I can honestly say that the last thing I expected when I applied for law school was that I would need the help of a science course to be a more effective attorney. After all, I was applying to law school, not medical school. However, as the newest attorney at Rehm, Bennett & Moore, I recently had the opportunity to attend an all-day seminar titled “Anatomy for Lawyers” with Prof. Samuel D. Hodge, Chairman of the Legal Studies Department at Temple University. Jennifer Ohmberger and Megan Nicholson, legal assistants with the firm, also participated in the seminar.
The seminar was an anatomy course designed to teach the knowledge and skills needed to efficiently and effectively handle workers’ compensation and personal-injury cases. So much of what we do in working with our clients’ workers’ compensation and personal-injury claims is attempting to understand injuries to the human body. Something as simple as understanding the difference between a sprain and a strain, which parts of the body are most susceptible to injury, or how a doctor interprets a diagnostic test can greatly affect the type of medical treatment a client receives, the ability to return to work, and ultimately, how much compensation they are entitled to.
This process typically requires review of medical records and a considerable amount of translation of medical jargon (which is, by the way, literally another language). Understanding what the medical records say in plain English and putting together the puzzle pieces of medical opinions can be half the battle in understanding our clients’ claims and obtaining compensation for them. The “Anatomy for Lawyers” seminar focused on the very specific challenges attorneys and clients face with injury claims and helped to make more practical sense of the complicated medical world.
In our last 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. 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.
Today’s post comes to us from our colleague Jon L. Gelman of Wayne, New Jersey. We encourage all workers to report their injuries to the appropriate person within their company, and if the proper reports are not filed, to seek legal representation. We are concerned about workers being discouraged from reporting injuries on the job. Mr. Gelman, one of the nation’s leading commentators on workers’ compensation, points out this is potentially a national problem.
The National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC) has proposed a project to review the Underreporting of Occupational Injuries and Illnesses by Workers.
“In 2008, the Congressional Committee on Education and Labor released the report, “Hidden Tragedy: Underreporting of Workplace Injuries and Illnesses,” indicating “that work-related injuries and illnesses in the United States are chronically and even grossly underreported.” Based in part on the report’s results, Congress allocated funds for NIOSH to conduct a follow-up study using NIOSH’s occupational supplement to the National Electronic Injury Surveillance System (NEISS-Work) to estimate underreporting among individuals who seek care at an emergency department (ED) for an occupational illness, injury, or exposure.
“Objectives for this project are to (1) assess the reporting behavior of workers that are injured, ill, or exposed to a harmful substance at work; (2) characterize the chronic aspects of work-related injuries or illnesses; and (3) estimate the prevalence of work-related chronic injuries and illnesses among United States workers treated in EDs. Particular attention will be paid to self-employed workers, workers with work-related illnesses, and workers with chronic health problems.
“Data collection for the telephone interview survey will be done via a questionnaire containing questions about the respondent’s injury, illness, or exposure that sent them to the ED; the characteristics of the job they were working when they were injured, became ill, or were exposed; their experiences reporting their injury, illness, or exposure to the ED and their employer (if applicable); the presence of an underlying chronic condition that was associated with their ED visit; and the nature of any other work-related chronic conditions they have experienced. The questionnaire was designed to take 30 minutes to complete and includes a brief series of questions to screen out individuals who were not seen in the ED for a work-related injury, illness, or exposure; who are younger than age 20 or older than age 64; who do not speak English or Spanish; or who were working as volunteers or day laborers when the injury, illness, or exposure occurred or was made worse.
People hire lawyers when they have problems they have been unable to solve without help. Most of our clients have never hired a lawyer before and are concerned about the process. A wise observer (my wife) once said, “Happy people don’t need lawyers.” So how do a client and lawyer develop a good working relationship that will lead to the best possible solution?
Communication is a key ingredient to a good attorney-client relationship.
Communication is a key ingredient to a good attorney-client relationship. A client should be satisfied that she/he can talk to and understand the lawyer. Lawyers have different communication styles, as do clients. Listening is part of communication, and both parties to a conversation must listen. A good attorney-client relationship starts if the client feels he/she can talk comfortably with the lawyer. This feeling should be present early on in the relationship, or problems are likely to develop later.
Knowledge of the law and willing ability to explain the law is another part of a good attorney-client relationship. The lawyer needs to know what she/he is doing and should be willing and able to explain the law and what is being done to solve the client’s problem. Lawyers who can’t or won’t explain have trouble maintaining a good relationship with their clients. Lawyers who know the law are interested in making sure the client is informed and comfortable with the process and the actions being taken. Some law firms provide copies of all court documents to clients and others make them available on request. The lawyer and client should discuss what practice will be followed. Our firm provides documents on request.
