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Contact a Workers’ Compensation Lawyer, Even if Your Medical Bills Are Being Paid: Here’s Why

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

Nebraska is a state that has a “prompt payment rule” for medical expenses in workers’ compensation cases. This means that so long as your employer has sufficient knowledge that your medical care is necessary because of the injury, your bills should be paid. This is a huge plus because even a minor workers’ compensation injury can cause an employee to rack up thousands of dollars in medical bills.   

In Nebraska, delay of medical payment is treated as a denial of a claim. That is why a delay in paying for medical bills from a work injury gives the employee the right to pick their own doctor for a work injury.

The issue of doctor choice brings up a couple of the hidden dangers of the prompt payment rule.  Many times, employers will promptly pay medical expenses for doctors who will oftentimes release employees before they are done healing and return employees back to work before they are ready. Employees need to be able to know their doctor-choice rights before they agree to an employer/insurer-oriented clinic or doctor – especially if that doctor is not their family doctor.  link know their doctor choice rights to  title Physician choice crucial to work comp claimants )

Secondly, employees can get lulled into contentment when an employer pays their medical bills. Medical benefits are one aspect of workers’ compensation benefits; the other is loss of income benefits. An employer/insurer may use their leverage with a doctor to minimize loss of income benefits. Also, when employees get into litigation, they are oftentimes confused by the fact that an employer will pay for medical benefits, but not loss of income benefits, or will deny that the injury is even work related. This is related to the prompt payment rule. Just because an employer pays medical bills, that doesn’t necessarily mean that they or a workers’ compensation judge will believe those medical bills are related to the work accident.

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Increased in risk of specific NHL subtypes associated with occupational exposure to TCE

Trichloroethylene

Today’s post comes from guest author Jon Gelman, from Jon L Gelman LLC.

Study published linkig trichloroethylene exposure to cancer.

The chemical compound trichloroethylene (C2HCl3) is a chlorinated hydrocarbon commonly used as an industrial solvent. It is a clear non-flammable liquid with a sweet smell.

Objectives We evaluated the association between occupational exposure to trichloroethylene (TCE) and risk of non-Hodgkin lymphoma (NHL) in a pooled analysis of four international case-control studies.

Methods Overall, the pooled study population included 3788 NHL cases and 4279 controls. Risk of NHL and its major subtypes associated with TCE exposure was calculated with unconditional logistic regression and polytomous regression analysis, adjusting by age, gender and study.

Results Risk of follicular lymphoma (FL), but not NHL overall or other subtypes, increased by probability (p=0.02) and intensity level (p=0.04), and with the combined analysis of four exposure metrics assumed as independent (p=0.004). After restricting the analysis to the most likely exposed study subjects, risk of NHL overall, FL and chronic lymphocytic leukaemia (CLL) were elevated and increased by duration of exposure (p=0.009, p=0.04 and p=0.01, respectively) and with the combined analysis of duration, frequency and intensity of exposure (p=0.004, p=0.015 and p=0.005, respectively). Although based on small numbers of exposed, risk of all the major NHL subtypes, namely diffuse large B-cell lymphoma, FL and CLL, showed increases in risk ranging 2–3.2-fold in the highest category of exposure intensity. No significant heterogeneity in risk was detected by major NHL subtypes or by study.

Conclusions Our pooled analysis apparently supports the hypothesis of an increase in risk of specific NHL subtypes associated with occupational exposure to TCE.

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Wal-Mart & McDonald’s: Passing the Buck to Taxpayers

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

Came across this post today: “How McDonald’s and Wal-Mart Became Welfare Queens.”  News like this has become so commonplace that you almost accept it with a shrug.   Yeah, big box stores and fast food chains are paying their workers cruddy wages, forcing them to go on state health insurance and food stamp assistance.  Oh well.  Move along.  Nothing to see here.

But the outrage should exist.  These stories make my blood boil.  Many of these companies are making massive profits.  You’re telling me you can’t pay a living wage?  All of us, as taxpayers, are helping pad the the coffers of these companies.  By not providing sufficient wages or health care, the actual taxpayers serve as the necessary social safety net for these workers.  Is that really how we want our society and country structured?

