Many injured workers are unable to return to their former line of work due to physical or medical limitations. For example, a shop worker who must regularly lift and carry 60-pound objects needs to find a new line of work if he hurts his back and gets a lumbar fusion. Such a worker may be a good candidate for vocational rehabilitation services at the Utah State Office of Rehabilitation (USOR).
USOR services are good if medical problems require you to change careers. At USOR, you'll attend an orientation and be placed on a waiting list. The process can take several months so it is good to contact USOR sooner than later. USOR's website is www.usor.utah.gov and the phone number for the Southern Utah District Office is (435) 673-5091.
USOR services are helpful in two ways: First, and most obviously, USOR can help many injured workers get back into a career and earn a living. Second is the evidence benefit: If USOR is unable to rehabilitate an injured worker, then that is good evidence to support the workers compensation claim for permanent total disability (PTD). (It can also be good evidence to support an SSDI claim.)
If you do not receive USOR services, the most important documentation is still the work restrictions you receive from your treating physician, e.g., no lifting > 20 lbs.
Thursday, June 1, 2017
Wednesday, February 22, 2017
Utah Insurance Department - Complaints
Would you believe it? Sometimes injured workers feel that the workers compensation insurance company is not following the rules. Utah law governs insurance companies that operate in Utah, and the Utah Insurance Department oversees insurance companies' activities. The Utah Insurance Department website (www.insurance.utah.gov) allows consumers--including injured workers--to seek help a`nd file a complaint. If you feel that the workers compensation carrier is not treating you fairly, you may want to either call the Utah Insurance Department at 1-800-439-3805 or file a written complaint online at www.insurance.utah.gov. Since lawyers typically cost money, this may be a good option for many injured workers. But you are always welcome to call me with questions.
Monday, January 23, 2017
Reimbursement for Travel Expenses
Some injured workers live a considerable distance from the doctors they need to see for their industrial injury. The gas money for these trips can add up and impose a financial burden.
Utah law (Rule 612-300-8) allows injured workers to be reimbursed for their travel expenses, including gas, meals and lodging, if two conditions are met: (1) The travel is required, meaning the medical treatment cannot be obtained closer to home. (2) The injured worker submits the claim to the adjustor within 12 months after the travel expenses were incurred.
Travel to pick up prescriptions is generally not allowed (unless you don't have a pharmacy in your community). Lastly, the adjustor must pay the travel expenses within three months of receiving the claim, or when at least $100 of expenses have accrued, whichever is earlier.
Note: The reimbursement rates generally change a little each year. The Labor Commission publishes a "Quick Reference" guide which is a great resource about the various workers compensation benefits and payment amounts. The 2016 guide is available at laborcommission.utah.gov. Go to "Forms/Publications" and then search for "Quick Reference".
Utah law (Rule 612-300-8) allows injured workers to be reimbursed for their travel expenses, including gas, meals and lodging, if two conditions are met: (1) The travel is required, meaning the medical treatment cannot be obtained closer to home. (2) The injured worker submits the claim to the adjustor within 12 months after the travel expenses were incurred.
Travel to pick up prescriptions is generally not allowed (unless you don't have a pharmacy in your community). Lastly, the adjustor must pay the travel expenses within three months of receiving the claim, or when at least $100 of expenses have accrued, whichever is earlier.
Note: The reimbursement rates generally change a little each year. The Labor Commission publishes a "Quick Reference" guide which is a great resource about the various workers compensation benefits and payment amounts. The 2016 guide is available at laborcommission.utah.gov. Go to "Forms/Publications" and then search for "Quick Reference".
Monday, January 2, 2017
Time Limits - Don't Delay!
Workers compensation claims typically do not get better with age. In fact, Utah law requires injured workers to submit medical expenses to the employer or insurance carrier within one year. That's right--only one year to get submit medical bills to the workers compensation carrier, so it is easiest to simply have your treating doctor send all bills to the workers comp carrier even if you think the carrier will refuse to pay. Then, you can tell the treating doctor's office staff to bill your private insurance if the workers comp carrier refuses to pay. Doing this lets you preserve your ability to assert these medical claims before the Utah Labor Commission. After all, co-pays and out-of-pocket medical expenses can add up to hundreds or even thousands of dollars.
Utah law says employees "shall provide notification to the employee's employer promptly of the injury." Further, the law bars workers comp claims for injuries not reported within 180 days to the employer or to the Utah Labor Commission. You might not trust that your employer will properly document your injury, so it is often wise to report the injury immediately to your doctor and make sure he or she notates that the injury happened at work, i.e., explain exactly how you got hurt at work.
Some injured workers might think, 'Hmm, I think my back pain will go away and my boss will hassle me if there's a workers compensation claim. I'll just take more Ibuprofen." Many injured employees feel this way and it puts them in a bind, a catch .22: If they report the injury to the employer, they may be fired (perhaps wrongfully). If they do not report the injury and the condition gets worse and worse, then they may be harming their potential to get workers compensation benefits. This is a real problem. Workers Comp attorneys have ideas on how to both (1) preserve your job and (2) increase your ability to obtain the workers compensation benefits appropriate in your case. Many attorneys provide free initial consultations.
