What happens when an injured worker misses a medical appointment?

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Missed medical appointments can effect a workers’ compensation claim

Injured workers may have to deal with scheduling medical appointments with multiple providers and all the other juggling of work schedules, travel and child care arrangements that go with seeing multiple doctors.So what happens when an injured worker misses a medical appointment?

Neb. Rev. Stat. 48-120 allows the Nebraska workers’ compensation court to reduce benefits if an employee refuses medical treatment provided by an employer. Likewise Neb. Rev. Stat. 48-134 allows the court to suspend benefits due if an employee refuses a medical examination requested by the employer/insurer. But even if a court reduces benefits for a refusal of medical treatment or a medical examination, that refusal of treatment or an examination would not effect whether a claim is covered by workers’ compensation. 

Even if missed appointments don’t lead direcrly to denial of benefits, missing medical appointments can be used as a way to attack the credibility of an injured worker in court.

Unintentionally missing a medical appointment wouldn’t be a refusal of treatment, but I have seen insurers, particularly third-party claims administrators, deny claims where an employee misses a medical appointment for whatever reason.

Very rarely do I see my clients refuse medical treatment. Often times clients are talking to me until after care has been denied for whatever reason. But I often have clients who are suspicious of medical examinations set up by their employers for litigation purposes. I don’t blame them.

Why employers have broad authority to examine injured workers.

Neb. Rev. Stat. §48-134 requires injured workers to submit to a reasonable medical examination and deems an “unreasonable refusal” to submit to an examination as reason to deduct from compensation of an injury. The Nebraska Workers Compensation Court has also adopted the Nebraska Rules of Civil Discovery through NWCC Rule 4. Rule 6-335 allows a defendant to have the plaintiff to submit to an examination upon showing of just cause. A refusal of an injured worker to submit to an examination set up by their employer could also lead to financial sanctions under Rule 6-337.

Why it’s more difficult for an injured worker to get a medical examination in Nebraska.

In my experience, it is hard to quash a medical examination in a contested case. But if a plaintiff wants a medical examination under Neb. Rev. Stat. 48-134.01, it’s a different story. In order for the plaintiff to obtain a court ordered IME at the expense of the defendant, the plaintiff needs to establish medical causation and show there is some dispute between doctors that an independent medical examiner can resolve. Plaintiff’s can find some leverage under Neb. Rev. Stat. 48-120(5) which gives the court some authority to order medical examinations on their own outside the medical examination statutes at 48-134 and 48-134.01.

Recently an Ohio court suspended a claim for an employees refusal to submit to a psychological examination. I am fairly certain a Nebraska court would have ruled the same way as the Ohio court.

The recent Ohio case concerned an employee who was seeking medical treatment for psychological injuries. Such a case would be difficult to bring in Nebraska. In Nebraska when medical treatment is sole issue in the case, there must be a court-appointed medical examination before an employee can file a petition.

 

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in independent medical examination, medical treatment, Nebraska, Workers' Compensation and tagged , , , .

Are plaintiff’s lawyers unintentionally spreading myths about claimant fraud?

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The Social Security Administration (SSA) plans to implement rules, that if enacted, would allow SSA to review social media posts by Social Security Disability Insurance (SSDI) applicants and beneficiaries to check for benefits fraud.

Administrative agencies and adjudicatory bodies usually have broad authority to enact procedural and evidentiary changes that can affect the substantive rights of claimants. In the case of federal executive agencies like the Social Security Administration, those rules can be challenged in the judiciary branch and struck down by Congress.

Complaints about social security fraud are evergreen and overblown because of the difficulty in getting SSDI. SSDI benefits became even harder to receive as a result of bi-partisan reforms signed by President Obama in 2015 that included the repeal of the so-called treating physician rule.

Complaints about social security fraud echo and overlap with complaints about workers’ compensation fraud. Workers’ compensation fraud is rare on the employee side and even the workers’ compensation industry admits that workers’ compensation fraud is at least as much of a problem on the employers’ side as it is with employees.

So why does the trope of the fraudulent disability or workers’ compensation claimant continue to exist? I would argue that the plaintiff’s bar unintentionally perpetuates the myth. Here is the how and why of how I think the plaintiff’s bar perpetuates the fraudulent claim trope.

Any good plaintiff’s lawyer is going to make sure they know about their client’s social media feeds and will warn their clients about social media use. Plaintiff’s lawyers often take this standard advice and publish it on blogs and their own social medial feeds. Whenever a story breaks about an injured worker or disability claimant being caught for fraud with a social medial post, plaintiff’s lawyers reflexively post “See what happens, don’t do that.” But by engaging with these stories, the plaintiff’s bar amplifies stories about claimant fraud which are admittedly rare.

