Monthly Archives: July 2013

The 12 Things You Must Do If You Are Hurt At Work

Today’s post comes from guest author Paul J. McAndrew, Jr. from Paul McAndrew Law Firm.

Injured workers call me all the time asking me what they need to do to make sure they protect their legal rights.  If you are hurt on the job, whether it is due to an acute traumatic injury (like cutting yourself on a saw), cumulative-trauma injury (like carpal-tunnel syndrome) or some other job-related injury, there are several basic things you should do. If you do not do any of the things on the list below, you may lose your rights under Iowa’s workers’ compensation law. 

Although there may be rare exceptions to this list,  following it will leave you reasonably secure that your rights are protected:

  1. Report the injury. By “injury,” I mean almost any condition including but not limited to (a) an acute traumatic injury, (b) a cumulative-trauma injury, or (c) a disease or a hearing loss. You should report the injury to your supervisor or company nurse (for clarity we’ll just call these people your Supervisor from here on out), making clear your injury was caused by work. Under Iowa law, you need to make the report within 90 days of the date of your injury.
  2. Make sure your Supervisor prepares a company accident report.  If your Supervisor won’t prepare the report, Continue reading

Why Do Roofers Fall From Roofs? Is it just because of gravity?

Today’s post comes from guest author Jon Gelman from Jon Gelman, LLC – Attorney at Law.

Today I received an urgent call from attorney representing a client in New Jersey who fell from a roof. Before she told me the job description of the injured worker, now in a coma, I correctly anticipated that it was probably a roofer who had fallen from a roof, yet again.

This scenario has played out in workers’ compensation claims for decades. How the accident happened is usually an argument with the employer. The employer claims that the employee was either intoxicated or not following safety precautions. My instinct always tell me that this is probably incorrect, since roofers tend to lose their balance and fall for many other reasons, including “gravity.”  Some reason a deprivation of oxygen and/or exposure to toxic neurological irritants contained in the roofing materials, and weather related events that make roofs slippery.

Continue reading

“Opting Out” of Worker’s Compensation Hurts Workers and Employers (Part 1)

Today’s post comes from guest author Tom Domer from The Domer Law Firm.

More than a century ago, Wisconsin’s initial efforts in worker’s compensation led the nation. In 1911 Wisconsin became the first state in the nation to place a broad constitutionally valid worker’s compensation system into operation. Recent events, specifically Oklahoma’s passing legislation to allow employers to “opt out” of worker’s compensation (following the “lead” of Texas) calls into question the great bargain made between employers and workers over a century ago. Prior to the enactment of worker’s compensation in the early 20th Century, workers who were injured on the job had to overcome three common law obstacles in order to recover from their employer.

Under contributory negligence, a worker could not recover from the employer if the worker had been negligent in any way and that negligence contributed to the accident, regardless of how negligent the employer may have been.

Under assumption of risk, if a worker knew or should have known of the danger inherent in the task at issue before undertaking it, the employer was not liable for an accident arising from the task even if the employee was not negligent.

Under the fellow servant rule, employers could not be held liable for accidents caused by fellow employees. 

The combined effect of these common law defenses served to deny Continue reading

Social Security Disability Denied? Don't Give Up Hope. (Part 2)

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

Last week we told you about the denial of John’s claim for Social Security Disability. This week we present the results of John’s appeal. 

Unfortunately, John’s run of bad luck with the Social Security Administration continued, and the Appeals Council affirmed the judge’s decision. The only good thing about this decision was that it came relatively quickly, allowing us to move on to the next step in the process. With the Appeals Council denial, there were two options.  John could file a new application and begin the process again, which would mean forfeiting all the retroactive benefits that he would otherwise have been entitled to, or we could file a lawsuit in Federal court. 

The only good thing about this decision was that it came relatively quickly, allowing us to move on to the next step in the process.

I selectively file these lawsuits because of the lengthy process and the standard of proof required. After discussing his options, John and I decided to move forward with the lawsuit. After a lawsuit is filed, the Assistant United States Attorney (AUSA) assigned to the case contacts me to work out a schedule for filing our briefs and for oral arguments in front of the judge.

When I heard from the AUSA this time, it wasn’t to set up a briefing schedule. She had reviewed the case file and realized that the judge’s decision was wrong and couldn’t be defended. She was the first person who I felt had really taken the time to review the case and realize that John was truly disabled. She prepared an order for the judge to sign sending the case back to Social Security for a new hearing and a new decision.

 The same judge who had issued John’s original unfavorable decision was again assigned to the case. I was concerned that John would be in for another denial, but the judge had clearly changed his mind about John. After a brief hearing, the judge stated on the record that he would be issuing a fully favorable decision. John received the decision granting him benefits two weeks later. John and his family were awarded all of the benefits that they were entitled to, because I believed in his case and didn’t give up.

Even if you get turned down the first time, or you get an unfavorable decision from a judge, don’t give up.

