December 10, 2018

Can You Collect Workers’ Compensation Benefits if You Were at Fault in your Work Accident

Would you be surprised to learn that you are eligible to pursue workers’ compensation benefits in Georgia cases even if you were at fault in the accident?

Workers’ compensation law in Georgia is considered a “no fault” system, meaning that you are covered even if your injuries arose from your own negligence.  Under Georgia law, you are automatically covered by workers’ compensation is your injury arose out of and in the course of your employment.  This idea that in order to be covered you need to be acting for the benefit of your employer is common in workers compensation statutes in many states – for example in North Carolina the work injury law asks if your employer exercise control and direction over your work?

Examples:

  • a forklift driver turns too late and knocks over a scaffolding, causing boxes to fall on him, resulting in a broken arm and a closed head injury.  The forklift driver is eligible for benefits.
  • an industrial sewing machine operator gets distracted and loses a finger to a cutting knife.  The machine operator can pursue workers’ comp. benefits
  • a backhoe operator fails to properly park his machine and he gets run over when trying to exit the cab.  The backhoe operator is covered.

While you are eligible for workers’ compensation benefits even if you were at fault, you can be denied if your injury was the result of “horseplay.” [Read more…]

Defense Lawyers Scour Social Media for Evidence to Challenge Your Claim

man on climbing wall

I have written before about the danger associated with keeping your social media profiles active while you are pursuing workers’ compensation benefits. Comments, posts, tweets and especially photos can and will be used against you.

Perhaps you decided to change your Facebook profile picture and you chose a photo taken the year before your work injury. What if an old friend makes reference to a “camping trip” but does not provide any context as to the date or duration. [Read more…]

How Insurance Companies Try to Cut You Off

aggressive insurance companyYou might think that if your employer is paying weekly benefits and has paid for medical care, you are not likely to have any significant disputes in your work injury case. As the case I am about to discuss shows, however, challenges from the insurance company may be right around the corner.

The case I want to highlight is not one of my cases. The decision in this case is part of the public record in that it is published on the web site of the Georgia State Board of Workers’ Compensation. I bring this case to your attention for several reasons:

  • first, I want you to see how a State Board judge analyzes evidence
  • second, there are certain elements of this case that are not discussed in the decision, but we can assume they are there because the insurance company did not raise the issue and the judge did not mention the issue. We’ll read between the lines to reveal these issues.
  • third, this is a case that shows how insurance companies operate to cut off the benefits of a deserving claimant and to force a below market settlement.

The case I am discussing was decided in 2013 in south Georgia. Because State Board files are confidential, neither the name of the claimant nor the name of the employer is disclosed.  Here is a link to the written decision.

The employee is a female who worked as the manager of a restaurant. In December, 2006 the employee hurt herself and developed neck pain which radiated into both hands and lower back pain that radiated into both legs. The employer accepted the claim and began paying her TTD (weekly wage) benefits. The employer also paid for medical care that include surgery on her cervical spine and surgery on her lumbar spine. [Read more…]

Do Not Expect Respect from the Insurance Company

insurance company bad faithI 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…]

Video Surveillance Most Likely being Used in Your Case

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.

[Read more…]

Beware of Insurance Company Surveillance

surveillanceIf 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…]

Post Injury Recorded Statements: A Trap for the Unwary

Atlanta workers compensation practiceWhen you are injured on the job, the workers compensation claim that arises will be filed against both your employer and an insurance company.   This is why, by the way, that I frequently refer to the “employer/insurer” on this blog and on my web site.

As a worker, your dealings are obviously with your employer – your direct supervisor, a human resources manager or the owner of your company.   Once you file a claim, however, responsibility for processing that claim goes to a claims adjuster working for an insurance company.  It is possible, therefore, that your supervisor or HR manager may be pleasant, sympathetic and genuinely interested your well being but you may face a very different attitude by the claims adjuster.

Often, your first introduction to the claims adjuster may come when the adjuster contacts you to schedule a recorded statement by phone.   Insurance companies use recorded statements to learn more about what happened when you got hurt, but they mainly use these statements to find reasons to deny your claim or limit your medical care.

You should assume that a recorded statement in your workers’ compensation case is like a police interrogation – anything you say can and will be used against you. [Read more…]