The malpractice of a Georgia workers’ compensation company, which has been compared to the fraudulent actions of Enron, will ultimately have a large negative impact on innocent citizens.
The State Insurance Commissioner's office has begun a criminal investigation into SEUS, an insurance company that provided workers’ compensation insurance to dozens of Georgia communities.
Suspicions of SEUS, short for Southeastern U.S. Insurance Inc., began when department analysts learned that the company had engaged in questionable business practices with a hunting club it owned in Seminole County. SEUS had invested $10 million in the hunting club when the company was in no financial condition to make such an investment. Upon investigation, the department also discovered that SEUS was inflating company assets while drastically understating liabilities.
In October 2009, Fulton County Superior Court Judge Thomas R. Campbell, Jr., ordered SEUS, which at the time held over 200 workers’ compensation policies and provided coverage to dozens of towns and school boards in Southern Georgia, into liquidation.
Georgia Insurance Commissioner John Oxendine was named as the liquidator. Following investigations into the company’s financial transactions, Oxendine compared the bookkeeping methods of SEUS’s former chief executive, M. Clark Fain III, to those of Enron.
Companies like Enron and SEUS, which are motivated by corporate greed, inexcusably disregard the large negative affect their misconduct will have on innocent citizens. Oxendine’s office has taken over the operation of the workers compensation insurer and is now authorized to sell off its assets to pay claims. SEUS has also been banned from involvement in further business.
Filed under Blogs, Recent developments, Workers' Comp Fraud by 
Although Georgia's workers' compensation system is supposed to foster an environment where legitimately injured workers can get needed treatment and then return to work, the reality is much different. It has been my experience that workers' compensation practice is just about as adversarial as divorce practice. Often justice and fair play take a back seat to "winning" and efforts by employers insurance companies to avoid paying benefits.
Case in point. This week I received the following email from a young woman who works at a factory in north Georgia:
Where I work I have been told that carpel tunnel is not recognized as a workman's comp injury if I wasn't having problems with numbness before. Is this correct?
The short answer is "no, this is not correct." Repetitive motion injury (often resulting in a diagnosis of carpel tunnel syndrome) is a very common work injury, especially for factory workers performing manual labor with their hands.
Any employer who tells an employee that "carpel tunnel is not recognized as a workers' comp. injury" is either very misinformed or downright dishonest.More on Employee Gets Bad Information About Legitimate Job Injury
If you have a computer and enjoy sufing the web, there is a good chance that you have a profile on Facebook, mySpace, Twitter or any of more than a hundred social media sites. These sites exist to help you connect with others – often for social purposes, and sometimes for business purposes.
How can an account at Facebook or many of these other sites hurt your workers' compensation case? When you create a profile on Facebook, your account has a default privacy setting that offers no privacy. Anyone who has a Facebook account anywhere in the world can find your profile and read what you have posted, what others have posted on your "wall" and view photos that have been "tagged" with your name.
Insurance defense lawyers are well aware of Facebook, and they are aware that many Facebook users may not be very savvy about changing privacy settings. Perhaps there is a photo of you attending a ball game or a family gathering. Maybe you listed yourself as the CEO of ABC Enterprises. Thanks to New York workers' compensation lawyer Jim Reed who posted about this issue on his New York InjuryLaw blog.
Photos and updates can easily be taken out of context. Even your frequency of posting can be used as evidence that you have the capacity to perform clerical type of work. Posts on Facebook and other social media sites can be used against you to put you on the defensive and as leverage to reduce the value of your case.
So, if you enjoy using Facebook or similar sites, take a few minutes to learn about the privacy settings. Block your profile to all but known friends and avoid "friending" someone that you don't really know.
If you were not already aware that there is no real privacy in the world, now you know. Take steps to protect yourself.
Filed under Maximizing your settlement, Miscellaneous information by
A front page story in the Sunday, May 24, 2009 edition of the Atlanta Journal-Constitution details the struggle of five catastrophically injured Atlanta police officers to obtain needed medical help from the City of Atlanta's workers' compensation office. Each of these police officers was injured in the line of duty – with injuries ranging from brain damage to paralysis arising from gunshot wounds to the spinal cord.
Like many city and county governments, the City of Atlanta "self-insures" against workers' compensation claims, meaning that weekly wage benefits and funds for medical treatment come directly out of the City's budget. The City does use a private claim's administration service called NovaPro Risk Solutions out of San Diego.