Lawyer or lawyer-staff availability is important as well. Most successful lawyers are very busy and have to rely on staff to assist with the wide variety of details involved in representing clients. Lawyers simply can’t answer every question or take every phone call and be able to attend and prepare for court appearances, do legal research, prepare for and participate in depositions, and have time to make good decisions. Our firm assigns at least one legal assistant to be familiar with and assist each client. A good strong support staff is very important to having a good attorney-client relationship. No law office is perfect, but a responsible office makes a good-faith effort to be available and helpful.
The discussions will likely include an inquiry regarding the client’s health before the injury, which is often vital information to the case.
In addition, we have a nurse on staff to deal with the medical issues that are present in most of the cases we handle. Part of the conversation we have in the medical arena includes a frank discussion about the client’s health. The discussions will likely include an inquiry regarding the client’s health before the injury, which is often vital information to the case. We will also ask for a list of the medical providers and doctors who have been involved with care and treatment of the injury or illness. One reason we ask for a list of all doctors, their contact information, and the client’s medical records is so we can communicate how the current situation has affected the client’s overall well-being. Clients have the added benefit of the nurse’s expertise in navigating through the health-care challenges of appointments, prescriptions, and follow-ups.
Modern communication is important to a good attorney-client relationship.
Modern communication is important to a good attorney-client relationship. People now communicate in a wide variety of ways. A law firm interested in building and maintaining good attorney-client relationships will also be able to communicate in a wide variety of ways. Phone systems should provide for 24/7 answering and messaging. E-mail should be available. Social media such as Facebook (our firm is at Rehm, Bennett & Moore Attorneys at Law P.C., L.L.O. https://www.facebook.com/rbmlawfirm and Trucker Lawyers https://www.facebook.com/truckerlawyers), Twitter (www.twitter.com/rehmlaw and www.twitter.com/truckerlawyers), and Pinterest (https://pinterest.com/rehmbennettmoor), etc., enhances communication. Video conferencing via the internet using services such as Skype is free and effective for face-to-face communication when distance and other constraints prevent in-person meetings. This firm will provide Web cameras to clients if needed to make that method of communication available.
The final and most important factor in the attorney-client relationship is truth.
The final and most important factor in the attorney-client relationship is truth. Lawyers need to be truthful and sometimes blunt in their evaluations and communications with clients. There will be difficult conversation in many cases, but the lawyer must be willing and able to speak the truth, even if it is bad news. The clients must also be completely honest with the lawyer. Clients should not hold back any information about their past and should answer all questions completely and honestly even if they feel the information will “hurt the case”. Actually, a surprise due to lack of complete honesty will hurt the case much more. If a lawyer knows all the facts, she/he will be better equipped to help.
If an injured worker has documented and permanent work restrictions or even long-term work restrictions, thanks to the Americans with Disabilities (ADA) Amendments Act of 2008, that worker can likely invoke the protections of the ADA, unlike the injured worker in the recent St. Martin v. City of St. Paul case. He was found not to be disabled despite being permanently restricted to light-duty work.
However in Nebraska, employers are not obligated to put an injured worker in a light-duty job like they are in other parts of the country.
Injured workers have to reach out to their employers to help themselves stay employed. This reaching out could include suggestions about modifying the job or changing work hours. It’s good practice to be able to document these attempts to reach out to an employer via e-mail. If employers ignore these suggestions, then the employee has a good case for a failure-to-accommodate claim. However in Nebraska, employers are not obligated to put an injured worker in a light-duty job like they are in other parts of the country. Employers can force employees to apply for re-assignment. The employee then needs to be diligent about applying for open jobs. Otherwise, they can jeopardize an otherwise-strong ADA claim.
One trap disabled workers fall into is assuming that their employer is trying to get rid of them and failing to apply for jobs after a reasonable assignment. Courts in Nebraska take this behavior from workers as being unreasonable and use such behavior to justify dismissal of ADA claims.
Sometimes doctor-given restrictions do not match what an employee can actually do. Employees may be tempted to quit if an employer adheres rigidly to doctor-given restrictions. Technically an employer has to take an employee’s explanation of their own disability into account when setting a work restriction. However, courts in Nebraska usually require the employee to give something more than complaints of pain in order for an employer to modify doctor-given restrictions. The wisest move for an employee in such a situation is to try to do the job for a week or so and if the pain continues to consult with a doctor again about changing the restrictions. Employees might want to consider getting a second opinion if they believe their current doctor isn’t cooperating with work restrictions. However, employees should probably consult with a competent workers-compensation attorney if they are switching doctors in the context of a workers-compensation claim.