Lastly, we have the 6-year statute of limitations for filing an application for hearing with the Utah Labor Commission. This 6-year rule can completely bar your workers compensation claim, so as usual it is wise to call an attorney rather than wait to see what happens. Attorneys can provide ideas on how to obtain necessary medical opinions and preserve your rights under the law.
Utah law says employees "shall provide notification to the employee's employer promptly of the injury." Further, the law bars workers comp claims for injuries not reported within 180 days to the employer or to the Utah Labor Commission. You might not trust that your employer will properly document your injury, so it is often wise to report the injury immediately to your doctor and make sure he or she notates that the injury happened at work, i.e., explain exactly how you got hurt at work.
Some injured workers might think, 'Hmm, I think my back pain will go away and my boss will hassle me if there's a workers compensation claim. I'll just take more Ibuprofen." Many injured employees feel this way and it puts them in a bind, a catch .22: If they report the injury to the employer, they may be fired (perhaps wrongfully). If they do not report the injury and the condition gets worse and worse, then they may be harming their potential to get workers compensation benefits. This is a real problem. Workers Comp attorneys have ideas on how to both (1) preserve your job and (2) increase your ability to obtain the workers compensation benefits appropriate in your case. Many attorneys provide free initial consultations.
Lastly, we have the 6-year statute of limitations for filing an application for hearing with the Utah Labor Commission. This 6-year rule can completely bar your workers compensation claim, so as usual it is wise to call an attorney rather than wait to see what happens. Attorneys can provide ideas on how to obtain necessary medical opinions and preserve your rights under the law.
Monday, December 5, 2016
Medicaid and Workers Comp Settlements
Suppose you get hurt at work and Medicaid pays for your medical treatment. Your workers comp lawyer is required to notify the Medicaid Office of Recovery Services (ORS) so they can get reimbursed. In legal terms, Medicaid has a statutory lien on the workers compensation settlement. After all, since you got hurt at work, the workers compensation insurance carrier should be paying the bills, not Medicaid. So, when you visit your attorney, he/she will need your Medicaid recipient ID number.
Before we settle a workers comp case, we will find out how much the final ORS lien is, and then make sure we settle for enough to pay the ORS lien, the other medical bills, the attorney fee and still leave enough for the client to feel that the settlement was in his/her best interest. For example, if ORS gets $5,000 and there are other doctors' bills of $7,000--a total of $12,000--then it would be silly to settle the case for $15,000 because that would hardly leave anything for attorney fees and the client's take-home share. In a situation like this, the attorney may see if ORS can reduce or waive their lien. And, sometimes doctors or clinics are willing to reduce their bills.
In summary, having Medicaid is a blessing for many clients who do not have other health insurance, but it is very important that we consider Medicaid's lien when deciding whether to settle a case.
Note: If you get hurt at work and do not have private health insurance, consider applying for Medicaid ASAP.
For personalized advice, contact an experienced workers comp attorney. Tim Daniels Law Services offers a free initial consultation. For more information call (435) 592-1235 or visit www.timothydanielslaw.com.
Before we settle a workers comp case, we will find out how much the final ORS lien is, and then make sure we settle for enough to pay the ORS lien, the other medical bills, the attorney fee and still leave enough for the client to feel that the settlement was in his/her best interest. For example, if ORS gets $5,000 and there are other doctors' bills of $7,000--a total of $12,000--then it would be silly to settle the case for $15,000 because that would hardly leave anything for attorney fees and the client's take-home share. In a situation like this, the attorney may see if ORS can reduce or waive their lien. And, sometimes doctors or clinics are willing to reduce their bills.
In summary, having Medicaid is a blessing for many clients who do not have other health insurance, but it is very important that we consider Medicaid's lien when deciding whether to settle a case.
Note: If you get hurt at work and do not have private health insurance, consider applying for Medicaid ASAP.
For personalized advice, contact an experienced workers comp attorney. Tim Daniels Law Services offers a free initial consultation. For more information call (435) 592-1235 or visit www.timothydanielslaw.com.
Monday, November 21, 2016
Talking with the Adjustor - Recorded Statements
When you report a workplace accident, you will likely get a phone call from the workers compensation adjustor, who holds the pocketbook and decides whether to pay your claim. The adjustor will tell you that you must cooperate with their investigation by filling out some forms. And the adjustor will tell you he or she needs to interview you to determine how you got hurt.
At this point, injured workers have three choices:
(1) Tell the adjustor "no" which would cause the adjustor to stop processing the claim, resulting in no workers compensation benefits. (Not recommended.)
(2) Tell the adjustor "sure" which would cause the adjustor to record your interview and thereafter potentially use your statements (or inferences from your statements) against you. (Not recommended.)
