How Insurance Companies Try To Rip Off Injured Workers:  A Series – Volume 2:  Manipulating The Medical Care

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Unfortunately, under our Workers’ Compensation Law, the insurance company in a workers’ compensation case has an almost unlimited right to direct a claimant’s medical care, throughout the claim.  The insurance carrier often uses this advantage, rather immediately, to attempt to impair or terminally damage an injured worker’s case; instead of just trying to restore him or her to a state of good health.  It would be a common scenario, for example, for a recently injured claimant to first be sent to a ‘company’ doctor, well known to the employer, and who has treated many injured employees of that particular company in the past.  In some instances, the company doctor may have certain instructions from the insurance company and/or employer, such as that an MRI or other diagnostic tests are not to be ordered unless they are imminently necessary.  The insurance carrier may also hire a nurse case manager (which will be discussed in more detail in Volume 3 of this series) to further pressure the treating doctor to save costs in the claim, at the claimant’s expense.

If the company physician feels that the injured worker needs a referral to a specialist, it is very common for an insurance company to once again intervene in the medical decision making process and shift the claimant’s medical care to some other insurance doctor.  If the insurance carrier doesn’t like what the specialist has to say, it sometimes sends the claimant for an allegedly “independent” medical examination, typically conducted by – yes, you guessed it – yet another insurance doctor.  By the time the claim gets to this point, the ‘evidence’ generated by the insurance carrier many times so overwhelmingly disfavors the injured worker that the case can never be successfully revived, even by the most skilled of workers’ compensation attorneys.  Oh, but it doesn’t stop there.  Insurance companies have been known to continue paying nurse case managers, for example, to try to collect additional medical evidence, favorable to them, even when a claimant has finished treating and the case is in active litigation.

If some of all of the above sounds familiar, we’d be glad to visit with you, anytime, about how we may be able to repair your case, before it’s too late.

Neal L. Hart, Attorney at Law

How Insurance Companies Try To Rip Off Injured Workers: A Series – Volume 1: The Weekly Compensation Rate

compensation

As outlined previously, in this blog (http://hartlawfirmllp.com/the-weekly-compensation-rate-in-workers-compensation-law/), an injured employee’s weekly compensation rate is extremely important to a workers’ compensation case, because it often represents the only source of a worker’s household income, while he or she is disabled and off work; and, generally, larger weekly compensation rates generate larger workers’ compensation settlements. Adjusters know all this, and will try to calculate the weekly compensation rate in a manner designed to make it as low as possible.  It is important, therefore, to analyze an employee’s actual wage records closely, in order make sure that the carrier’s compensation rate numbers are legally accurate; and, if they are not, to force the insurance company to adjust them (upward) accordingly.  At Hart Law, we receive (and are happy to answer) compensation rate questions from injured folks frequently, because the weekly compensation rate calculations done by an insurance company are sometimes very wrong.    

Neal Hart, Attorney at Law

Is An Independent Medical Examination Really ‘Independent?’

Independent medical examinations (IMEs) are very common in Arkansas workers’ compensation claims.  The way it typically works is that the insurance company or one of its agents contacts the injured employee, in the middle of a claim, and says:  “We’re going to set you up for a second opinion.” Most claimants don’t know a whole lot about workers’ compensation law and just want to get physically better, so they usually think seeing another doctor for free is a great idea.  But is it?  Insurance carriers are typically very interested in two things:  1.  Getting a case closed.  2.  Saving as much cash as possible while doing so.  In order to better facilitate this, insurance companies often reuse the same physicians they’ve retained (and paid a bunch of money to) for IMEs in past cases; hoping that the IME doctor will once again arrive at a medical conclusion that will somehow impair an injured workers’ claim.

Under Arkansas law, an IME must be, among other things, reasonable, necessary, convenient for the claimant, and actually ‘independent.’  If a proposed IME doctor is generally well known in workers’ compensation system circles as an ‘insurance’ doctor, it would be difficult to contemplate that an IME conducted by that particular physician either would or ever could actually be ‘independent’ in nature.  Unfortunately, many lawyers just go ahead and allow their clients to attend an IME scheduled by an insurance company, without putting much thought into either the IME itself or the potential damage it could ultimately do to the case.  Legally resisting an independent medical examination that isn’t actually ‘independent’ could mean the difference between developing a solid case for a client, while he or she remains in a state of improving physical and mental health; and having a denied claim with medical evidence too damaging to possibly ever overcome.

Have questions about an IME?  Give us a call or send us an e-mail.  We’re always here to help.

