Workers’ Compensation


Another Option for You\u2026<\/span><\/h2>\r\nIf you find that you\u2019re in a position in which you can\u2019t work for over a year because of your injury, then you may want to apply for <\/span>Social Security Disability Insurance (SSDI)<\/span>.\u00a0<\/span>\r\n\r\nIf you qualify for SSDI, you will be eligible for Medicare, but you have to receive SSDI benefits for two years first. Until you\u2019re enrolled in Medicare, you can apply for MassHealth, which is Massachusetts\u2019 Medicaid program.\u00a0<\/span>\r\n\r\nIn addition to SSDI, you may also qualify for supplemental security income (SSI). If you qualify for SSI, you are automatically eligible for MassHealth. It\u2019s possible to get both Medicare and Medicaid.\u00a0<\/span>\r\n\r\nWith your existing condition covered due to the injury at work, applying for SSDI is sometimes the best option.\u00a0<\/span>\r\n

Hire the Right Lawyer by Looking for This One Thing<\/span><\/h2>\r\nI\u2019m about to hand you the secret sauce that\u2019s going to give you the best possible outcome.<\/span>\r\n\r\nYou may already know that hiring a lawyer to handle these problems is the key to getting what you want. However, there are specific things you need to look for so you can hire the best attorney possible. One who is so good a simple phone call could solve your problems. There are no guarantees, but your chances of success will be greatly improved.<\/span>\r\n\r\nLook for <\/span>online reviews<\/span>. Did you know that until recently it was illegal for attorneys to collect testimonials and reviews?<\/span>\r\n\r\nThe bad lawyers didn\u2019t want the rest of the world to know that they weren\u2019t good at their jobs, especially when it comes to workers\u2019 comp. They lobbied the bar associations to keep their client feedback under wraps.<\/span>\r\n\r\nHowever, this changed a couple of years ago, and now you can actively see what their clients think of them.<\/span>\r\n\r\nEven better, call them up and ask them for a video interview or something similar from a past client. The most successful attorneys always have clients who are so ecstatic they would leap at the chance of doing a video testimonial or interview.<\/span>\r\n\r\nOnce you get the reviews, video interviews, and testimonials you asked for, make sure they are specifically related to workers\u2019 comp; not just general \u201dpersonal injury\u201d but work-related injuries.<\/span>\r\n\r\nThere are many lawyers out there who try and take on every single case that comes their way without having experience in that specialty area.<\/span>\r\n

In Summary<\/span><\/h2>\r\nI told you it was a complicated answer. Everyone\u2019s situation is different, and the laws are immensely complex. Speaking to a personal injury attorney who specializes in worker\u2019s comp in Boston is definitely your best bet.<\/span>\r\n\r\nHere\u2019s a quick summary of the information provided in this article:<\/span>\r\n
    \r\n \t
  1. There are laws in the state of Massachusetts that help you keep your health insurance for a certain length of time after you lose your job.<\/span><\/li>\r\n \t
  2. You can get up to 12 weeks of protection from a federal law called FMLA, but only if your employer has more than 50 employees in a 75-mile radius, along with some other caveats.\u00a0<\/span><\/li>\r\n \t
  3. COBRA allows you to retain your group plan for up to 18 to 36 months, depending on the circumstances, but you have to pay the premiums (often cheaper than market rates).<\/span><\/li>\r\n \t
  4. A long-term injury that keeps you from working could qualify you for Social Security Disability Insurance (SSDI).<\/span><\/li>\r\n<\/ol>","post_title":"What Happens to Your Employee Health Insurance While Receiving Workers\u2019 Compensation Benefits in Boston?","post_excerpt":"","post_status":"publish","comment_status":"open","ping_status":"closed","post_password":"","post_name":"happens-employee-health-insurance-workers-compensation","to_ping":"","pinged":"","post_modified":"2021-05-31 07:34:52","post_modified_gmt":"2021-05-31 14:34:52","post_content_filtered":"","post_parent":0,"guid":"https:\/\/\/?p=87008","menu_order":0,"post_type":"post","post_mime_type":"","comment_count":"1","filter":"raw"},{"ID":87070,"post_author":"998","post_date":"2021-02-25 12:20:56","post_date_gmt":"2021-02-25 19:20:56","post_content":"Legal information is complex, and understanding the intricacies of a workers\u2019 compensation claim is no different. I have tried to simplify it in this article, but you'll need laser-sharp focus to understand the important information that follows.<\/span>\r\n\r\nWorkers' compensation laws are designed to cover the expenses of employees who are injured while executing work-related duties. This includes compensation for medical bills, rehabilitation costs, and partial wages. That said, there are some twists and turns that may require professional assistance to navigate.\u00a0<\/span>\r\n\r\nSo, while I've touched on virtually everything you need to know about workers' compensation claims, make sure you speak to a personal injury attorney if you have further questions and concerns.<\/span>\r\n\r\nLet's dive in!<\/span>\r\n