So why do we as plaintiff’s lawyers post cotnent on social media that perpetuate myths about our clients? It’s hard to say, but I have a few theories. The first is there is a pressure for plaintiff’s lawyers to engage on social media. A lot of plaintiff’s attorneys view social media engagement as marketing and outsource marketing to vendors.  When plaintiff’s lawyers take a hands off approach to social media, content tends to reflect whoever is actually producing the content rather than the attorney.

If social media posting is viewed as marketing, then from a marketing perspective, attorneys might be afraid to alienate potential clients by directly challenging client assumptions about claimant fraud. If a plaintiff’s attorney posts a generic “Be careful on social media” post, the subtext is “I only represent legitimate claimants.” Plaintiff’s lawyers are trained to frame their cases in a way that appeals to jurors that are skeptical of litigation and those who bring lawsuits. While that approach often works with juries in individual cases, that assumption can amplify those same views if used as part of attorney marketing.

Plaintiff’s lawyers try to do what is best for their clients and practices. Even if plaintiff’s lawyers don’t push back against directly about stereotypes about their clients and practices in their marketing, many of us push back against harmful laws and regulations on a state and federal level.  Social media is still a relatively new platform that has given many firms a way to engage with the public in a cost-effective way. We as plaintiff’s lawyers should use this new platform to confront negative stereotypes about our practices rather than unintentionally perpetuating harmful stereotypes.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Nebraska, social security disability, Workers' Compensation and tagged , , , .

Could suicide nets be coming to American workplaces?

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Coming to a worksite near you?

Stressed out and disaffected white collar workers seem to idealize blue collar work as physically taxing, but not mentally straining. The stress-free blue-collar worker is personified by the character Larry in the classic movie, Office Space.

But in reality, many blue-collar jobs can be every bit as mentally stressful, if not more stressful, than white-collar jobs. The Daily Beast ran an investigative report involving suicide attempts by workers in Amazon warehouses. The mental stress comes from trying to keep up with the fast pace of work.

The complaints of Amazon workers eerily mirror those of Chinese employees of Apple contractor Foxconn, which notoriously installed suicide prevention nets to prevent further employee suicides.

I hear many of the same complaints about stress from about the pace of work from my clients who work in meat packinghouses. A work injury can often worsen the stress of keeping up with production because a physical injury usually makes it harder to do a job. The Daily Beast article profiled one worker who suffered increased mental problems after an ankle injury on the job impacted his ability to keep up with the demands of his job.

Mental stress is part of my many workplaces, but purely mental injuries usually aren’t covered by workers’ compensation laws. For a mental injury to a warehouse worker in Nebraska to covered by workers’ compensation, it would have to be directly related to a physical injury. Mental stress from being unable to keep up with job demands due to a physical injury could be covered.

In Nebraska, certain workers such as police, firefighters and other first responders can collect workers’ compensation for purely mental injuries. But even before the Daily Beast article about extreme mental distress among Amazon employees, me and other workers’ compensation bloggers have questioned why so called mental-mental benefits are limited to first responders. I’ve taken a particular interest in convenience store clerks and other retail employees are often subject to or witnesses of violent crime.

My view is the answer to why so-called mental-mental benefits tend to be limited to first responders is politics. Retail workers and non-unionized warehouse workers don’t have the kind of clout as police officers or firefighters.

First responders deserve mental-mental workers’ compensation benefits because they can be subject to terrible trauma on the job. But other workers can be also be subject to serious mental distress on the job. That stress should be covered by workers’ compensation laws in Nebraska and other states.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in mental distress, Mental Injuries, Nebraska, Workers' Compensation and tagged , , , .

Settling a workers’ compensation and wrongful termination case at the same time

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Many employers want to settle all employment-related claims when they settle a workers’ compensation case

Clients often ask me, “If I settle my workers’ compensation case, can I still sue my employer for wrongful termination?” My answer is almost always yes. But for one unfortunate employee in Louisiana, it appears settling their workers’ compensation case may have doomed their wrongful termination case.

A federal district court in Louisiana held that a worker who settled their workers’ compensation case with a release that released all claims arising from their work injury was deemed to have settled their wrongful termination case under various civil rights laws.

The Louisiana decision raised the ire of some employee-side attorneys. Workers’ compensation laws and civil rights laws provide different remedies for different harms. A Minnesota court recently used this fundamental tenet of law to hold that a disability discrimination claim under their state’s civil rights laws was not barred by the exclusive remedy provision of their state’s workers’ compensation act.

