-The-Job Injury – Do I Have to Pay Them?

Posted on by

Today we have a guest post from Kit Case, our friend at the Causey Law Firm of Seattle, WA, which was founded by my good friend and fierce worker advocate Jay Causey. Workers compensation claims can affect how billing is handled when it comes to medical concerns. This article discusses Washington state law. Nebraska and Iowa law have essentially the same rules, but be sure to consult with a workers’ compensation attorney who is familiar with the laws in your state if you have questions or concerns.

Question: I’m Getting Medical Bills, but I have a Workers’ Compensation Claim – Do I have to Pay Them?

Answer: No! Well, maybe…

If the bill you have received is for a balance due, left over after payment from the Washington State Department of Labor and Industries claim for services rendered by a medical provider, then you do not have to pay the bill. Under RCW Title 51 and WAC Chapter 296-20 and all of its provisions, the medical provider is required to accept payment from the workers’ compensation claim for services rendered as payment in full, and is not allowed to seek from the claimant payment of any additional balance. To be more specific, if a charge is billed to the workers’ compensation claim for a particular service and payment is made by the claim for that service in such a way that a balance remains for that same service, the medical provider is not entitled to payment from the claimant for that difference.

In contrast, if authorization for a medical service is denied under the claim completely, you may, under those circumstances, be required to make payment for any denied services. If you also have private medical insurance, your medical provider may be able to receive payment for treatment services denied under the workers’ compensation claim by submitting a bill for his or her services to the private insurance carrier.

To find out what you should do if you have already paid a medical bill for an on-the-job injury, check back in soon for the next installment of this series.

In Nebraska, Who Chooses My Surgeon?

Posted on by

If you are involved in a workers’ compensation situation, it is essential to know your rights, as they vary from state to state. Attorneys at Rehm, Bennett & Moore are licensed in both Nebraska and Iowa, and the workers’ compensations systems are very different between the two states. This video addresses what happens in Nebraska if a person needs surgery.

Ladder Safety Could Save You From A Painful Injury

Posted on by

Thanks to colleague Leonard Jernigan from North Carolina for this extremely informative blog post. It is essential that we remember basic safety tips like dealing with ladders both at work and at home. Too often people get in a hurry and use faulty equipment or take shortcuts. When it comes to ladder safety, gravity is always in effect, regardless of your profession. There are graphic, but effective and thought-provoking, picture and video pieces in this blog post.

Unsafe LadderThe 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

Is Insurance Still For Policyholders?

Posted on by

Insurance began in the Middle Ages, and policies could be written for almost anything. Policies were taken out to protect risks of trade, against the death of a head of state, and for many other forms of speculation. There was almost no limit on what a policy could be written for. Additionally, there was no shared risk as these policies were taken out only by individuals.

In the early 18th century, mutual insurance was created. Instead of individuals essentially placing bets that would pay off if tragedy struck, these policies created communities of members who were concerned with offsetting risk with reward. The lack of tragedy led to the payout of dividends to the members. Gradually, governments forced the transition of insurance from legal gambling on misfortune to companies behaving more like public utilities. Mutual-insurance companies helped the betterment of society with innovations like workplace-safety measures.

Over the last four years Edmund Kelly, former CEO of Liberty Mutual, has pocketed over $200 million in compensation.

In 1911, the first workers’ compensation insurance was written in Massachusetts in the form of a state-subsidized mutual-insurance company. Like most mutual insurance, the aim was the mitigation of risk by providing incentives to reduce risk and demanding small sums from each participant that were then combined into large sums for the victims or beneficiaries of the policy.

In the mid-1990s, insurance companies began pushing for legislation to authorize them to place their assets into holding companies that could then sell stock. Critics believed the policyholders were being divested of their ownership in such an arrangement, but little true resistance was brought to bear. What has transpired as a result of this shift is that increasingly the profits from insurance companies were being captured by its executive leadership instead of being reflected as profits and returned to its policyholders as dividends.

As such, 200 years after mutual insurance was created, history reversed itself. No longer was insurance sold to people who had a stake in the assets and risks on which they bet. The community no longer bore the rewards of mutual insurance as company profits were put in the hands of the elite leadership and not distributed across policyholders. One can surmise that policyholders also lost more control over how claims were handled than was anticipated when mutual insurance was created. Policyholders also likely see little incentive to follow risk-averse practices as they receive no return benefit in the form of dividends as they used to. When profit is the only goal in business only the business itself and, more specifically, its executives truly gain. One indication of this is Edmund Kelly, former CEO of Liberty Mutual. Over the last four years he has pocketed over $200 million in compensation.