    No. 1: It's Your Right!<\/h2>\r\nEmployers in every state of the U.S. are required by law to carry workers' compensation insurance. The law is designed to protect you and your family in the case of an unfortunate event.\u00a0<\/span>\r\n\r\nHere's the complicated part - workers' comp requirements and coverage levels vary from one state to another. State laws may differ based on the number of employees, <\/span>the type of injury<\/span>, the timeframe an employee has to file a claim, qualifying requirements, etc. States also have different laws on the minimum and maximum duration of coverage and policy amounts.\u00a0<\/span>\r\n

    No. 2: Your Employer Doesn't Have to Be at Found at Fault for You to Get Workers\u2019 Compensation<\/h2>\r\nLots of people mistakenly think they have to prove that their employer is guilty or at fault before the employer can be required to pay compensation. If you genuinely like your employer you might have a hard time bringing yourself to file for your much-deserved compensation.<\/span>\r\n\r\nFortunately, that's not how it works. In fact, workers\u2019 compensation insurance is a \"no-fault insurance.\" This means it's not a blame game. The law is aimed at protecting you regardless of fault, not nailing erring companies.<\/span>\r\n\r\nTo access your benefits, you have to prove just one thing:<\/span>\r\n\r\nYou have to prove that the injury was sustained while doing work-related activities in adherence to standard operating procedures.<\/span>\r\n\r\nWhile this may be difficult to prove, hiring a lawyer skilled in workers\u2019 compensation will make it a lot easier.<\/span>\r\n

    No. 3: You Reserve the Right to Sue Your Employer<\/h2>\r\nWhile I've said your employer doesn't have to be the villain, there are unique situations where employers have directly or indirectly caused life-altering accidents.<\/span>\r\n\r\nImagine a situation where an employer asks an employee to carry out a task beyond their skillset or without providing appropriate protective gear. If an accident occurs in such conditions, the employee may want to take further legal action against the company.<\/span>\r\n\r\nIf your injury occurred due to the negligence of your employer and standard workers\u2019 compensation isn\u2019t enough to cover your losses a lawsuit against your employer might be your best option. However, suing your employer may not always be the right move. You'll want to seek the professional help of an experienced workers\u2019 compensation and personal injury attorney to learn what your best options are to get the compensation you deserve.\u00a0<\/span>\r\n

    No. 4: Workers\u2019 Compensation Covers Long Term Injuries<\/h2>\r\nThis one can be a bit tricky, yet crucial. Read on, and I'll keep it as concise as possible.<\/span>\r\n\r\nCertain workplace conditions can cause severe health hazards in the long run. For instance, if your job involves using handheld tools or typing all day, you may develop musculoskeletal disorders (MSDs) from <\/span>repetitive use<\/span>, like carpal tunnel syndrome or rotator cuff injuries. Or, if you work in a chemical production plant, you may come down with a respiratory condition or worse, cancer.\u00a0<\/span>\r\n\r\nBut how do you prove your workplace conditions caused a long-term disease or disability? Photos and witnesses won't cut it this time. The short answer:<\/span>\r\n\r\nYou'll need a seasoned attorney. One who can reach out to their network of professionals and prove, using research studies and evidence from similar occurrences, that your work led to your injury or illness.\u00a0<\/span>\r\n

    No. 5: Your Benefits May Extend Beyond Financial Compensation<\/h2>\r\nSometimes these injuries can deal a blow to you and your family. And while money can alleviate most of the problems, you'll need something more to help you adapt to your new reality.<\/span>\r\n\r\nFor example, suppose you've sustained an injury that keeps you out of work for a long time or makes you unable to perform your usual job. In that case, you'll be eligible for a vocational rehabilitation program.\u00a0<\/span>\r\n\r\nVoc Rehab is available in virtually every state. The program enables you to keep your job or, if impossible, prepares you for a new career that suits your new reality. This ensures that you and your family are not left at the mercy of unemployment benefits.\u00a0<\/span>\r\n\r\nSo, while money is essential, vocational rehab programs help provide the foundation for rebuilding your future.<\/span>\r\n\r\n

    No. 6: You're Protected Against Retaliation From Your Employer<\/h2>\r\nThe law is clear on one thing: Employers cannot bring down the hammer on employees who file a workers' comp claim.<\/span>\r\n\r\nEmployees are often worried about their employer's retaliation if they file for a comp claim. I know this fear has stopped some misinformed employees from claiming their rightful compensation.<\/span>\r\n\r\nHowever, the law offers zero tolerance for employers who fire or punish employees just because they file a workers' comp claim. Even if you've got bad employers, they know the law, so you should have absolutely nothing to worry about.\u00a0<\/span>\r\n\r\nYour employer should understand you're only trying to protect yourself and your family. No hard feelings. However, if you find yourself in a situation where an employer violated the law, seek legal help immediately.\u00a0<\/span>\r\n