But as a practical matter, some employers like to settle all claims arising out of the employment relationship when they settle a workers’ compensation case. In these cases there is usually consideration, or seperate amounts, to settle the workers’ compensation claim and the employment law claim. Sometimes this can be advantageous for a client. I am not sure of how the release was structured in the Louisiana case, but here is how I structure so-called global releases. In short, you need two releases: one for the workers’ compensation claim and one for the wrongful termination case.

Settling the workers’ compensation case

I wrote earlier about the so-called exclusive remedy of workers’ compensation. In Nebraska, that exclusive remedy also means the workers’ compensation court has limited jurisdiction. Nebraska courts have stated repeatedly that the Nebraska Workers’ Compensation Court can not adjudicate employment law cases because they are a court of limited jurisdiction. Neb. Rev. Stat. §48-139 gives the court jurisdiction over workers’ compensation settlements. 48-139 also dictates the language of workers’ compensation settlements, states when settlements must be approved by the court and mandates the filing of settlement papers with the court. In short, if the Nebraska Workers’ Compensation Court does not have jurisdiction to hear a wrongful termination or discrimination case, any settlements in that court should not effect any wrongful termination case or discrimination case.

Settling the wrongful termination or discrimination case

A settlement agreement in a wrongful termination case is a different document. Usually there is no requirement that it be filed or approved by a court. These agreements are often synonymous with severance agreements and oftentimes included language required by the Older Workers’ Benefit Protection Act if the employee is over 40 years old.

Settlement agreements in employment cases usually also talk mention tax liability. Tax liability is usually not mentioned in a workers’ compensation settlement as workers’ compensation benefits are almost never taxed. But settlement proceeds in a wrongful termination or discrimination case are usually taxable and those agreements should include some discussion of tax liability.

Sometimes employers will want a resignation as a condition of paying a settlement to an injured employee. If the employee is still working, that provision can be a deal breaker. But for an employee who has been terminated the extra money for a wrongful termination claim can be beneficial. Settling all claims at once may also help an employee minimize taxes by apportioning the majority of the value of the severance or employmennt law settlement into the non-taxable workers’ compensation settlement.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in employment law, Nebraska, Workers Compensation and tagged , , , , , .

What is an accident in workers’ compensation?

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Accidents happen is a common refrain. Most people believe that an accident is something that happens suddenly and was caused by carelessness. But nothing is quite that simple in the world of workers’ compensation.

            Nebraska law defines accident as happening suddenly and violently, being unexpected and having objective symptoms. Suddenly violently means that an injury 1) happens at a definite time 2) stops employment and 3) the employee stops work.

            This definition can cover all sorts of injures that might not be considered an accident by a lay person.

            .Examples of such cases are: (1) carpal tunnel from repeated use of hands, (2) rotator cuff shoulder injuries from repeated use of arms above the shoulder, (3) skin conditions from repeated exposure to chemicals, dust or heat, (4) blood clotting from long periods of sitting, (5) heart attack and stroke from unusually heavy exertion, (6) lung diseases from exposure to chemicals, grain dust and cement dust, (7) cancer from exposure to chemical or substance known to be carcinogens (8) death from a work related disease, (9) mental health disease caused by long term pain from a work related injury, disease or condition.

            In cases that aren’t thought about as “accidents” injured workers may not be clear in relating their symptoms to their work. There could also be confusion over the exact date of an injury. Some employers may even be confused about what happened – or if they acting in bad faith they may try to discipline an employee for not reporting the “accident” in a prompt manner. Injured workers can end up losing their job and or having their claim denied because they don’t understand what accident means in workers’ compensation law.

            Nebraska workers facing such challenges should contact a lawyer if they suffer from a disease or condition from work activity or environment mental factors. You may be entitled to benefits. Nebraska Workers compensation benefits are not limited to sudden accidents.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Nebraska, Workers' Compensation and tagged , , , , , .

What To Do When You Get Hurt At Work

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Today’s post comes from guest author Catherine Stanton, from Pasternack Tilker Ziegler Walsh Stanton & Romano.

As an attorney who has practiced in the field of Workers’ Compensation for more than 28 years, I have seen many changes in how the system treats injured workers.  During this age of progressiveness in New York, when the minimum wage has increased and the requirement for paid sick leave has been implemented, it only stands to reason that injured workers would be treated with dignity during their quest to obtain monetary benefits for their lost time and obtain the medical treatment necessary during their recovery. 

Unfortunately, however, there has been a nationwide focus on Workers’ Compensation reform with the emphasis on cost savings, often at the expense of the injured worker.  New York State has followed along in this national trend; therefore, it is even more imperative to know what to do in the event of a work-related injury or illness.  Injured workers must notify their employer immediately – preferably in writing if possible – within 30 days and file their claim with the New York State Workers’ Compensation Board within two years of the date of an accident or onset of an illness.     

