Monthly Archives: July 2012

How To Deal With A Difficult Doctor (Part 1)

Today’s post comes from guest author Leonard Jernigan from The Jernigan Law Firm.

A doctor’s opinion is crucial to every workers’ compensation claim.  Most doctors give honest and rational opinions. As we all know, however, there are some physicians who have a different agenda and either do not take the time to properly evaluate a patient or they intentionally downplay the potential seriousness of the injury.  For attorneys working on a workers’ compensation case, the following steps may help in the search for the truth.

(1)     Check the doctor’s credentials.

It is a strange but true fact that some experts have falsified their curriculum vitae.  If a physician has lied about his qualifications, his expert opinion just went out the window.  One way to verify credentials is to check the American Medical Association’s web page.   Select “Doctor Finder” and then follow the instructions until you get to “Find a Physician” and type in the name, address and zip code.  If you are seeking a specialist, a doctor certification can be checked by phone with the AMA.  For medical doctors call (800) 776-2378.  For osteopathic doctors call (800) 621-1773, ext. 7445.

(2)     Check disciplinary records. 

According to the Federation of State Medical Boards 4,432 disciplinary actions were taken against 3,880 physicians in 1996.  There are approximately 650,000 licensed physicians in the United States.  The Federation is responsible for promoting high standards for licensure and practice, and serves as the primary center for collecting, monitoring and reviewing actions taken against physicians. (A full report can be obtained by calling (817) 868-4000.  The report is also available on their web site.  Sidney Wolfe, a physician who is director of the Public Citizens Health Research Group, a consumer watchdog organization, has analyzed this document and his report can be obtained by calling (202) 588-1000.  A list of “Questionable Doctors” can also be obtained from Public Citizen for each state.

(3)     Communicate, communicate, communicate.

It is important to find out as much as you can about the physician involved in your case.  See if he is listed on the internet.  If he has written any articles, see what the focus is.  Ask other physicians, nurses, hospital employees and others in the community about this person.  Now, with this information in hand, schedule an appointment to talk with the doctor.  Try not to schedule it during his lunch break, or while he is seeing patients.  You want his undivided attention and you will not get it if he is thinking about some medical crisis sitting in the next room.

(4)     Build a relationship. 

Lawyers who specialize in workers’ compensation are likely to see the same physician Continue reading →

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How To Manage Worry Without Medication

Today’s post comes from guest author Kit Case from Causey Law Firm. It is part 3 of 3 in a series about the dangers of psychological stress and how to cope with it.

For the last few weeks we’ve been talking about the very real medical dangers of worry. For injured or disabled workers, worry can add an additional and very significant burden on the body. In this post, we’ll talk about some of the ways that worry can be treated or even avoided.

Much of the time treatments are simply medications that increase GABA. Cognitive therapy is prescribed depending upon insurance coverage. Addressing the physical and mental effects of excessive worry can aid in recovery from an injury or disability and can increase levels of success in vocational retraining efforts. In rare cases, worry and anxiety can become permanent fixtures in a person’s life, and the effects of this condition can result in ratable permanent impairment. But, the greater part of lay and scientific literature lists non-medicine tips to reduce worry, fear and anxiety to a more modulated level, thereby providing some relief from this constant invader that often creates unproductive and hurtful periods in life.

Here, summarized, are six tips cited in the literature to help manage worry without medication:

  • Separate out toxic worry from good worry: Good worry amounts to planning. Toxic worry is unnecessary, repetitive, unproductive, paralyzing, frightening, and in general, life-defeating.
  • Get the facts rather than letting your imagination run away. Analyze the problem and take corrective action.
  • Develop connectedness in as many ways as you can: family, social, information and ideas, organizations and institutions. Never worry alone.
  • Touch and be touched: in addition to massage therapy, seek out hugs and laughter – being around children or family can help.
  • Be good to yourself. Exercise, eat well, get enough sleep, meditate, do yoga and be aware of over consumption of substances detrimental to your health, such as alcohol.
  • Sing, read, cry, do what you love, look for what’s good in life and don’t sweat the small stuff.

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The Very Real Dangers Of Worry (Part 2)

Today’s post comes from guest author Kit Case from Causey Law Firm. It is part 2 of 3 in a series of posts about the dangers of worry.