Source: The Atlantic

How To Select A Good Lawyer For Your Problem

Posted on by

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). For workers’ compensation organizations, see the Workers’ Injury Law and Advocacy Group. For other personal-injury matters, see the American Association for Justice. For general trial-attorney needs, see the American Board of Trial Advocates.

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 Martindale and Hubbell 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.

Falling Asleep On The Job: Insufficient Sleep Is A Compensable Condition

Posted on by

There can be consequences to not getting enough sleep. For many, working patterns vary. Examples include truckers or those who do shift work. Throw in shifts that switch from night to day every few weeks, and it can be even harder to get enough sleep. But as our colleague Jon Gelman of New Jersey shows us in today’s guest post, sleep is essential for health and well-being. And not enough sleep is a compensable condition.

The National Sleep Foundation recommends that U.S. adults receive, on average, 7–9 hours of sleep per night; however, 37.1% of adults report regularly sleeping <7 hours per night. Persons reporting sleeping <7 hours on average during a 24-hour interval are more likely to report unintentionally falling asleep during the day at least 1 day out of the preceding 30 days (46.2% compared with 33.2%) and nodding off or falling asleep at the wheel during the previous 30 days (7.3% compared with 3.0%). Frequent insufficient sleep (14 or more days in the past 30 days) also has been associated with self-reported anxiety, depressive symptoms, and frequent mental and physical distress (4).

Even short term sleep duration is linked with:

  • Increased risk of motor vehicle accidents
  • Increase in body mass index – a greater likelihood of obesity due to an increased appetite caused by sleep deprivation
  • Increased risk of diabetes and heart problems
  • Increased risk for psychiatric conditions including depression and substance abuse
  • Decreased ability to pay attention, react to signals or remember new information

Such findings suggest the need for greater awareness of the importance of sufficient sleep. Further information about factors relevant to optimal sleep can be obtained from the National Sleep Foundation and CDC.

Does Moving To A Different State Affect My Workers’ Compensation Case?

Posted on by

movingWe are frequently asked whether moving from one state to another will have any legal consequences for a workers’ compensation case. The answer is no. Your rights are not changed if you move from the state where the law is being applied to your case. If injured workers are entitled to benefits under a state’s law, it does not matter where the worker lives.

However, moving will have several practical effects on a workers’ compensation case. Benefit payments are sometimes interrupted with address changes, and injured workers must keep everyone advised of the correct address so checks can get to the right location. People who should be notified as soon as you know the new address include your lawyer and the insurance adjuster (if you are not represented). In certain states, you may also need to advise a state agency if the insurance is administered by a state fund.

Medical care becomes more complicated when an injured worker moves. State laws are different on who can pick your doctor, and moving usually requires changing doctors, therapists, and pharmacies. The workers’ compensation lawyer or his staff members should help you with these changes.

It is essential that injured workers get proper care. To get proper care, Continue reading

Highlights From Nebraska’s 102nd Legislative Session

Posted on by

Nebraska State CapitolClients of Rehm, Bennett & Moore helped make a positive difference this legislative session. They are parents who lose their children as a result of work injuries.

Albert and Diane DeLeon of Grand Island persuaded their state Sen. Mike Gloor to introduce a bill that was signed into law that increased the funeral benefit from $6,000 to $10,000. This was after they lost their son Emilio in a construction accident. In addition, Gene Cary testified in favor of a similar bill that would have raised the funeral benefit for the families of dead workers as well as giving a $25,000 death benefit to parents who have had a child killed in a work accident. Gene’s son Neil was killed in a work accident in 2010. The bill awarding an automatic death benefit to parents who have their child killed in a work accident failed to advance out of committee. Bills held in committee are killed for this session of the legislature and must be re-introduced next session. However, the combined stories of Cary and the DeLeons helped to advance the cause of parents who lose a child in a work accident.

Besides the bill increasing funeral benefits for parents who lose their children in work accidents, the only other bill to pass that affected injured workers was a bill that gave employers protections for information given in employment references.

Besides the bill increasing funeral benefits for parents who lose their children in work accidents, the only other bill to pass that affected injured workers was a bill that gave employers protections for information given in employment references. As the bill was originally introduced by Sen. Charlie Janssen of Fremont, the bill would have given employers almost free reign to Continue reading