Additionally, finding the right doctor is one of the most important decisions you can make during this particularly rough time. After you are injured, you obviously must seek immediate medical attention before you do anything else. Don’t wait or assume your injury is going to heal, because if you are unable to work, benefits will not be payable until the date of the first medical treatment. You might need to go to the hospital if your injury is an emergency or life threatening, but in most cases you should be able to visit your physician. Either way, be sure you notify the medical professional that you are being treated for a work-related injury as any treatment should be billed through Workers’ Compensation.  It is important that your treating physician be coded to practice before the New York State Workers’ Compensation Board because of the medical evidence necessary to proceed with a claim, the myriad of forms they are required to file, and the possibility of their testimony in the future.  

The New York State Workers’ Compensation Board has implemented medical treatment guidelines for injuries to the back, neck, shoulder, knees, and bilateral carpal tunnel syndrome. Medical providers must comply with these guidelines in their treatment of injured workers, which have a number of treatments or tests that are preauthorized based upon certain findings. If the modality of treatment is not included in the guidelines, a variance may be requested. There are different forms for different requests and different timelines in which to file. A doctor not coded in Workers’ Compensation or inexperienced in this procedure could prevent you from receiving proper or timely treatment. 

Payments made for lost time are based upon the earnings of the injured worker, as well as the overall degree of disability. The degree of disability is based upon the medical evidence submitted by the injured worker’s treating doctor, as well as the opinion of the insurance company’s consultant. Many times these opinions are at odds and medical testimony is necessary so the law judge can make an informed decision. Doctors who are coded understand the procedure and the necessity of being available to testify on your behalf at these medical depositions. The insurance carrier will question the doctor on whether he or she is coded, which may impact the judge’s perception as to a doctor’s credibility regarding treatment guidelines, degree of disability, or earning capacity. Ultimately, the length of time and the amount of weekly benefits an injured worker is entitled to receive benefits once permanency is determined by a law judge is based on a finding of loss of earning capacity. In many cases, there can be a difference in years. 

Nothing is better than finding a doctor who is competent, empathetic, and an expert in his area of specialty, but finding one with all of these qualities who is also knowledgeable in Workers’ Compensation is invaluable. 

 

Catherine M. Stanton is a senior partner in the law firm of Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP. She focuses on the area of Workers’ Compensation, having helped thousands of injured workers navigate a highly complex system and obtain all the benefits to which they were entitled. Ms. Stanton has been honored as a New York Super Lawyer, is the past president of the New York Workers’ Compensation Bar Association, the immediate past president of the Workers’ Injury Law and Advocacy Group, and is an officer in several organizations dedicated to injured workers and their families. She can be reached at 800.692.3717.

 

  

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Workers' Compensation, Workplace Injury and tagged , , .

What is an accident in workers’ compensation?

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Accidents happen is a common refrain. Most people believe that an accident is something that happens suddenly and was caused by carelessness. But nothing is quite that simple in the world of workers’ compensation.

Nebraska law defines an accident as happening suddenly and violently, being unexpected and having objective symptoms. Suddenly violently means that an injury 1) happens at a definite time 2) stops employment and 3) the employee stops work.

This definition can cover all sorts of injures that might not be considered an accident by a lay person.

Examples of such cases are: (1) carpal tunnel from repeated use of hands, (2) rotator cuff shoulder injuries from repeated use of arms above the shoulder, (3) skin conditions from repeated exposure to chemicals, dust or heat, (4) blood clotting from long periods of sitting, (5) heart attack and stroke from unusually heavy exertion, (6) lung diseases from exposure to chemicals, grain dust and cement dust, (7) cancer from exposure to chemical or substance known to be carcinogens (8) death from a work related disease, (9) mental health disease caused by long term pain from a work related injury, disease or condition.

In cases that aren’t thought about as “accidents” injured workers may not be clear in relating their symptoms to their work. There could also be confusion over the exact date of an injury. Some employers may even be confused about what happened – or if they acting in bad faith they may try to discipline an employee for not reporting the “accident” in a prompt manner. Injured workers can end up losing their job and or having their claim denied because they don’t understand what accident means in workers’ compensation law.

Nebraska workers facing such challenges should contact a lawyer if they suffer from a disease or condition from work activity or environment mental factors. You may be entitled to benefits becuase Nebraska Workers compensation benefits are not limited to sudden accidents. You may also have a case for wrongful termination if you were fired for reporting a work accident.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Nebraska, Workers' Compensation and tagged , , , , , , , , .