Admittedly my experience is anectodal, but I see a number of these workers in my practice–from the greeters at Wal-Mart to those flipping burgers at McDonald’s.  Many are making a minimum hourly wage of $7.25.  No matter how hard they work (and, in my experience, some of these fast food and retail workers are the hardest workers out there, in light of their work condition), they cannot get ahead or make enough to avoid the necessity of seeking food stamp assistance or of searching for the local food pantry.  

Corporations simply should not be able to get rich on the public’s back.  As taxpayers, we continue to allow this grossly one-sided equation to continue.

 

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How US Business Routinely Steals Your Legal Rights

Today’s post comes from guest author Jay Causey, from Causey Law Firm.

     You’ve just bought a new car, or signed an employment agreement, or engaged an investment firm to act for you, or made substantial charges on your credit card, or even just bought a Starbucks card.  Now something’s gone wrong, and you’re looking for relief, maybe contemplating a lawsuit.

     Unfortunately, you can probably forget any real legal remedy because chances are you’ve agreed to some fine print in the transaction that forces you into binding arbitration of any claim you have. For years the US Chamber of Commerce has been working behind the scenes to ensure most consumers lose access to the courts through these stealth provisions that hide in most contracts. The Chamber recently convened its annual summit for its Institute for Legal Reform, whose primary goal is to find ways that corporations can eliminate the rights of consumers, small businesses and employees to hold them accountable in court.

     The American Association for Justice (AAJ) calls the Chamber’s efforts “Corporate America’s Trojan Horse” which substitutes big businesses owned dispute resolution mill for the real machinery of justice in the courts. Most Americans are unaware of the some half billion arbitration provisions in transactions they have unwillingly consented to. Forced arbitration by arbitrators selected by big business, not bound by law, and making decisions not subject to any meaningful judicial review, has substantially altered the civil justice system of this country, and what’s left of your legal remedies.

 

For the full report on this go to: License to Steal: How the US Chamber of Commerce Forced Arbitration on America.

 

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“60 Minutes” Misses the Mark on Social Security Disability

Today’s post comes from guest author Kristina Brown Thompson, from The Jernigan Law Firm.

What happens when a major journalism program runs a program without interviewing both sides? You get something like what “60 Minutes” aired in early October in “Disability, USA.” It’s one of the media’s favorite topics, “exposing” disability fraud on the part of the claimant. But how much truth is there to the allegations made on “60 Minutes”?

After watching the show, the viewer is lead to believe that almost anyone with any medical condition could be approved for Social Security Disability. You hear from an administrative law judge that the standards are too lax. However, over 66% of all disability claims are initially denied. Thereafter, only about 10% win disability benefits on appeal. The application and appeal process alone takes months, if not years. This sure doesn’t sound like an easy way to survive. Even if benefits are ultimately awarded, they are taxable and paid only on a monthly basis with the average disability payment of about $1,100.00.

While it’s true the number of disability claimants has increased, this is hardly surprising. Overall, we have an aging population which increases the ratio of disabled claimants. Likewise, with jobs scarce, those with disabilities are having an increasingly difficult time finding work.

It’s very disappointing that no one at “60 Minutes” took the time to interview a single disability applicant. If they had taken the time, they would have learned that the application is an arduous process. Failure to present your medical records or respond within strict timeframes, results in an automatic denial. Recently, one of our workers’ compensation clients reported that he underwent two separate disability applications and four appeals (cumulatively) before finally being approved in 2013. He has been out of work since 2006.

For more information, check out “Just the Facts” as well as this article published by the National Organization of Social Security Claimant Representatives in response to “Disability, USA.”  

How workers’ comp failed injured nurse

Kaiser Hospital San Diego

Today’s post was shared by Gelman on Workplace Injuries and comes from capitolweekly.net

 I am a Registered Nurse with more than 35 years’ experience caring for patients. I always loved my work caring for the injured, ill and disabled. Little did I know that when I became disabled myself, my employer and its workers’ compensation insurance carrier would care so little about me.

In 1998, I was working as an operating room nurse at Kaiser Foundation Hospital in San Diego, when I was injured at work.  I had worked at Kaiser for 12 years without any problems, until I tripped and fell over a parking lot barrier. Kaiser treated my injured knee, but later ignored four doctors’ reports that I had also injured my neck and back. Kaiser denied that those injuries were from the fall.

Little did I know that when I became disabled myself, my employer and its workers’ compensation insurance carrier would care so little about me.

