Category Archives: Workers’ Compensation

Surprising Findings On Baby Boomers and Worker’s Compensation (part 1)

You may be surprised to learn that age does not correlate with frequency of injury.

Today’s post is from our colleague Tom Domer of Wisconsin.

What is the impact on worker’s compensation from aging Baby Boomers who have postponed their retirement, working much longer than the previous generation? In a recent study by the NCCI (National Council Compensation Insurance) some interesting and surprising conclusions resulted. It is not surprising that the number of older workers is increasing. The study looked at the frequency and severity across age groups and tried to identify factors that accounted for the severity of injuries between older and younger workers.

Among the key findings are the following:

  • The major difference among age groups occurs between the 25-34 and the 35-44 age groups. All workers 35-64 appeared to have similar costs per worker. These reassuring findings suggest an aging workforce may have a less negative impact on the lost cost per worker than many analysts originally thought.
  • Many workers’ compensation professionals have the belief that younger workers have a much higher injury rate. That appears not to be true any longer. Differences in frequency by age have virtually disappeared.
  • The major factor involving older workers involves severity. Older workers tend to have more shoulder rotator cuff claims and knee injuries while younger workers have more back and ankle sprains.
  • Higher wages for older workers are a key factor leading to higher costs for older workers. On the medical side, more treatment per claim has increased medical costs.

The study indicated that older workers account for an increasing share of the U. S. workforce. In particular, the share of workers age 55-64 has been growing steadily. The number of workers age 45-54 has increased modestly. Workers over 65 were about 3% of all workers in 2000 and about 5% in 2010. Taken as a whole, the percentage of workers over 45 has increased from 34% in 2000 to 42% in 2010. (Our practice has seen a similar increase in older workers, many of whom must remain in their positions due to reduced or non-existent pension benefits, wage and benefit cuts, and an overall poor economy.)

For more on the working Baby Boomer generation, check back with us next week.

With over 30 years of experience representing injured workers in Wisconsin, Tom Domer was recently named the 2011 Milwaukee Workers’ Compensation Lawyer of the Year in Best Lawyers. Tom teaches the worker’s compensation course at Marquette University Law School, providing the instruction and training for many other lawyers. He lectures frequently around the nation. He also is a prolific writer, editing the national magazine Workers’ First Watch. He has co-authored over two dozen texts. Tom earned all his degrees in Wisconsin.

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Misdiagnosed Worker Can Amend The Cause Of Injury More Than 2 Years Later

It isn't always easy to know what is causing pain. Multiple doctors may get it wrong. Be persistant.

The Appellate Division Third Department issued a decision last week (Searchfield v. Lowe’s Home Centers) that is interesting case because it pertains to the establishment of an injury that was originally misdiagnosed.

In October 2005, an employee was injured at work while lifting a hot water heater. As a result of the injury the employee went to the emergency room. He was diagnosed by an emergency room physician with myofascial strain of the legs and hips. A November 2005 physician’s report diagnosed the claimant with hip/thigh sprain and sciatica. The later medical reports focused on the groin, lower back and leg pain.

In July 2006, a Law Judge established the claim for a work related injury to the claimant’s lower back. However, the employee continued to report worsening symptoms in his hip area. In 2009, the claimant saw an orthopedic surgeon. The doctor performed a MRI of the right hip. The MRI revealed a right hip labral tear that required surgury. According to the surgeon the claim was originally misdiagnosed and the claimant had, in fact, sustained injuries to his right hip as a result of the October 2005 accident.

The claimant applied for a hearing to amend the claim for the right hip. The Judge ruled that the right hip claim was time barred (pursuant to Workers’ Compensation Law Section 28). This states that a claim for a causally related condition must be made within two years of the date of accident. On appeal the Board Panel reversed and the Appellate Division affirmed the Board Panel.

The Appellate Division stated that the early medical reports reflect initial concerns relating to the claimants hips. Also there was supporting medical evidence that the claimant’s ongoing pain was the result of a labral tear in the right hip, a condition which is often misdiagnosed as a low back injury. The Court went on to add that the claimant could not have filed a claim for a causally related right hip injury at the time of the accident because it was not properly identified and diagnosed.

This case is important as it allowed the amendment of a claim for a serious injury that misdiagnosed early on in the case.

You can find the entire court decision here.

 

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Well-documented Expense Records Increase Value of Your M&T Reimbursement

Expense ReportWhile receiving medical treatment related to a workers’ compensation case, claimants often have additional expenses such as mileage, fuel costs, transportation fares, and out-of-pocket prescriptions. Yet many claimants don’t realize they are entitled to reimbursement for expenses they incur in obtaining treatment.

Submitting information related to these expenses is an important part of the workers’ compensation process. Problems can arise, however, when incomplete or disorganized information is provided to an insurance carrier. This can result in delays and errors in receiving the proper amount to which they are entitled.

Claimants can avoid these sorts of problems with small acts of diligence and record keeping. Here are a few suggestions:

Save your receipts and keep a record of your doctor visits. Keeping a log and saving receipts incurred from specific doctor visits provides a “narrative” that makes it easier to tie together dates and expenses.