    No. 7: A Little on Workers' Compensation Fraud<\/h2>\r\nThe law is enacted to help employees in dire need. Like everything else, it has been abused by some dishonest people. Employers and employees alike.\u00a0<\/span>\r\n\r\nDishonest employees may stage an accident. This is usually to get compensation for a non-work-related injury. Other times, they may exaggerate the severity of an injury to inflate the value of their claim.\u00a0<\/span>\r\n\r\nOn the other hand, employers may attempt to dissuade employees from filing a legitimate claim, or wrongfully accuse an employee of making a fraudulent claim.<\/span>\r\n\r\nYou've got nothing to worry about, though. A good workers' compensation lawyer can sniff out traces of fraud from miles away.<\/span>\r\n\r\nWhile it might be tempting to try to claim more than you\u2019re entitled to, or for an employer to take advantage of the system there are severe penalties when you\u2019re caught. Between possible jail time and hundreds of thousands of dollars in fines, it\u2019s best to just be honest.\u00a0<\/span>\r\n

    In Summary<\/h2>\r\nAs I mentioned at the beginning, the legal world is a complex one. You may never learn all the ins and outs. At least, not as well as an attorney.<\/span>\r\n\r\nHowever, I have simplified some necessary information about workers' compensation laws, and here's a summary:<\/span>\r\n
      \r\n \t
    • It's YOUR RIGHT to receive workers' compensation in the unfortunate event of a workplace injury.<\/span><\/li>\r\n \t
    • Your employers can't penalize you for filing a compensation claim. In fact, you may sue them (if necessary) and still keep your job.<\/span><\/li>\r\n \t
    • You don't have to prove your employer is at fault.<\/span><\/li>\r\n \t
    • Long-term injuries are covered.<\/span><\/li>\r\n \t
    • Your compensation may go beyond money and medical treatment.<\/span><\/li>\r\n<\/ul>\r\nHopefully, you found the information here useful.<\/span>","post_title":"Workers\u2019 Comp Claims: 7 Essential Facts Every Employee Should Know","post_excerpt":"","post_status":"publish","comment_status":"open","ping_status":"closed","post_password":"","post_name":"workers-comp-claims-7-essential-facts-every-employee-should-know","to_ping":"","pinged":"","post_modified":"2021-05-31 07:35:42","post_modified_gmt":"2021-05-31 14:35:42","post_content_filtered":"","post_parent":0,"guid":"https:\/\/\/?p=87070","menu_order":0,"post_type":"post","post_mime_type":"","comment_count":"1","filter":"raw"},{"ID":87028,"post_author":"998","post_date":"2021-02-15 12:05:42","post_date_gmt":"2021-02-15 19:05:42","post_content":"Because no two injuries are exactly alike and every person heals differently, there's no hard and fast rule about when you should return to work after a workers' compensation claim. Assessing when an injured person is fit to return to work should always be done on an individual basis.<\/span>\r\n\r\nHowever, this creates a lot of room for unfair manipulation by employers and insurance companies who are eager to stop losing money on the direct and indirect costs of an employee\u2019s workers\u2019 compensation-related absence.\u00a0<\/span>\r\n\r\nWhat this means is that, to protect yourself, you have to be armed with proper knowledge. Pay close attention to the information on this article, and for further clarity, book a free consultation with a <\/span>workers' compensation attorney<\/span><\/a>.\u00a0<\/span>\r\n\r\nLet's dive right into what you MUST know about returning to work after a workers' comp claim.<\/span>\r\n

      Don't Rush the Process; Wait Until You're Physically Capable<\/span><\/h1>\r\nIt is not uncommon to have employers and insurance companies pressuring you to return to work. Sometimes they may offer juicy incentives. DON'T GIVE IN. Returning to work earlier than you should severely affects your recovery process and may cause you to get re-injured. I'm sure you don't want that.<\/span>\r\n\r\nThe determination of when you\u2019re ready to return to work should be made between you and your doctor. Even though you may be eager to get back to work it\u2019s not advisable until you\u2019ve received clearance from your doctor.\u00a0<\/span>\r\n\r\nSuppose your employer or insurance company feels you should resume work while your doctor thinks otherwise. In that case, the <\/span>Department of Industrial Accidents (DIA)<\/span><\/a> may order an <\/span>Independent Medical Examination (IME)<\/span>.<\/span>\r\n\r\nIn many cases, the doctor you see for an IME may conclude that you're capable of working at a higher physical level than your doctor says. If this happens, contact a workers' comp lawyer immediately.\u00a0<\/span>\r\n\r\nSo, what happens when you do go back to work? As you may have noticed, it\u2019s a bit complicated but I promise to touch on every important point.<\/span>\r\n

      Know Your Restrictions and Communicate Them<\/span><\/h1>\r\nYou should provide your doctor with comprehensive information about your work duties. This way, he can know when you're able to fully return to carrying out those tasks.<\/span>\r\n\r\nIn some cases, your doctor may clear you to return to work but with some restrictions. Ask your doctor to provide a written note that clearly states your limitations. Present a copy to your employer and keep one for yourself. If, for any reason, your employer fails to honor those restrictions when you return to work, you shouldn't let them put your health at risk. Contact a workers' compensation lawyer immediately.<\/span>\r\n