Neal L. Hart, Attorney at Law

Using Your Right to a Change Of Physician Wisely

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Under Arkansas Law, the insurance company in a workers’ compensation claim has the right to direct an injured employee’s initial medical care.  Often times, this means that an injured worker will be sent to a “company doctor” who is familiar to both the insurance carrier and employer.  If the injured worker needs a referral to a specialist, the insurance company might tell the company doctor where to send a claimant for further evaluation. Under this scenario, it may not take very long at all for a work injury claim to become so overloaded with insurance-friendly physicians that it completely sinks the entire case, before the claimant even knows what happened.

Thankfully, our Workers’ Compensation Act allows an injured worker to ask for a one-time change of physician, to a doctor he or she wants to see, at basically any point during the claim.  The problem is that the insurance company may only have to pay for one office visit to the new doctor, unless the new physician provides the parties with some pretty compelling medical opinions to advance the evidence in the claim.  Because of this, knowing exactly when and how to use a physician change may be extremely important to the outcome of the claim.  If, for example, an uninformed claimant asks for a physician change at an unwise juncture in the case, to a doctor who thinks most folks alleging work injuries are scam artists, the physician change may have just been completely wasted, or worse.

Have questions about a physician change?  Give us a call.  We’re always here to help.

Neal L. Hart, Attorney at Law

AWCC Bacis Facts including Change of Physician

Knee Replacements in Workers’ Comp

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A fairly common work injury scenario in Arkansas goes something like this:  A middle-aged employee, with a history of heavy manual labor jobs, twists his knee at work.  He’s never really had any knee problems to speak of before; or at least none that he knows about.  The treating physician does surgery to fix torn cartilage, or maybe a torn ligament.  The operation doesn’t work, and the doctor says that the claimant needs his knee replaced.  The claim seems to be going great, right up until the doctor recommends the knee replacement.  The insurance company then alleges that the surgery isn’t work-related.

Unfortunately, this happens to working Arkansans far too often.  Knee replacements are expensive, involve substantial residual permanent impairment, and can make it so all or at least portions of an injured worker’s claim will remain open for life.  Insurance companies know this, and routinely try to skirt paying a partial or total knee replacement claim by making the argument that the claimant had “chronic” or “degenerative” knee problems that were present before the work injury.  While it is true that many knee claims we handle involve claimants who have chronic, preexisting knee problems they don’t necessarily know about, the fact remains that if a work injury is found to be even the slightest cause of the need for a knee replacement, the insurance company is probably going to have to pay for it.  If you’re content, however, to blindly rely upon the insurance carrier’s kindness and good will in this regard, you may be out of luck.

Have knee injury questions?  Feel free to give us a call anytime.

Neal L. Hart, Attorney at Law

How Should I Choose A Workers’ Comp Attorney?

It’s an important question about an important choice.  A choice so important, in fact, that a favorable outcome in your case could very well depend upon it.  Some law firms handle workers’ compensation matters as a ‘side job’ of sorts; to pay the light bills and hope that it leads some other, more valuable case.  Retaining a law firm that dabbles in five or ten different areas of law to handle a workers’ compensation claim seems sort of like hiring a knee, shoulder and hip specialist to operate on your brain.  Some law firms use television ads and big billboards to clamor for the attention of the injured masses, hoping to land new workers’ compensation clients.  At the end of the day, however, judges and insurance companies really don’t care whether or not your attorney is on TV.  They’re interested in knowing if he’s good at what he does.

 

Believe it or not, there are workers’ compensation claimants out there who know basically nothing about the lawyer they’ve hired to represent them in their case.  They just saw some ad somewhere, and then signed on the dotted line.  When they call for information about their case, their “lawyer” may be “out,” and they’re shuffled over to some assistant who may or may not know anything of value about either the law or the claim.  At Hart Law, we want to know our clients, and we want them to know us.  When our clients call the firm, we know who they are, and we know about their case.  We believe that our clients deserve a very high level combination of legal skill and customer service; and we deliver that, every single day.  Insurance adjusters respect our work, and when we appear in court on your behalf, the folks there already know that we are experienced, successful, and highly skilled.

 

You may only have one shot at picking the right workers’ compensation attorney.  Before selecting one, it’s important to know what (and who) you’re actually getting.  At Hart Law, what you see is exactly what you get.  Workers’ compensation law is what we do.