Previously we posted on how worry can affect the lives of injured or disabled workers. In today’s post, we’ll talk about some of the specific effects of worry on the body.

The physical reactions to excessive fear and anxiety (worry) initiate a chain or cascade of pathological events by stimulating the amygdala area of the brain (fight/flight response), releasing neurotransmitters to the cortex. There, the fear or anxiety, whether real or imagined, is analyzed in detail and the analysis is returned to the amygdala where, in normal situations, the fear response is shut off by amino-butyric acid (GABA). GAD worriers may not have high enough GABA levels to shut off this pathway. Consequently, there are constant marked secretions of glucocortocoids and catecholamines that increase blood sugar levels. Marked levels of epinephrine and norepinephrine dilate blood vessels in skeletal muscles and other adrenergic (adrenal) stimulations that in turn create modifications in breathing, increased temperatures, sweating, decreased mobility of the stomach, bowels, and intestines, constrictions of the sphincters in the stomach and intestines.

Simply said, constant fear and anxiety result in debilitating amounts of stress hormones like cortisol (from the adrenal glands) and hormones that cause blood sugar levels and triglycerides (blood fats) to rise significantly. This process, if not shut off or modulated, can cause premature coronary artery disease, short-term memory loss, digestive problems, and suppression of the natural immune system. The scientific literature is now implicating constant stress, such as constant work stress or toxic fear and anxiety, in causing large weight gains in the midriff area which can greatly exacerbate orthopedic injuries, particularly of the spine or knees, and can lead to increased incidences of diabetes and cancer.

Worry causes increased mortality and morbidity. It is that simple.

For information on how to treat and avoid worry, check in with us later this week for the next installment in this 3-part series.

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10 Things To Do If You Get Hurt At Work

If you are hurt at work make sure to follow these guidelines to protect your rights

When you’re injured at work in New York, people often ask what they should do immediately following the accident. There are several basic things you should do to protect your rights under New York State Workers’ Compensation Law.
  1. Report the accident to your supervisor/employer as soon as is possible. Under NYS law you have 30 days to give your employer notice of the accident. Report the injury to your supervisor and be clear about how it happened and that it happened at work.
  2. Follow up with your employer to ensure they have prepared an accident report. If a report is not being prepared, you should write a letter stating the circumstance of the accident for your Supervisor. If you can, send your letter by email or have your supervisor sign a note that acknowledges receipt. A paper trail is always helpful.
  3. When you receive a copy of the accident report, or any paperwork from your employer or its insurance carrier, be sure to make copies for yourself. Keeping your own file is always helpful in the long run. You should bring that file with you to hearings to show your attorney and the judge, if needed.
  4. If you are a member of a union, you should tell your shop steward of the injury as well. Be sure that you report to the shop steward who you gave notice to, when you gave it, and ask what your union policy is on Workers’ Compensation injuries.
  5. Keep a log of<!–more–> all significant contacts you make along the way. Note your doctor visits, conversations in adjusters, and any documents received.
  6. If you are out of work because of your injury, you need to see your doctor every 45-90 days (depending on your injury). The reports that your doctor submits to the NYS Workers’ Compensation Board is the evidence required to support your continuing disability. Without those reports your treatment may be obstructed and any indemnity payments you’re receiving may be stopped.
  7. When you visit the doctor remember to be clear and discuss in detail the circumstances of your injury. Everything from what job you do, to where you were hurt, to the mechanics of the injury (For example: Did you fall backwards? Sideways? Land on your knees? Your back? Some other way?)
  8. If your doctor says you can return to work in a lighter capacity, be sure to get a letter that lays out what physical restrictions you have. You should keep a copy for yourself and provide copies to your employer.
  9. Do not be afraid to follow up with your doctors to get copies of the medical reports they are submitting to the Board. Up to date medical evidence is an essential component of a workers’ compensation claim. You do not want to leave your fate to the efficiency and prowess of others to prepare, scan, and upload documents to State computer programs.
  10. If your doctor tells you that treatment has been denied, discuss the need for treatment with your doctor and ask if he/she needs you to sign a “variance” request to affirm you would like to bring the issue to the Board.

Sometimes the “smell test” is most applicable. If something doesn’t smell right don’t be afraid to consult your attorney (or retain one if you haven’t already). There are a number of moving parts in these cases — doctors, adjusters, independent medical consultants, physical therapists, judges, your lawyers, insurance company lawyers — that asking questions and doing your best to get a firm grasps on the status of your claim is only going to help you as you recover from your injury.