      Return to Work (RTW) Policy<\/span><\/h1>\r\nMany companies have a Return to Work (RTW) policy. This policy is in place to give sick and injured employees a soft return back to work. One of the benefits of RTW policy is that it eases injured employees back to the working environment and among supportive employees without putting their health at risk.\u00a0<\/span>\r\n\r\nHowever, some RTW policies are plain selfish. The companies focus on conserving funds that would otherwise be spent due to the absence of a valuable worker. So they plug this hole by using policies to lure employees back to work without a care in the world about their state of health.\u00a0<\/span>\r\n\r\nBefore you rush back to work based on RTW policy, get a workers' comp lawyer to iron out the terms with your employer.\u00a0<\/span>\r\n\r\nAnd sometimes, the terms may look good on paper, but then, employers have a hard time adhering to them. At this point, you should contact a Boston workers' compensation lawyer.<\/span>\r\n\r\n

      Test the Waters: Go Back to Work for a Trial Period<\/span><\/h1>\r\nIf you've been injured and out of work for a while, sometimes it isn't easy to know when you're physically able to get back to work. In some cases, you just have to give it a try to find out. Luckily, the law covers you on this one.<\/span>\r\n\r\nMassachusetts' law allows workers to take a shot at work on a trial basis to see if they're ready. The trial period lasts for 28 days. Within the trial period, you can choose to back off if you don't feel up to it and request your health benefits to be reinstated.\u00a0<\/span>\r\n\r\nIf a worker fails to notice that they're incapable of carrying out their work duties within the 28-day trial period, and then later realizes their limitations they may have to go through the long and winding road of filing for a whole new workers' compensation claim.<\/span>\r\n\r\nPro Tip:<\/b> When you do get back to work, your employers may want to have you sign some papers regarding your case. They may trivialize and sugarcoat the documents by saying things like: <\/span>\"It's just to help us process your final compensation check.\"<\/span>\r\n\r\nDon't fall for it. In fact, don't sign any papers without having your workers' compensation lawyer review them.<\/span>\r\n\r\nHopefully, you found the information here useful.<\/span>\r\n\r\nAs you may have noticed, deciding when and how to return to work after an injury can be complicated and you\u2019ll benefit from a workers' compensation attorney virtually every step of the way.\u00a0<\/span>","post_title":"When Do I Have to Return to Work After a Workers' Compensation Claim?","post_excerpt":"","post_status":"publish","comment_status":"open","ping_status":"closed","post_password":"","post_name":"when-do-i-have-to-return-to-work-after-a-workers-compensation-claim","to_ping":"","pinged":"","post_modified":"2021-05-31 07:36:53","post_modified_gmt":"2021-05-31 14:36:53","post_content_filtered":"","post_parent":0,"guid":"https:\/\/\/?p=87028","menu_order":0,"post_type":"post","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":69330,"post_author":"901","post_date":"2020-07-13 15:05:31","post_date_gmt":"2020-07-13 22:05:31","post_content":"As a lawyer who has represented injured workers for the past 15 years, I believe that the law should favor coverage for those who contract COVID-19 in their workplace. If you find that your lost work time due to COVID-19 is extended beyond 14 days and you are continuing to suffer lost wages while your medical bills pile up, you should contact an experienced workers\u2019 compensation attorney.\r\n\r\nThe Family First Coronavirus Relieve Act (FFCRA) states that employees who are unable to work due to COVID-19, and who work for employers who have less than 500 employees, are entitled to paid sick leave at their full rate of pay for up to 80 hours. In this scenario, if you recover well and can return to work after the 14-day period, then your potential workers\u2019 compensation claim is likely not worth pursuing.\r\nIf after the 14-day period you are still ill and out of work due to treatment, hospitalization, etc., you may be eligible for ongoing benefits under one or a combination of several government-funded unemployment programs. You may select to pursue the assistance available from these sources while you speak to legal counsel (recommended) or weigh the potential for pursuing your COVID-19 exposure as a legal claim.\r\n

      WHAT EXPENSES CAN I RECOVER?<\/h2>\r\nIn North Carolina, workers\u2019 compensation generally pays for three things: (1) medical treatment (with doctors chosen by the insurer\/employer); lost wages (at 2\/3 of the average weekly wage); and payment for any permanent impairment sustained by the injured worker.\r\n\r\nIf the claim for COVID-19 exposure is accepted, benefits should commence right away with the carrier directing medical treatment and paying lost wages.\r\n\r\nIf the claim is denied, then a request for a hearing may be filed with the NCIC. Unfortunately, that process is lengthy and may take 12-24 months or longer to obtain a decision (win or lose) that will be final (not appealable).\r\n\r\nIf the COVID-19 claim is denied as a workers\u2019 compensation claim and there are identifiable elements of negligence on the part of the employer, it may be advantageous to file the claim as a civil lawsuit. In the civil arena, the remedies for an injured person are greater. In addition to compensation for medical treatment, the plaintiff in a civil lawsuit may be entitled to reimbursement of their full lost wages and may also recover compensation for pain and suffering, loss of enjoyment of life, and a number of other elements that go beyond the remedies available in a workers\u2019 compensation claim.\r\n