Today’s blog post is great advice from New York friend Kate Fitzgerald. The same problems and solutions happen nationwide. Always tell your lawyer the whole truth and provide details. Sometimes a thing that a person doesn’t think is a big deal or are little details are the most important part of the conversation from a legal perspective.
We represent a client whose hands were directly injured a few years ago. The insurance company, as part of its defense, is raising a provision in the law which requires an injured worker to file a claim for a direct injury within two years of the accident (WCL § 28). While interviewing the client, we learned that she had been feeling symptoms in her hands years ago, at the same time as she began experiencing the symptoms to other areas of her body. But because she only mentioned that her hands hurt now, we may not be able to get her the compensation she deserves.
Our client told me that originally brought up the symptoms of numbness, tingling and weakness in her hands with her doctor, but he felt these symptoms were related to her neck, another
If you are hurt, tell your attorney everything, even if you aren’t sure if it is relevant.
area where she was injured. The doctor tried to treat her hand symptoms by treating her neck first. He Continue reading →
If you were not following your employer’s safety rules, you can still collect workers’ comp’, but staying safe is always your best bet.
Our respected colleague from Wisconsin Tom Domer points out in today’s guest post that employee fault can reduce compensation in that state. Nebraska does not reduce recovery for partial fault but does bar recovery if the employee is willfully negligent. The defense is rarely successful.
Workers’ Comp is “No Fault” (even if it is the worker’s fault).
Workers may be reluctant to file a workers’ compensation claim if they feel the injury is due to their own fault. Sometimes they feel that the injury was due to their own violation of a safety rule. In some states, this could bar a workers’ comp, recovery—but not in Wisconsin. An injury caused by the employee’s failure to use a safety device or adhere to a safety rule results in a 15% decrease in workers’ comp benefits, to a cap of $15,000, but the worker can still claim benefits. A worker earning $600/week, with a $400/week disability rate would only lose $60/week.
A worker’s failure to use a safety device causing injury will not reduce benefits if the device isn’t adequately maintained or easily accessible, nor will a worker’s rule violation reduce benefits if the safety rule is unreasonable or not reasonably enforced.
Employers and insurers sometimes deny claims that involve a worker’s intoxication or use of non-prescription drugs. This is inappropriate. However, the benefits can be reduced by 15% if the injury is due to intoxication or drug use.
About a year ago we posted a blog from a colleague of ours, Tom Domer from Wisconsin, on this topic. However, Nebraska laws are different from Wisconsin laws on this matter, and this distinction is important.
As a reminder of that post, Mr. Domer pointed out that Wisconsin allows workers’ compensation benefits for workers who suffer from mental injuries unaccompanied by physical injury (so called “mental-mental” injuries).
Unlike in Wisconsin, mental injuries in Nebraska are only compensable if the psychiatric problem or depression is a product of a physical work-related injury (“physical-mental” injuries). An exception to this rule is that first responders (sheriff, police, state patrol, firefighters, and EMT/paramedics) may recover work comp benefits for mental-mental injuries in Nebraska.
In sum, Nebraska limits mental-mental injuries only to first responders, and limits workers’ compensation coverage for mental injuries even when they are accompanied by physical injuries.
The Nebraska courts tend to split hairs as to whether a mental injury is caused by the physical injury or whether the mental injury is caused by something else. For example, if the mental injury is shown to have been caused by the stress of work or the stress of the workers’ compensation process or litigation, the mental injury will not be covered under work comp.
In sum, Nebraska limits mental-mental injuries only to first responders, and limits workers’ compensation coverage for mental injuries even when they are accompanied by physical injuries. Therefore, it is important that if you have a mental issue after your work comp injury, make sure to report to your doctor that it is from the physical injury and not from the stress of your workers’ compensation claim, if that is accurate for your situation. If not properly reported and/or documented, your mental injury many not be covered by workers’ compensation even if the depression came soon after your back injury.
I can honestly say that the last thing I expected when I applied for law school was that I would need the help of a science course to be a more effective attorney. After all, I was applying to law school, not medical school. However, as the newest attorney at Rehm, Bennett & Moore, I recently had the opportunity to attend an all-day seminar titled “Anatomy for Lawyers” with Prof. Samuel D. Hodge, Chairman of the Legal Studies Department at Temple University. Jennifer Ohmberger and Megan Nicholson, legal assistants with the firm, also participated in the seminar.