For years, doctors’ recommendations were delayed or denied by Kaiser’s insurer, Sedgwick Claims Services. All they would approve were painkilling drugs, but not the treatment I needed for the underlying medical issue. These drugs’ side effects caused additional medical problems. In 2010, my teeth began breaking off at the roots.

Sedgwick denied the dental treatment I needed, so I took them to court.  In February 2013, the judge ordered Sedgwick to provide this urgent medical treatment. To this day, they have refused to do so, and have instead defied two judge’s orders to provide…

[Click here to see the rest of this post]

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The Wounded Warrior Program Expedites Social Security Disability Claims For Veterans

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

Veteran’s Day is a day that the American people have set aside to celebrate and honor all those who have served in the armed forces. Veteran’s Day – originally known as Armistice Day – has been celebrated in the United States since 1919. Armistice Day became a national holiday in 1938, and has been known as Veteran’s Day since 1954. It is celebrated on November 11th to commemorate the armistice that ended the fighting in World War One.

The Social Security Administration recognizes the sacrifices that the members of our armed forces make every day. With the Wounded Warrior Program, the Administration ensures that military members who were injured on active duty have their cases processed in an expedited manner. While the standard of disability remains the same for all claimants, individuals injured on active duty can obtain a decision faster.

Even if you are still on active duty and receiving full pay, you may be eligible for Social Security disability benefits. Social Security looks at the activities you are performing, not the pay you are receiving, to determine if you meet the standard of disability. These benefits are in addition to any benefits you may receive from the Veteran’s Administration – it is important for you to know that a separate application for each type of benefit is required.

If you have any questions about applying for Social Security disability benefits, even if you are still on active duty, please contact us today for a free case evaluation.

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The Affordable Care Act, brought to you by ……… the Republicans!

Many might now welcome a Nixon ticket.

Today’s post comes from guest author Jay Causey, from Causey Law Firm.

     Looking for information in the media that is supportive of the nation’s transition to the Affordable Care Act (ACA), aka “Obamacare?”  At the moment Republican and right wing noise is drowning out much of the lower–decibel cheerleading by the Administration on why this is a good thing.

In 1974, Pres. Richard Nixon proposed what is essentially the 2010 healthcare act – all but the smallest employers would provide medical insurance to their employees or pay a penalty, expansion of Medicaid would insure the poor, and subsidies would be provided to low–income citizens and small employers.

     In a recent op-ed piece, former Secretary of Labor under President Clinton and leading economic expert, now at the University of California, Berkeley, Robert Reich summed up the history of the origin of “Obamacare,” pointing out the irony of the right wing’s fuss over it.

     In 1974, Pres. Richard Nixon proposed what is essentially the 2010 healthcare act – all but the smallest employers would provide medical insurance to their employees or pay a penalty, expansion of Medicaid would insure the poor, and subsidies would be provided to low–income citizens and small employers. While private insurers liked this plan, Democrats favored a system more like Social Security and Medicare, so there was no consensus.

     Fast-forward to 1989, and the right–leaning Heritage Foundation proposed a plan that would mandate all households obtaining adequate insurance. This plan worked its way into several bills introduced by Republicans in 1993, supported by Senators Hatch (R–Utah) and Grassley (R–Iowa), along with subsequent Speaker of the House, Newt Gingrich, all now vocal opponents of the ACA.

     When in 2004 Massachusetts Gov. Mitt Romney made the original Nixon plan the law in his state, with the same mandate to buy private insurance, he said, “we got the idea of an individual mandate from Newt Gingrich, and he got it from the Heritage Foundation.”

     Health insurance companies, now retooling their policies around the individual mandate, are jubilant about the possibilities of long–term membership growth through the insurance exchanges. These giant corporations have traditionally supported conservative and Republican politics.

     So as Reich notes – – why are Republican spending so much energy trying to sabotage the ACA, and act they designed and about which a huge sector of their patrons are wildly enthusiastic? The answer: it is the singular achievement of the Obama Administration, the head of which is still considered by a large segment of the right to Illegitimately occupy the White House.

     Reich goes on to observe that had the Democrats prevailed on the idea of a system built on the Social Security and Medicare model – – cheaper, simpler, and more widely accepted by the citizenry – – Republicans would nevertheless be making the same noise.