      WHAT RECORDS DO I NEED TO KEEP?<\/h2>\r\nTo prove an occupational disease claim, specific facts and details are needed. You should preserve any documentation and witness statements that will confirm the number of people infected, quarantined, etc. due to COVID-19 in the workplace. Make note of actions taken to protect employees who have not tested positive; cleaning procedures in areas where infected people had contact; the types of personal protective equipment (PPE) issued or required for those coming into the workplace; and the limitations, if any, placed upon the public interacting with people inside the workplace.\r\n

      EXAMPLE OF A POTENTIAL CLAIM<\/h2>\r\nA nurse in a nursing home tests positive for COVID-19 after being exposed to several residents who are sick and tested positive. The nurse potentially has an \u201coccupational disease\u201d claim. With an occupational disease claim the employee must prove two things in order for their claim to be accepted as a workers\u2019 compensation claim: (1) work was the cause of their getting COVID-19; and (2) their work with the employer put them at an increased risk of getting COVID-19 over and above the average person not so exposed. Without an expert (doctor) stating \u201cmore likely than not\u201d that these two things are true, it is unlikely that the nurse\u2019s claim will be successful.\r\n

      WHAT SHOULD I DO IF I HAVE TESTED POSITIVE?<\/h2>\r\nIf you have tested positive you will have to be quarantined from all non-infected individuals for a minimum of 14 days. If you are not symptomatic and your employer provides the option for you to telework, then that is your quickest and simplest remedy. If you can recover from the illness within the two-week period, then you will likely not have a workers\u2019 compensation claim that is worth pursuing.","post_title":"Is COVID-19 a Work-Related Injury Eligible for Workers\u2019 Compensation?","post_excerpt":"","post_status":"publish","comment_status":"open","ping_status":"closed","post_password":"","post_name":"is-covid-19-a-work-related-injury-eligible-for-workers-compensation","to_ping":"","pinged":"","post_modified":"2022-11-15 08:43:28","post_modified_gmt":"2022-11-15 15:43:28","post_content_filtered":"","post_parent":0,"guid":"https:\/\/\/?p=69330","menu_order":0,"post_type":"post","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":31841,"post_author":"650","post_date":"2019-07-30 14:58:03","post_date_gmt":"2019-07-30 21:58:03","post_content":"Over the years, there have been a variety of changes to the workers\u2019 compensation process in California. One of the most significant was the July 2013 implementation of the independent medical review (IMR) process to settle utilization review (UR) disputes. Although this change was meant to make the process easier and less costly for the state, the IMR process has made California workers\u2019 comp more complicated and has resulted in more denied claims for injured workers.\r\n

      The Workers\u2019 Compensation Medical Process<\/h2>\r\nIn order for workers\u2019 compensation insurance to cover medical treatment for an injured worker, the worker must submit a DWC-1 claim form. A review board will then establish liability. Their decision determines whether or not insurance will cover medical expenses.\r\n\r\nIn many cases, an injured worker will need continued treatment for their workplace injury. They will need to see a qualified medical evaluator (QME) to get approval for additional medical care. This doctor must be specifically approved for California workers\u2019 comp and must work within the rules and regulations of the system. Specifically, they must request a utilization review for any recommended treatment.\r\n\r\nThe UR, which is conducted by physicians and non-physicians, examines the medical records and uses California standards to determine if a given treatment is medically necessary. This request may be approved, denied, delayed, or modified. In any case, where the UR does not approve treatment, a letter will be sent that explains the reasons for the decision.\r\n\r\nIf the worker or the worker\u2019s representative disagrees with the UR, they may request an IMR. In those cases, the state of California has designated Maximus as the organization that conducts all IMR. Maximus will select an independent physician to review relevant medical documents pertaining to the workers\u2019 compensation case. It\u2019s important to note that the physician conducting the IMR never sees the injured worker. Instead, they only work off of the documents provided by the QME.\r\n\r\nThe independent physician will then issue a written decision. They will either overturn the UR and recommend medical treatment, or they will confirm the initial UR by deeming the requested treatment as not medically necessary. Although disputing an IMR decision is possible, the injured worker\u2019s legal team may only do this under specific circumstances. In most cases, the IMR represents the final decision in regards to that specific medical treatment.\r\n

      Problems with the IMR<\/h2>\r\nEven though the IMR was initially designed to make workers\u2019 compensation quicker and easier, the reality is that the new system has caused many problems for injured workers. In many cases, the new system is skewed toward insurance companies. Instead of helping workers, the IMR is more likely to lead to a denial of medical treatment.\r\n\r\nThe California Workers\u2019 Compensation Institute (CWCI) conducted a study in 2018 to examine the effects of implementing the IMR. They found that in over 90% of cases the IMR physician upheld the initial decision of the UR. As a result, a large number of workers did not receive the medical care they and their physicians initially requested.\r\n