(3) Tell the adjustor "sure" and then set up a time and have an attorney like me with you for the interview. This would cause the adjustor to still take your statement but be more circumspect in the questions asked. More importantly, I can help make sure the needed information is discussed in the interview. (Highly recommended.)
A quick story: I once had a client where he had me be present during the telephone interview. The Client clearly got hurt at work but the adjustor failed to ask several legally-important questions. During the interview, I chimed in and had the Client explain some important aspects of how he got hurt. With that pertinent information, the adjustor was persuaded to accept the claim.
Bottom line: The adjustor does not work for the injured worker and has little incentive to ensure injured workers receive the proper benefits under the law--it's easier for the adjustor to simply say, "The injured worker is in his 50's and has pre-existing conditions, so this claim is denied." But the law is not that simple, and most injured workers do not know the nuances of Utah workers compensation law. (Benefits usually depends on the mechanism of injury and other factors.)
Invitation: If you want me to help you with your interview, please call. Remember, there is never an attorney fee unless/until you and I agree to that fee and we both sign an attorney-fee agreement.
So, have a question? Just ask! Call me at (435) 592-1235 or visit www.timothydanielslaw.com.
At this point, injured workers have three choices:
(1) Tell the adjustor "no" which would cause the adjustor to stop processing the claim, resulting in no workers compensation benefits. (Not recommended.)
(2) Tell the adjustor "sure" which would cause the adjustor to record your interview and thereafter potentially use your statements (or inferences from your statements) against you. (Not recommended.)
(3) Tell the adjustor "sure" and then set up a time and have an attorney like me with you for the interview. This would cause the adjustor to still take your statement but be more circumspect in the questions asked. More importantly, I can help make sure the needed information is discussed in the interview. (Highly recommended.)
A quick story: I once had a client where he had me be present during the telephone interview. The Client clearly got hurt at work but the adjustor failed to ask several legally-important questions. During the interview, I chimed in and had the Client explain some important aspects of how he got hurt. With that pertinent information, the adjustor was persuaded to accept the claim.
Bottom line: The adjustor does not work for the injured worker and has little incentive to ensure injured workers receive the proper benefits under the law--it's easier for the adjustor to simply say, "The injured worker is in his 50's and has pre-existing conditions, so this claim is denied." But the law is not that simple, and most injured workers do not know the nuances of Utah workers compensation law. (Benefits usually depends on the mechanism of injury and other factors.)
Invitation: If you want me to help you with your interview, please call. Remember, there is never an attorney fee unless/until you and I agree to that fee and we both sign an attorney-fee agreement.
So, have a question? Just ask! Call me at (435) 592-1235 or visit www.timothydanielslaw.com.
Thursday, August 11, 2016
Reporting Workplace Injuries
Workers who get hurt in the workplace should try to report the accident immediately for several reasons:
(1) As time goes on, there are greater chances of additional non-work aggravations.
(2) It becomes more difficult to prove that the symptoms were caused by the workplace accident.
(3) With unclear proof, the workers comp adjustor is less likely to pay for the medical treatment I need.
(4) Without the medical treatment, I'm in too much pain to work hard and I get fired.
(5) Being hurt and without employment, I cannot pay my bills, and it will take the Utah Labor Commission about 18 months to process my workers compensation claim. I cannot afford to be without income for 18 months.
The best practice is to go to WorkMed immediately following the accident because WorkMed knows how to file the Form 123 with the Utah Labor Commission. Also, report the accident to your management and get a copy of the Form 122 when the Human Resources manager files it with the Utah Labor Commission.
If you think that reporting the injury will get you fired, then that is a difficult situation to be in. Consider looking for a new job; but a new job does not heal your injury and the new workers comp carrier will likely not pay for the injury you suffered at the prior job. If the injury is very minor, then you might decide to forget about it and just keep working. You might want to talk with an attorney or with the Utah Labor Commission about your options. For more information, call me at (435) 592-1235 or visit www.timothydanielslaw.com.
(1) As time goes on, there are greater chances of additional non-work aggravations.
(2) It becomes more difficult to prove that the symptoms were caused by the workplace accident.
(3) With unclear proof, the workers comp adjustor is less likely to pay for the medical treatment I need.
(4) Without the medical treatment, I'm in too much pain to work hard and I get fired.
(5) Being hurt and without employment, I cannot pay my bills, and it will take the Utah Labor Commission about 18 months to process my workers compensation claim. I cannot afford to be without income for 18 months.
The best practice is to go to WorkMed immediately following the accident because WorkMed knows how to file the Form 123 with the Utah Labor Commission. Also, report the accident to your management and get a copy of the Form 122 when the Human Resources manager files it with the Utah Labor Commission.
If you think that reporting the injury will get you fired, then that is a difficult situation to be in. Consider looking for a new job; but a new job does not heal your injury and the new workers comp carrier will likely not pay for the injury you suffered at the prior job. If the injury is very minor, then you might decide to forget about it and just keep working. You might want to talk with an attorney or with the Utah Labor Commission about your options. For more information, call me at (435) 592-1235 or visit www.timothydanielslaw.com.
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