 

Neal L. Hart, Attorney at Law

On-The-Job Burn Injuries in Arkansas

Many Arkansans suffer burn injuries at work each year, and some of them are quite severe.  The skin is our largest organ.  When it is badly burned, the result is severe pain, a lengthy healing process, and often a high degree of permanent physical impairment.  Because of this, work-related burn cases can be highly complex.  The insurance carrier usually fights hard to end medical care in the claim as quickly as possible.  Getting a proper permanent impairment rating from the treating physician (or from some other doctor), at the end of the case, is crucial to the monetary value of the claim.  Unfortunately, many physicians either don’t want to do this, or don’t know how.  At Hart Law we know how to handle burn injury cases to achieve maximum results.  Let us help you get the benefits you deserve.  Call today!

Neal L. Hart, Attorney at Law

How Impairment Ratings Work

Some workers’ compensation injuries are deemed, by law, to be “permanent,” and some are not.  If an injured worker has a permanent injury, he or she may be entitled to receive a permanent impairment rating, which is worth money, in the form of permanent disability benefits.  Impairment ratings are usually determined by a doctor (mostly by the treating physician, but not always), who uses a book that is filled with complicated tables, graphs and charts.  Sometimes, doctors simply get the impairment rating wrong.  Many times, insurance companies will try to get out of paying the impairment rating by alleging that it’s not valid, either in whole, or in part.  Sometimes the insurance company will write an injured worker who has a permanent impairment and explain the impairment rating incorrectly; misstate the law; miscalculate the benefits owed; and/or advise that it is only paying some or none of the  impairment rating.  One reason insurance companies do this is because they know most injured folks have no idea about how impairment ratings work, and no idea how to correctly value them.

Having a permanent impairment rating can be very important to a claim, because it potentially opens the door for an injured worker to receive some of the most valuable benefits allowed under our workers’ compensation law.  If there is no impairment rating or if the impairment rating is deemed to be invalid, these benefits may not be available.  If you already have an impairment rating; think you may get one in the future; or think you may deserve one, we’d be glad to visit with you, about ratings and your rights, anytime.

By:  Neal L. Hart, Attorney at Law

 

 

Rule 099.34 Impairment Rating Guide  

Are You Being Watched?

It’s quite possible.

Insurance companies will try basically anything to defeat a workers’ compensation claim, including paying a private investigator hundreds or even thousands of dollars to track, watch and record an injured worker’s activities.  A skilled insurance lawyer can then use this evidence to build a case against a claimant that may eventually become too damaging to overcome.  Unfortunately, it happens all the time – many times in cases where an injured employee has not had the benefit of visiting with a workers’ compensation lawyer about how the system works and the common tactics used by insurance companies to impair claims.  I know all of the common tactics utilized by insurance companies to impair claims, including surveillance, because I used to be an insurance lawyer.  That’s some pretty valuable experience to have in your corner.

By:  Neal L. Hart, Attorney at Law

How To Settle Your Workers’ Compensation Claim

Let’s face it, when you’re injured at work, the last thing you’re thinking about is how to navigate the Workers’ Compensation claims process. And who could blame you? All you know is that you’re hurting and you want to get better – so you can get bacWorkers' Comp Claim Formsk to work. After all, there are bills to pay and mouths to feed.

But, in all honesty, figuring out how your Workers’ Comp injury translates into future medical expenses and possible job limitations should be at the top of your list. Because the longer you wait, the more uninformed decisions will be made that could jeopardize your Workers’ Compensation claim, your health and your future.

Here are the major steps to consider as you work to settle your Workers’ Compensation claim:

  1. Reach the end of your healing period.
  2. Make sure your employer has provided you with sufficient medical care.
  3. Verify that you’ve been paid benefits at the correct compensation rate.
  4. Assess the seriousness of your injury, most importantly, if you have a permanent impairment and permanent work restrictions.
  5. Determine if you have lost the ability to make your pre-injury wage.
  6. Decide if your injury will require training to perform a different job.
  7. Understand how much medical care you will need in the future and the cost associated with these healthcare services.
  8. Figure out how much all of this is worth under the Arkansas Workers’ Compensation Act and come up with a dollar figure reflecting that amount.
  9. Approach the insurance claims adjuster with a demand for settlement (this is often referred to as a “demand letter”).
  10. Convince the insurance claims adjuster – and likely their attorney – to agree to that settlement amount.
  11. Review and sign a lengthy set of settlement documents, prepared by the insurance company’s attorney(s).
  12. Go to court and ask an administrative law judge to agree to let you settle the case for the agreed upon amount.

If you have any questions about the Arkansas Worker’s Comp claims process, feel free to call us at 1-800-520-5874, or go hartlawfirmllp.com/#faqs. Helping injured workers is what we do. And even if we don’t represent you, we can help point you in the right direction.