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The Very Real Dangers Of Worry (Part 1)

Today’s post comes from guest author Kit Case from Causey Law Firm. It is part 1 of a 3-part series about managing psychological stress.

Worry is increasingly pervasive in our society as insecurity about the economy and safety, nationally and personally, grows daily. Worry is compounded in the daily lives of those who are injured or disabled, as they struggle with the added burdens of medical costs and loss of income, all of which engenders a bleak outlook on their future.

“At its worst, [toxic] worry is a relentless scavenger roaming the corners of your mind, feeding on anything, never leaving you alone.” This was the description of “worry” by Edward M. Hallowell, MD, in Worry, 1997, with a 2002 introduction. (This study is still considered the “bible” in lay literature and often quoted in scientific research.) Long ago, Dr. Charles Mayo said, “Worry affects circulation, the glands, the whole nervous system and profoundly affects the heart.” Indeed, worry appears to be, at worst, of genetic origins, and to a lesser degree a learned or environmental response.

Hallowell defines worry as two types: toxic worry and good worry. He likens toxic worry to a virus, insidiously and invisibly attacking you and robbing you of your ability to work, your peace of mind and happiness, your love and play. On the other hand, good worry, or adaptive worry, is necessary to avoid real danger and life-threatening situations.

Worry is categorized as part of Generalized Anxiety Disorder (GAD) in most lay and scientific literature. The National Institute of Mental Illness (NIMH) defines GAD as people who go through the day filled with exaggerated worry and tension, even though there is little to provoke it. NIMH literature states that people with GAD anticipate disaster and are overly concerned about health issues, money, family problems or difficulties at work. GAD is diagnosed when a person worries excessively about everyday problems for at least six months. Worry, as part of GAD, is commonly treated with medication and cognitive therapy.

The everyday worry of the disabled or injured worker is direct, with anxiety and fear over money, physical abilities, medical care, vocational options, housing, food, and family disintegration. It does prey upon so many, compounding their physical health problems and environmental lives.

For more on the very real physiological implications of worry, check in next week for the next installment in this series.

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How To Select A Good Lawyer For Your Problem

Today’s post comes to us from Rod Rehm of Rehm, Bennett & Moore.

Selecting and hiring a good lawyer is critical in dealing with a legal problem. Lawyers are increasingly limiting the types of cases handled in an effort to provided better representation. The Internet is a common starting point for consumers to locate and select lawyers who have the right kind of knowledge and experience for their problem. I recommend the following steps for selecting a lawyer.

1. Check with family, friends, neighbors, or others whom you trust and respect to learn if they know of a lawyer or law firm who they would recommend for the kind of problem you are dealing with. This approach is the traditional way to find a professional and often leads to a good attorney-client relationship with satisfactory results.

2. Consult a general-practice lawyer you know and ask for recommendations. This approach gives you the advantage of having someone who knows area lawyers help you find the right mixture of knowledge and expertise.

3. Internet searches will turn up a large variety of lawyers who handle the kind of problem you are experiencing. Read several of the websites with a careful eye for the following:

a. Is the firm A-rated by the leading peer-rating organization Martindale and Hubbell? The ratings are very good indicators of how the firm is regarded because they come from judges and other lawyers who work with the firm.

b. Do the members of the firm appear to be actively involved in organizations dealing with your kind of problem? Are the lawyers officers or board members of such groups? Have the lawyers been speakers at seminars? This kind of activity shows the lawyers are interested in improving and protecting the law for people with your kind of problem and respected by other lawyers and judges. Here are some examples of law organizations. For employment matters, see the National Employment Lawyers Association (NELA). For workers’ compensation organizations, see the Workers’ Injury Law and Advocacy Group. For other personal-injury matters, see the American Association for Justice. For general trial-attorney needs, see the American Board of Trial Advocates.

c. Do the lawyers from a firm belong to any organizations indicating that they have been honored or selected for membership based on knowledge and experience?

d. Do the lawyers appear to belong the bar associations in their area? Have they served on any committees, sections, or governing bodies?