Even if you get turned down the first time, or you get an unfavorable decision from a judge, don’t give up. If John had decided to file a new application, he may have eventually been awarded some benefits, but he wouldn’t have received all the retroactive benefits to which he was entitled. Having an attorney who believes in you and will work hard to get you the benefits you deserve is very important to the success of your case.  If you would like our assistance with your claim, please contact us today.

Take Someone to the Doctor with You

Today’s post comes from guest author Jon Rehm from Rehm, Bennett & Moore.

Having a work injury is incredibly stressful. Sometimes when a worker is under stress, they won’t understand what a treating doctor is telling them, which leads to frustration and anger on the part of the worker directed toward the doctor. In turn, the worker’s attitude will lead many doctors to not cooperate in a worker’s case. This is especially true if the insurance company has a nurse case manager working on the claim.

One solution for an injured worker is to bring a trusted friend or family member to the doctor with them to medical appointments. I see at least two advantages to bringing in someone else:

1) another person would be able to help you describe symptoms and how the injury happened and

2) the other person can help you understand what the doctor is telling you.

But not every friend or family member is the right choice to go to an appointment with you. You should choose someone who is level headed so that they do not get into an argument with the doctor. You should remember that the doctor is taking down a record of your visit and that that written record will likely be looked at by the judge deciding your workers’ compensation case, should your case go to trial. If you or a friend or family member gets into an argument with a doctor, it will likely hurt your case.

Injured workers who are non-English speakers can present more challenges to effective medical treatment. Not only is there a language barrier but there is often a cultural barrier as well. The language barrier is often used to the advantage of the employer and insurer, because they will often provide interpreters to the doctor. Non-English speakers should try to bring along a fluent interpreter in their language. A bad interpreter can almost be as bad as no interpreter. However, the same rules about temperament and judgment apply for those who go to doctors with non-English speakers. Sometimes doctors get frustrated with language and cultural barriers of non-English speaking injured workers. Employers and insurers know this and use this to their advantage.

Social Security Disability Denied? Don't Give Up Hope. (Part 1)

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

I’ve handled many Social Security disability cases over the course of my career, and helping people obtain the benefits they deserve is extremely gratifying. Today, I want to tell you about one of my clients who was eventually awarded Social Security disability benefits after a long fight.

This man – I’ll call him John – was injured at work. He was bringing a wheelbarrow loaded with materials up a flight of stairs when he slipped and fell down the stairs. He sustained significant back and shoulder injuries and was taken to the hospital that day. When I met with him, he had been out of work for several months and wanted to get back to work, but was unable to do so. I filed his application and waited for Social Security’s initial decision.

Because John was 48 years old when he was injured, I had to prove that he couldn’t do any type of work, not just the construction work he had done since he graduated from high school. John’s case was denied initially, as most cases are. I filed a request for a hearing in front of an Administrative Law Judge (ALJ) and started to develop John’s case.

In addition to his back and shoulder injuries, John was also depressed due to his chronic pain and inability to live his life the way he used to before his accident.

In addition to his back and shoulder injuries, John was also depressed due to his chronic pain and inability to live his life the way he used to before his accident. He started treatment with a psychiatrist and a psychologist. All conditions count in a Social Security disability benefits case, both physical and emotional. 

As his hearing date approached, I obtained updated medical records from all of John’s doctors and obtained supportive opinions from them as well.  Before the hearing, I prepared John for the questions he was likely to face.  Going into the hearing, I felt confident that John would get the benefits he deserved.  However, at the hearing, the ALJ did not seem to feel the case was as strong as I did. I told John to prepare for a denial from the judge.

While reviewing the decision, I noticed that the judge had made several significant errors…

Sure enough, the judge denied John’s claim. While reviewing the decision, I noticed that the judge had made several significant errors, from improperly evaluating the credibility of John’s statements, to giving improper weight to the opinions of his treating doctors. I met with John to review the decision and talk about our options.  Given the number of errors contained in the judge’s decision and the strength of John’s case, we decided to file an appeal with the Appeals Council. The Appeals Council, located in Falls Church, Virginia, is charged with reviewing appeals from individuals who disagree with the decision made by the judge at their hearing.

The Appeals Council review process can take anywhere from 18 to 24 months, and only about 20 percent of appeals are successful.  Despite these odds, I felt good about John’s chances due to the support of his treating physicians and the multiple errors made by the judge. I prepared a comprehensive legal brief detailing all of the judge’s errors and sent it to the Appeals Council for review. When I sent the appeal, I felt that the Appeals Council would recognize that the judge had issued a flawed decision and vacate it.  When a judge’s decision is vacated, the case is sent back for a new hearing and a new decision. 

In next week’s post we’ll reveal the outcome of John’s case.

Returning to Light-Duty Work – What, When, How & Why

Women making airplane wings, circa 1920. Seattle Municipal Archives

Today’s post comes from guest author Kit Case from Causey Law Firm.