The City is not denying responsibility for paying wage or medical claims, but it has been refusing to pay for various medical procedures and medical devices.
In one instance a police officer who had been rendered a parapalegic from a gunshot wound needed surgery on his Achilles tendon because his feet kept slipping off his wheelchair footrests.More on Injured Atlanta Cops Fight Workers Comp System
A workers' compensation claim can result in many unpleasant changes in your life. Besides the health issues and the stress that you have to deal with, financial problems also often arise. Recently one of my workers' comp clients called me to say that he was very concerned that he was about to be sued for past due credit cards. In addition, he had other debts and was receiving daily phone calls and threatening letters.
He wanted to know if he should consider bankruptcy. As you may know, my husband, Jonathan Ginsberg, has been a consumer bankruptcy lawyer for many years and I asked him to speak with my client. Here is what Jonathan has to say about dealing with these debt issues:More on Weekly Wage Benefits are Exempt from Garnishment
Filed under Income benefits by
In our Georgia workers compensation law practice, we regularly see carpal tunnel cases. Carpel tunnel syndrome arises when the muscles in the wrist swell and compress the nerve running down the arm into the hand. When this median nerve gets squeezed, you will experience pain, numbness and tingling in the hands. In severe cases, a patient can suffer permanent nerve damage. Females are more likely than males to develop carpel tunnel syndrome.
If rest does not resolve the condition, the usual treatment for carpel tunnel injuries is surgery called a carpel tunnel release expands the space for the nerve and tendons and thereby relieves the pressure on the nerve.
Carpel tunnel injuries usually arise from repetitive motion type jobs. Examples of these types of jobs include:
- deboning chickens
- typing
- sewing
- meat packing
- small parts assemblers
At Ginsberg Law Offices, we represent many carpel tunnel claimants. An important part of our work is to get our clients to a doctor who specializes in wrist, hand and repetitive motion injuries and to see to it that our clients get appropriate rehabilitation care.More on Carpal Tunnel Diagnosis Need Not Arise from Repetitive Motion Job Tasks
Filed under Carpel Tunnel, Case studies by
Several times a year, I get a call from an injured worker who is facing a denial from the insurance company on the grounds that no timely notice of a claim was filed. The Georgia workers' compensation statute contains two separate notice provisions, both of which must be met:
Notice to Employer
The Georgia Code says that an injured worker must give notice to his employer within thirty (30) days after his on-the-job injury. We advise our clients to give notice, preferably in writing, to a direct supervisor. The the sooner you give this notice the better. When giving notice to your supervisor you should be as clear as possible about the exact date and time you were injured and about exactly what happened. The more specific the better as we find that employers tend to question vague and uncertain reports about a work injury.
Remember that workers' compensation covers injuries "arising out of and in the course of " your employment. This means that an injury incurred while you are on break, or coming or going from work may be challenged. Be suspicious if your employer's workers' comp rep tries to put words in your mouth about when or how your injury happened. A quick word about the phrase "arising out of and in the course of employment." The Georgia State Board of Workers' Compensation spends a lot of its time listening to lawyers argue about what this phrase means. What you tell your employer about your injury, and what you tell your doctor can make a huge difference. For this reason, we encourage injured workers to seek legal counsel sooner rather than later.
Once you report an on-the-job injury, your employer is supposed to write up a "first report of injury" and send it to both the State Board of Workers' Compensation and to its insurance carrier. Not surprisingly, this does not always occur as employers try to avoid filing claims with their workers' comp. carriers. Your employer may delay filing the required paperwork and may tell you to file with your group health insurer. They may suggest you file under short or long term disability for lost time from work. Do not let this happen as group health and/or STD/LTD carriers will not pay for either lost wages or medical costs related to a work related injuries, as workers' compensation insurance is considered "primary" coverage. We have seen some situations in which the group health carrier initially accepts the claim, but later rejects it once the file is audited. This could leave you stuck with a medical bill that otherwise should be covered.
Notice to State Board of Workers Compensation
In theory, once you give your employer notice of your injury, the employer will file a notice of claim with the State Board of Workers' Compensation. A better course of action would be for you to file that notice directly. You file notice using a form called a WC-14, and this form must be filed within one (1) year from the date of your accident. Our office regularly completes and files WC-14 forms for our client. If you are not sure how to fill out this form, you should speak to an experienced attorney as filling out this form improperly can negatively impact your case later on.More on How, When and To Whom Do I Give Notice of my On-the-Job Injury?
Filed under Georgia Workers' Compensation by