      What We Can Do<\/h2>\r\nCalifornians should also contact their local lawmakers and California State Congress representatives in order to express concerns with the new IMR program. Over five years have passed and the process continues to fail injured workers. If more citizens contact lawmakers, there is a greater chance that we will see a positive change in the workers\u2019 compensation system.","post_title":"How IMR Impacts Workers\u2019 Compensation","post_excerpt":"","post_status":"publish","comment_status":"open","ping_status":"closed","post_password":"","post_name":"how-imr-impacts-workers-compensation","to_ping":"","pinged":"","post_modified":"2021-05-31 09:28:12","post_modified_gmt":"2021-05-31 16:28:12","post_content_filtered":"","post_parent":0,"guid":"https:\/\/\/?p=31841","menu_order":0,"post_type":"post","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":17580,"post_author":"469","post_date":"2016-02-09 13:04:56","post_date_gmt":"2016-02-09 20:04:56","post_content":"There are many flaws in the workers\u2019 compensation system. These flaws can egregiously harm the injured worker physically, financially and emotionally. The news and TV seem to focus on the bad injured workers who have committed fraud or abused the system. The truth is that those injured workers do not represent the average workers\u2019 compensation claimant. Those are the rare exceptions. The news and TV never seem to focus on any of the bad things that injured workers experience when going through the workers\u2019 compensation system.\r\n\r\nOne of the many issues is the length of time appeals can take to approve treatment or surgery. For example, an injured worker was on temporary total disability, which was appropriately approved in the hearing process under the claim. The injured worker required surgery, which took several months to approve through the appeal process. If it would\u2019ve been approved promptly, the injured workers\u2019 ailments would\u2019ve been addressed and he would\u2019ve been able to return to work sooner. Instead of returning to work three-six months after the incident, it took 18 months awaiting approvals.\r\n\r\nI have even seen cases in which the doctor no longer believes surgery to be the best option as it needed to be performed earlier. Delays allowed further damage to be done to the body as a result of the lack of medical intervention.\r\n\r\nThese situations cost not only the employee additional time in discomfort and away from work, it is costing the employer and the Bureau of Workers\u2019 Compensation money.\r\n\r\nMost of these injured workers want to be back to work and making their normal salary, not a lesser amount. Most don\u2019t want to await treatment or surgery in pain. They don\u2019t want to get behind on bills due to their lessened income. The public sector is often not aware that the length of time a worker is off work usually stems from the arduous appeals process. If they are off work and cannot have any treatment or the appropriate surgery for many months, they certainly cannot return to work until their injury is resolved.\r\n\r\nAdditionally, the injured worker who was on temporary total disability and was finally able to have surgery and return to work may have already suffered additional major consequences. Many suffer a severe financial loss while awaiting temporary total compensation. Some may have developed psychological conditions that need to be added to their claim due to long-term physical suffering as well as feeling like a loss to society from being unable to work. The psychological condition may also lead to the need for counseling, medication and\/or more time off work.\r\n\r\nThe lengthy periods for claim processing and appeals happen for many reasons. Sometimes, the Bureau of Workers\u2019 Compensation takes too long to initially issue an order or the claim gets lost in the shuffle of the volume of cases. It can be an employer who appeals every single issue at every hearing level despite a lack of contrary evidence. There are even cases in which the employer holds up the case and fights everything despite the fact that their own independent medical examination report states that temporary total disability as well as treatment or surgery should be approved under the claim. There are also instances in which the injured worker\u2019s own doctor or medical facility holds everything up, preventing the lawyer\u2019s access to the medical records or medical documentation needed to help the injured worker. Also, there are situations in which the injured workers may hold up the claim themselves due to not returning phone calls, sending back release forms or providing necessary information in order to keep the claim moving. Most often, however, that is not the reason for a major delay in their claim.\r\n\r\nThis is a hard issue to fix as there aren\u2019t any real answers as to how to solve many of the circumstances that delay the injured worker\u2019s claim or benefits. I do think everyone involved in the process should be more cognizant of the delays that occur and realize the harm done to the injured worker in these situations. After all, the real reason for the workers\u2019 compensation system is to help injured workers. This is an important detail to remember. More focus should be put on the injured workers and the pain and suffering they go through when workers\u2019 compensation is mentioned. The term is often associated with negativity and fraud. This is a huge injustice to the large amount of workers using the workers\u2019 compensation system for the reason it was created. They were injured at work. Many of them tend to suffer more while awaiting appeals, waiting for the treatment they need, making less money or going without money for a long period of time. These things can happen to anyone and this system was created for workers.