Make sure to use the correct form. The New York State WCB requires Continue reading

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Can I Move To Another State If I Have A Work’ Comp’ Claim?

Yes, you can move to a different state though you have a workers' compensation claim in New York.Question: Can I move to another state even though I have a workers’ compensation claim in New York?

Answer: Absolutely!

Many claimants move to other states during the course of their workers’ compensation claims. Here are the top five things to consider when moving to another state:

1. Tell your workers’ compensation attorney that you are moving, and update your contact information such as telephone number and address.

2. Find a doctor in your new state that handles workers’ compensation claims in New York state. A simple Google search should give you several hits. Be sure to ask if the doctor handles workers’ compensation claims for claimants.

3. As there is often confusion at the initial stages of treatment as to why a patient is seeing the doctor, be sure to tell your doctor that you have an ongoing workers’ compensation claim in New York for which you need continuing treatment.

4. Have your Notice of Decision authorizing medical treatment handy! This is how the doctor knows that he or she is allowed to treat you for your work-related injury. If you do not have a copy of that Notice of Decision or have lost it, ask your workers’ compensation attorney to send you a copy ASAP.

5. Be proactive. This is your workers’ compensation claim: you have a right to your medical records. Ask for them after each visit! Give your workers’ compensation attorney the doctor’s contact information, including telephone number, fax number, and address. Get in touch with your workers’ compensation attorney if the doctor is having any difficulty getting your medical treatment paid for by the insurance carrier.

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What Should I Do If I Receive A Bill From My Workers’ Compensation Doctor?

Put your money back in your wallet. Your employer's insurance carrier is responsible for medical treatment of work-related accidents.

Question: I received a bill from my doctor for treatment relating to my workers’ compensation claim. Am I responsible for payment?

Answer: You do not have to pay your doctor for treatment resulting from your work-related accident.

There is often confusion about paying doctor bills related to work-related accidents, but the reality is relatively simple. Take for example Joanna. While at work, a heavy box fell on Joanna’s foot. As a result, she was unable to walk and had to immediately go to the emergency room. Following treatment for her broken foot, Joanna received an expensive bill from the hospital. What should Joanna do?

Joanna should not pay the bill!

Under workers’ compensation law, Continue reading

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When Is It Time To See The Doctor?

If you're hurt, get treatment right away.

Putting off seeing medical care is commonplace for chronic medical conditions. Under the Workers’ Compensation Law there is no timeframe for a claimant to see a medical provider. There is nothing in the law that requires a worker to see his doctor within 24 hours or 30 days of the accident. However, the sooner an injured worker sees a doctor, the better, especially if that worker is losing time from work because of the accident. A Law Judge will only grant awards for lost time that is backed up by medical reports.

That means if a member is out of work for three weeks before they go to a doctor, it is possible that Workers’ Compensation benefits might not be paid during that time period. In order for a claim to be successful in this situation the report that the doctor submits must have several things on it:

  • It must contain the history of the accident,
  • diagnoses a condition,
  • explain how the condition is related to the on the job incident, and;
  • comment on disability.

Disability is an essential component that must be on the reports. Without an opinion on disability, there is no evidence to dispute what the carrier doctors submit to the NY Workers’ Compensation Board.

Physicians are required to submit to the Workers’ Compensation Board (WCB) complete and thorough reports. The sooner that you see a doctor and have a report sent to the WCB the better for you and your case.

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If You Have Symptoms, Tell Your Lawyer Immediately!

If You Have Symptoms, Tell Your LawyerWe represent a client whose hands were directly injured a few years ago. The insurance company, as part of its defense, is raising a provision in the law which requires an injured worker to file a claim for a direct injury within two years of the accident (WCL § 28). While interviewing the client, we learned that she had been feeling symptoms in her hands years ago, at the same time as she began experiencing the symptoms to other areas of her body. But because she only mentioned that her hands hurt now, we may not be able to get her the compensation she deserves.

Our client told me that originally brought up the symptoms of numbness, tingling and weakness in her hands with her doctor, but he felt these symptoms were related to her neck, another

If you are hurt, tell your attorney everything, even if you aren’t sure if it is relevant.

area where she was injured. The doctor tried to treat her hand symptoms by treating her neck first. He Continue reading

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Read This Before You Go To An Insurance Medical Examination

Insurance medical exams may seem like regular doctor visits, but these docs are not on your side.

Many times insurance medical examinations are considered by injured employees to be the same as Independent Medical Examinations (IMEs). There is nothing farther from the truth. These examinations are bought and paid for by the insurance company and for their benefit.

The insurance carrier doctor is no friend to an injured worker. He or she is a private consultant paid for by the carrier.

You should be prepared for these examinations by knowing your rights and how to protect them:

1) You have the right right to bring a family member or friend with you to the examination.
You can bring your spouse into the examination room during the examination. This is important because it allows for a witness to testify at court about the validity of the examination and to dispute tests that the doctor claims to have done.

2) You are permitted to audiotape or videotape the examination.
And there is nothing in the law that requires you to tell the insurance company doctor that you intend to tape the examination.

3) You should Continue reading

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