4. Go to Martindale and Hubbell and use the lawyer search. You can search for lawyers by city, state, and specialty. Lawyers are rated as follows. AV® Preeminent™ is the highest rating, followed by BV® Distinguished™ then Distinguished. We recommend only A-rated lawyers if they are available. One way to get the best of the best is to limit the search by checking the box “Featured Peer Review Rated.” The website is very user friendly.

5. Contact the lawyer or lawyers you focus on, and talk to the lawyer. Learn how the lawyer interacts with clients. The following are some questions that might be helpful: Do you feel comfortable talking with the lawyer? Are they Internet users? Will you have a specific team of people working with you? How do they charge? Can you have Skype conferences or do they have other face-to-face conferencing options through the Internet? Will retainer documents be required and available for review before an appointment?

These suggestions provide a framework on how to locate and evaluate an attorney to help you. The references we refer to are industry standards, so they not subject to as much manipulation as other online approaches, such as reviews, testimonials, or video recommendations on lawyers’ websites.

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Alternative Security Program Changes Collateral Rules

California’s self-insurance program is innovative

Today’s post comes to us from our colleague Jon Gelman from New Jersey.

Christine Baker, director of the Department of Industrial Relations (DIR), today approved the implementation of the 2012/13 Alternative Security Program (ASP), freeing $6.17 billion in capital, giving self-insured California businesses greater financial flexibility.

The ASP is a first-in-the-nation, innovative program operated by the non-profit California Self Insurers’ Security Fund with the California Department of Industrial Relations. The program provides guarantees to replace security deposits required to collateralize self-insured workers’ compensation liabilities.

“Self-insurance and the ASP are innovative ways that California can support businesses and help them reinvest capital back into growing their business,” said DIR Director Christine Baker. “With workers’ compensation representing a major expense to businesses, this program benefits both the businesses and the larger California economy in a meaningful and positive way.”

All employers in California are required to have workers’ compensation insurance to protect themselves and workers and minimize the impact of work-related injuries and illnesses. Meeting this requirement can be accomplished either by buying an insurance policy, or through obtaining authority from the DIR Office of Self Insurance Plans (OSIP) to self-insure the businesses’ workers’ compensation liabilities.

“I’m surprised that there are not more employers taking advantage of self-insurance,” said OSIP Chief Jon Wroten. “While there are standards and requirements that must be met, for employers with sound risk management practices the benefits can be substantial to the firm’s bottom line.”

Traditionally, self-insured employers are required to maintain a deposit to collateralize their risk in the amount equal to 135 percent of estimated future Liability. This deposit, which is cash, irrevocable letters of credit, securities or surety bonds, limits the employer’s ability to use the cash or credit line to expand their business. In contrast, ASP members can apply that cash or line of credit back into their businesses while the ASP assumes responsibility of the security deposits.

California currently has 7,952 employers protecting more than 4 million workers representing a total payroll of $173 billion through self-insurance workers’ compensation plans. One of every four California workers is protected by a self-insurance plan.

Self-insured employers in California represent large and midsized private companies, industry groups, and public entities such as city, county, state and school districts.

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Workers Beware Questionable (Fraudulent) Employer Tactics

It’s time to start talking about employer fraud.

Today we have a guest post from our colleague Tom Domer of Wisconsin. 

Over the course of 35 years representing injured workers, I have heard some whoppers – Employers’ questionable tactics that make even my jaw drop. With all the insurance company generated blather about “employee fraud” incidences of employer fraudulent tactics abound. Workers beware of the following:

  • Recorded statements taken by worker’s compensation carrier adjuster while employee is under medication or in the hospital still suffering from the injury. Questions such as “It’s true you had (low back pain, arm pain, fill in the blank pain, etc.) before your work injury, correct? You’ve had lots more pain from (your motor vehicle accident, sports injury, etc.) than you’re experiencing from your work injury, correct?
  • Employer “channeling” a work to its “Return to Work Clinic” (doctors on company payroll whose opinion is “like some athletic coaches, ‘rub some dirt on it and get back in the game’.”
  • Telling employees to take sick leave rather than claim worker’s compensation.
  • Telling employees to file medical bills under their group insurance, not worker’s comp.
  • Nurse Case Manager who initially befriends the employee but later makes every attempt with the worker’s doctor to prematurely return the worker to the job before a healing occurs.
  • Employer paying worker in cash with no payroll stub (or gives workers a Form 1099 rather than a W-2). Continue reading →

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