\u00a0Cindy Kobal<\/span>","post_title":"Flaws in Workers\u2019 Compensation System","post_excerpt":"","post_status":"publish","comment_status":"open","ping_status":"open","post_password":"","post_name":"flaws-in-workers-compensation","to_ping":"","pinged":"","post_modified":"2022-11-11 14:15:13","post_modified_gmt":"2022-11-11 21:15:13","post_content_filtered":"","post_parent":0,"guid":"http:\/\/\/?p=17580","menu_order":0,"post_type":"post","post_mime_type":"","comment_count":"1","filter":"raw"},{"ID":17619,"post_author":"473","post_date":"2016-01-04 13:42:51","post_date_gmt":"2016-01-04 20:42:51","post_content":"For many workers\u2019 compensation clients, their injuries lead them to also apply for Social Security disability. Later, most are upset to find out that some or even all of their Social Security benefits are offset by their workers\u2019 compensation payments (some states offset workers\u2019 compensation benefits, others Social Security). The windfall provision, under the Social Security Act (SSA), allows for the offset of benefits when the combination of Social Security and other public benefits, including workers\u2019 compensation, exceed 80 percent of the person\u2019s average current earnings (ACE) (see 42 USC 424a) or the family limit, whichever is higher. Social Security determines a person\u2019s ACE in one of three ways: the highest unindexed yearly total in the last five years, the highest five consecutive year average, or the average unindexed covered earnings. Social Security will use the highest of these three as the ACE for offset purposes. Minimizing the impact on Social Security benefits is a must. While little can be done about ongoing weekly payments through the workers\u2019 compensation system, specific steps taken, when settling these cases, will drastically reduce the client\u2019s offset and put more money into their pockets.\r\n\r\nSocial Security calculates the lump sum payment offset by establishing the weekly rate in one of three ways: the rate specified in the lump sum award; the latest periodic payment rate paid prior to the lump sum award; or when the award does not specify the amount and there were no previous periodic payments, the implied compensation rate should be used. If no rate is implied, SSA will us the state\u2019s workers\u2019 compensation maximum in effect on the date of injury or illness (for more, see SSA POMS 52150.060). Further, if a rate is specified in the lump sum award, Social Security must determine if that rate was determined before or after excludable expenses, such as attorney fees and medical expenses. If the rate was determined after excludable expenses were removed, the rate must be recalculated to reflect those expenses. Social Security will compare the offset, based on each proration rate to determine which is the most advantageous for the claimant. Generally, this is the specified rate in the lump sum award.\r\n\r\nTo best protect your client\u2019s Social Security benefits, worker\u2019s compensation attorneys must be aware of the different rates and how this may affect their client. Most awards will specify the rate, spread out over the life expectancy of the client with large lump sum awards, but even smaller awards may need this language to protect the client. A $10,000 award to a 55-yearold that does not specify a rate and a date of injury in 2012 results in $775 a week offset for your client. This would result in the client\u2019s Social Security benefits being offset for three months, at a potential rate of $3,000 a month. If the client had been getting payments before that, of $1,000 a month, it would result in a $1,000 a month potential offset for 10 months. But specifying a rate would make that potential offset only about $30 a month by spreading out the rate over the life expectancy of 27 years. Further, Social Security can review the rate to make sure that it is reasonable. Thus, you cannot extend the payments out over an unreasonable life span or have the monthly rate rise after retirement age.\r\n\r\nEven if your client has not yet applied for disability or has applied and is going through the appeal process, the windfall provision is retroactive. In addition, the provision is applied even if the workers\u2019 compensation injury is not what leads to disability. An example would be the client with a work-related back injury who becomes disabled after having a heart attack. The workers\u2019 compensation payments and settlement would still be offset under the windfall provision. Social Security will create an offset for any month in which they received or would have received both Social Security benefits and workers\u2019 compensation payments. This includes the months following the settlement, to which the period payment rate applies. Social Security can pay Title II benefits retroactively one year from application. Thus, if your client applies for benefits within a year of receiving the lump sum or prior to settling the case, it is very likely the windfall provision will affect them.\r\n\r\nBy taking the time to set a monthly rate into each of your client\u2019s workers\u2019 compensation, you will be able to limit the offset of your client\u2019s benefits and avoid any nasty surprises later on.\u00a0Erin Schmidt<\/span>","post_title":"Workers\u2019 Compensation & Social Security Payment Effects","post_excerpt":"","post_status":"publish","comment_status":"open","ping_status":"open","post_password":"","post_name":"workers-compensation","to_ping":"","pinged":"","post_modified":"2022-11-11 14:15:14","post_modified_gmt":"2022-11-11 21:15:14","post_content_filtered":"","post_parent":0,"guid":"http:\/\/\/?p=17619","menu_order":0,"post_type":"post","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":20988,"post_author":"506","post_date":"2015-08-04 08:47:32","post_date_gmt":"2015-08-04 15:47:32","post_content":"Take a moment and picture a typical workers\u2019 compensation injury. What you probably did not picture was the violent assault of vibrating sound waves upon the delicate structures within the inner ear. In fact, workers exposed to hazardous noise within the workplace do not generally associate their loss of hearing to a work-related injury for which they may be entitled to significant benefits.