          The Department of Labor and Industries encourages employers to offer light-duty positions to their injured workers – – the suggestion is written across the top of every time loss compensation order – – as early after an injury occurs as possible.  The employer of an injured worker can offer shorter hours, a transitional job/job modifications or a new position entirely.  The pay scale can be at any rate at or above minimum wage.  In order to qualify as a valid job offer, a description of the position must be approved by a physician.  Once approved, the job must be offered, in writing, to the injured worker with specific details including the work schedule, rate of pay and person supervising the work.

 

If an injured worker declines a valid job offer, time loss compensation will end. 

 

If an injured worker declines a valid job offer, time loss compensation will end.  If the employer offers a return-to-work position that pays less than the workers’ time loss compensation rate, the worker will likely be eligible for partial compensation to make up the difference.  This benefit, called Loss of Earning Power (LEP) compensation, is based on a comparison of the pre-injury wage less the actual wages earned through return to work and pays 80% of the difference, up to a state-wide cap on compensation or the time loss compensation rate, whichever is less.

The claim can remain open for medical treatment if the injured worker declines a valid job offer, but no further vocational assistance will be provided.  However, if the injured worker is unable to return to work and vocational retraining has been approved, the employer has a brief window of only 15 days within which to offer the injured worker a valid, full-time job or the plan will commence.  Once retraining has commenced, a job offer cannot be used to derail the retraining plan.

More and more employers are watching their claim costs closely; particularly those participating in the Retrospective Rating program (see earlier post about Retro Groups for more details).  Early return to work saves the employer and the Department a significant portion of the cost of an injury claim and, in some cases, allows the injured worker to maintain their wage and benefits during their recovery.

 

You’ve Received a Job Offer – Now What?

You should receive a copy of the job description that has been approved by your physician along with the letter offering you a job.  Review and keep this job description with you as you return to work, as well as any written physical restrictions from your doctor.  While at work, make sure that you are only performing duties within your restrictions to avoid additional injury.

Stay in contact with your physician and notify them of any change in your symptoms right away.  If you have an increase or change in symptoms but do not feel that you require medical attention, phone your doctor’s office and leave a message to advise of the activity that brought on the increase and the type of symptoms you are noticing.  This will make its way into your chart and can be reviewed by your doctor to see a progression of symptoms if one should occur after you return to work, providing a basis for further restrictions on activity or job modifications.

Keep track of your pay stubs.  If you are earning less in the transitional job, file an Application for LEP Compensation (link) and attach the pay stubs to document your earnings.  The LEP application forms are usually filed once or twice per month and require your employer and physician to provide information, as well.  Compensation is issued upon receipt of the application form so, unlike time loss compensation, you will not receive regularly-scheduled payments of LEP compensation.

 

DLI’s Stay-At-Work Program

The Department of Labor and Industries’ new Stay-At-Work program is a financial incentive that encourages employers to bring their injured workers quickly and safely back to light-duty or transitional work by reimbursing them for a portion of their costs. DLI will provide an employer of an injured worker reimbursement of 50% of the base wages paid to the injured worker for up to 66 weeks, up to $10,000.00 per claim.  The Department will also pay for some of the cost of training, tools or clothing the worker will need to do the light-duty or transitional work.

 

In a recent update, the Department released figures showing that it has paid reimbursements to over 1,200 employers in Washington State in the amount of $1.6 million. 

 

The purpose of the new incentive is to encourage more employers to return their injured workers to light-duty or transitional jobs with the doctor’s approval. This medical best practice can help the worker recover, and it also can reduce costs for the employer.  The Department’s goal is to bring down costs and shorten the length of injury claims overall.

The Department provides the following video – one of three available – to outline this program:

<iframe width=”853″ height=”480″ src=”http://www.youtube.com/embed/AC6VNnJ1o3Y?rel=0” frameborder=”0″ allowfullscreen></iframe>

 

In a recent update, the Department released figures showing that it has paid reimbursements to over 1,200 employers in Washington State in the amount of $1.6 million.  The Department release fuels the concept that the program is working and that the goal of lowing workers’ compensation claim costs will be achieved but the release does not provide any data to track the results at this time.

 

Photo credit: <a href=”http://www.flickr.com/photos/seattlemunicipalarchives/2701866522/”>Seattle Municipal Archives</a> / <a href=”http://foter.com”>Foter</a> / <a href=”http://creativecommons.org/licenses/by/2.0/”>CC BY</a>

Official Disabilities Guidelines Now Covers Diabetes

Today’s post comes from guest author Paul J. McAndrew, Jr. from Paul McAndrew Law Firm.

While diabetes is not a work injury or illness, it can have a serious impact on the rate at which an injured worker recovers. For instance, people with diabetes may have a much harder time healing from a foot or leg injury. The latest edition of the annual Official Disabilities Guidelines (ODG) has been released, including the latest ODG volume on treating patients. ODG Treatment is the nationally recognized standard for medicine in determining the scope and duration of medical treatment in workers’ compensation.

For the first time this year, ODG Treatment includes a chapter on diabetes. According to the American Diabetes Association, there are nearly 26 million people in the United States who have been diagnosed with diabetes, and an estimated 7 million more people suffering who have not yet been diagnosed. Clearly, the implications of diabetes on workers’ compensation are significant.