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

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 MUCH WILL A WORKERS’ COMP LAWYER COST ME?

Attorney Fees Are Set By The State At 12.5% From The Injured WorkerSo, how much do lawyers charge to help settle AR Workers’ Compensation claims? It’s a really good question, especially when you’re hurt, unable to work and you’re trying to keep the bills paid. Every dollar matters, right?

Well, the truth is, attorney’s fees don’t amount to near as much as you might think. Many people think AR Workers’ Comp is the same as personal injury law, where the attorney gets 1/3 of the total settlement. But that’s just not the case.

In fact, an attorney gets a relatively small portion of the Workers’ Compensation settlement amount. For starters, the fees charged by an attorney to represent an injured worker in an Arkansas Workers’ Compensation claim are set by state law at 12.5% from the injured worker. And sometimes even this fee is negotiated during settlement to be paid by the insurance company.

It’s also helpful to know that there are no “up front” charges, or fees. In fact, a claimant doesn’t owe their lawyer a dime unless he/she collects money on their behalf – either through settlement, or by asking a judge to force an insurance company to pay benefits they have wrongfully denied.

For answers to more of your Workers’ Comp questions, check out these FAQs, or call 1-800-520-5874. We’re here to help, even if we don’t represent you.

5 IMPORTANT FACTS ABOUT BACK AND NECK INJURY SETTLEMENTS

Back and neck injuries are very common in Arkansas workers’ compensation law. More importantly, spine and joint cases can be very valuable for settlement purposes. The main reasons is that these types of work injuries are often the most problematic, because they can involve long, painful healing periods and produce substantial permanent impairment.

Here are 5 very important things to know about back and neck injury settlements, as well as the insurance company playbook before getting too far along into the AR workers’ comp claims process:

back and neck injuriy settlements

Workers’ compensation claims that involve back and neck injuries can be very valuable for settlement purposes.

  1. Workers’ compensation claims that involve back and neck injury settlements can be quite valuable. In fact, the average settlement for joint and spine injuries can substantially higher than you might think.
  2. Insurance companies know this, and act accordingly, by immediately sending folks with spine and joint injuries to orthopedic doctors they think will help end these claims as quickly and as cheaply as possible. In fact, the insurance company will often hire a “nurse” to meet the injured worker at his, or her doctor’s appointment, at which time the nurse routinely goes into the examination room with the claimant, and then talks one on one with the doctor about the case.
  3. If the insurance company doesn’t like what the treating doctor has to say, the patient is sometimes sent for an Independent Medical Examination, again with a doctor chosen (and paid for) by the insurance company.
  4. Insurance companies want to keep back and neck disability ratings low; the healing periods short; and spine surgeries to a minimum. In the meantime, while the back and neck claims are being potentially dismantled beyond repair, the insurance company and its nurse sometimes tell the claimant that hiring an Arkansas workers’ compensation lawyer to protect them in the case simply isn’t necessary.
  5. If this scenario doesn’t sound quite right, it isn’t. It’s totally legal, but it’s not even close to totally fair. The insurance company may have a legal right to dictate the path of an injured worker’s initial medical care, but it doesn’t have the absolute right to dictate the direction, or the outcome of his or her case.

Knowing all this, it’s not surprising, really, that one of an insurance companies biggest nightmares is when injured workers with severe spine and back injuries seek the advice of a workers’ compensation lawyer early on in the claims process – especially from a lawyer who is already extremely familiar with the typical insurance carrier game plan and how best to counter it. At Hart Law, we already know the insurance company’s playbook. Which is why it’s so important to consider getting legal advice from an experienced workers’ compensation attorney when you have back and spine injuries.

For more information check out the Frequently Asked Questions (link to https://hartlawfirmllp.com/#faqs ), or give us a call 1-800-520-5874.