\r\n\r\nThe prevalence of work-related hearing loss is well documented. The United States Department of Labor estimates that approximately 30 million people are exposed to hazardous noise within the workplace every year and over the last 25 years ranks noise-related hearing loss as, \u201cone of the most prevalent occupational health concerns\u201d in the United States. Given those estimates, in the United States alone, potentially more than 145 million people have been exposed to hazardous noise in the workplace.\r\n\r\nGiven these statistics, one would assume that work-related hearing loss claims would represent a substantial percentage of total workers\u2019 compensation claims, especially in a state like Ohio where employees are engaged in jobs where risk to noise exposure is greatest. Production and construction workers; craft and\/or repair workers; machine operators; assemblers; inspectors; and service personnel (police, fire, etc.) represent a high percentage of the total workforce. This is, however, not the case in Ohio where hearing loss claims represent a relatively small percentage of all claims filed.\r\n\r\nPhysicians who treat hearing loss are generally not aware that workers\u2019 compensation is an option to cover treatment costs or may not know how simple it is to establish a claim where there is documented exposure to loud noise in the workplace. OSHA requires that employers in Ohio that expose workers to hazardous noise levels provide annual hearing tests, hearing protection, training, and monitor noise levels within the workplace. If a patient who suffers from hearing loss was employed in a workplace subject to these requirements then exposure is usually accepted. It is not an effective defense for an employer to simply argue that protection was provided. Where it is established that hearing loss has occurred and that exposure to noise in the workplace contributed to damage to the auditory system, a claim may be pursued regardless of whether protection was provided, utilized or even not utilized by the injured worker.\r\n\r\nIn addition, a claim is not precluded simply because the diagnosis occurs several years after the exposure occurred. In Ohio, the statute of limitations to file a claim for hearing loss is two years from the date the injured worker is made aware that the hearing loss is the result of workrelated exposure. In other words the statute begins to run upon the diagnosis of the condition by a physician as an occupational disease.\r\n\r\nThe full extent of the benefits available under a claim for hearing loss may not be realized by either the physician or the injured worker. Medical treatment, including annual exams to monitor deterioration and necessary hearing aids, are covered in full, relieving the injured worker from expensive co-pays. In addition, other conditions caused by noise exposure can be incorporated into the claim and treated. Vertigo is a common symptom of inner ear damage and can lead to flow-through injuries as a result of falls due to dizziness. Tinnitus, ringing in the ears, is a serious condition that can lead to insomnia and anxiety. These or any conditions causally related to the work-related hearing loss by a physician can be treated under an allowed claim.\r\n\r\nThe workers\u2019 compensation statute also provides a monetary award for total hearing loss. \u201cTotal loss of hearing\u201d as defined by the statute, does not mean that the injured worker is no longer able to perceive any sound. Within the context of the statute, the word \u201chearing\u201d connotes the ability to comprehend everyday speech. The mere fact that a person is able to discern certain sounds does not prevent a finding of a total loss of hearing if the person is unable to hear and comprehend the spoken word. State of Ohio, ex rel. Sheller-Globe Corporation, Superior-Lima Division, Relator, v. Industrial Commission of Ohio, (1981) 66 Ohio St.2d 51. It is vital for injured workers and medical providers to understand this definition because in many instances, hearing aids are prescribed precisely when an individual can no longer participate in normal conversation without them. The fact that the hearing device is necessary and covered under the claim is evidence supporting the payment of the significant total loss award. The statutory award in a 2015 workers\u2019 compensation claim is a lump sum payment of $107,750.\r\n\r\nGiven the potential severity of the injury and impairment coupled with the prevalence of the work-related exposure it is evident that injured workers\u2019 rights to workers\u2019 compensation benefits for employment-induced hearing loss are too infrequently exercised. With better understanding of the benefits available and the documentation necessary to access those benefits more injured workers suffering from noise-induced hearing loss in the workplace can seek payment of benefits through the workers\u2019 compensation program. The workers\u2019 compensation statute is specifically enacted to provide benefits to those injured as a result of their employment. Any individual who suffers from hearing deficits and is or was exposed to hazardous noise in the course of their employment should discuss with their physician and a workers\u2019 compensation attorney whether they qualify for benefits.\u00a0\u00a0 Christopher J. Stefancik<\/span>","post_title":"Workers\u2019 Compensation for Hearing Loss","post_excerpt":"","post_status":"publish","comment_status":"open","ping_status":"open","post_password":"","post_name":"workers-compensation-for-hearing-loss","to_ping":"","pinged":"","post_modified":"2022-11-11 14:15:16","post_modified_gmt":"2022-11-11 21:15:16","post_content_filtered":"","post_parent":0,"guid":"http:\/\/\/?p=20988","menu_order":0,"post_type":"post","post_mime_type":"","comment_count":"0","filter":"raw"}],"next":false,"prev":false,"total_page":1},"paged":1,"column_class":"jeg_col_2o3","class":"jnews_block_3"};

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