I tend to write a lot about bad behavior by insurance companies and why you should not try to represent yourself in your workers’ compensation case. Obviously I hope that you will consider Ginsberg Law Offices for your case but however you proceed, I hope that you understand clearly that you cannot and should not assume that the insurance company will act in good faith.
Just the other day, I received a letter in the mail in one of my cases stating that the insurance company had scheduled my client for an “independent” medical examination with a physician in Atlanta. The problem is that my client lives over 150 miles away.
I got on the phone with opposing counsel and demanded to know why his client had scheduled this exam when there were numerous specialists located within 5 miles, 10 miles, 25 miles, etc. from where my client lives. Obviously what’s going on here is that the insurance company knows that the Atlanta doctor will give them a report they want and they have no interest in finding out what is really going on with my client.
Opposing counsel said that his hands were tied so I requested a conference call with the judge. During this call I restated my objection to this farce and accused the insurance company of acting in bad faith. The judge felt that the insurance company had the right to choose a physician of its choice for the IME but he did order the insurance company to provide round trip transportation for my client. [Read More...]
As an advocate for my clients – employees who have been thrust into the workers’ compensation system – I often find myself asking hard questions to insurance adjusters. Outside the context of my law practice some of the questions I ask would be considered downright uncomfortable but in my business, I am going to make my opponents uncomfortable if that is what I need to do.
Here’s an example of what I am talking about. Earlier this year I got a call from one of my work injury clients who told me that his temporary total disability (TTD) checks had stopped coming in the mail. He had been receiving his TTD checks for several months and the insurance company had not filed any paperwork seeking to terminate benefits.
I immediately called the insurance adjuster who assured me that my client was still in “pay status” in their system and that his checks were being mailed out. This did not make sense to me because it is highly unlikely that 3 checks would be lost in the mail in consecutive weeks. [Read More...]
My clients are often surprised to learn that State Board judges do not render lump sum awards or verdicts about cases. Unlike a personal injury negligence case where a judge or jury serves as a finder of fact and determines whether you won or lost your case, judges in workers’ compensation cases decide disputed issues. For example, we may have a dispute with the insurance company about which doctor should serve as the treating physician, or whether the insurance company was within its rights to cut off your benefit. Other disputes involve such things as penalties for late TTD checks or who should have to pay for an MRI.
Workers comp. judges do not decide how much a case is worth or render a final dollar judgment.
Settlement in your case is totally voluntary – neither you nor the insurance company has to settle. In theory you can collect TTD (weekly wage benefits) for up to 400 weeks, and, in theory, the insurance company will remain on the hook for your medical costs forever. [Read More...]
Back in March, 2011, I released a video on YouTube called Beware of Insurance Company Surveillance. In that video, which you can view here, I pointed out that workers compensation insurance companies and defense lawyers here in Georgia often use private investigators to follow injured workers for the purpose of catching them engaging in activities inconsistent with their doctors' s restrictions. I pointed out that I always tell my clients to assume that their are being surveilled and to follow their doctor's advice to the letter, even if my client is having a good day or needs to lift or climb "only once." If the insurance company happens to be filming that day, then that "only once" activity may sink my client's case.
Following my release of this video about surveillance, I received several somewhat hostile and accusatory comments suggesting that I was advocating workers' compensation fraud or that my discussion of surveillance somehope proved that most or all workers' compensation claimants were dishonest. These comments missed the mark completely.
If you have read through my web sites and viewed my video on this topic, you know how much importance I place on pushing the insurance company to provide quality medical care. I am especially concerned about treatment provided by posted panel doctors because physicians who get most of their business from insurance companies may bring financial motivations into their treatment plans for you.
What often happens, therefore, is that many cases contain conflicting medical reports. The posted panel doctor may write that your back pain arises from a muscle strain and that your MRI report was inconclusive. A report from your claimant’s IME doc may identify a disc herniation and need for an (expensive) surgical consult.
Workers’ compensation judges, therefore are left with the task of trying to figure out from medical records and attorney produced forms what medical treatment is appropriate or just how severe an injury you have suffered.
If you are like me, it is really creepy to think that someone may be following you around, taking photographs and videotaping your activities without your knowledge or consent. Perhaps you are one of those people who senses that someone is looking at you and you may think that you are losing you mind when you catch glimpses in your peripheral vision of someone that you just know you have seen before somewhere.
Welcome to life when you enter the workers’ compensation world. More and more, I am finding that my clients are being surveilled by private detectives hired by insurance companies. My colleagues in the claimant’s bar are reporting the same thing so I think that there is a concerted effort by insurance companies to manufacture evidence that can be used to deny claims. [Read More...]
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