Posted on Thursday, January 17th, 2019 at 4:45 pm
North Carolina already had one significant snowfall during December of 2018 and early in 2018, southeast Virginia was struck by a crippling blizzard. Ice, snow, and cold weather can make it extremely difficult to work – especially for construction workers and anyone who works outside. Anyone who walks outside may slip and fall on the ice. Well-known dangers, although rare in our neck of the woods, include hypothermia and frostbite.
Some examples of outdoor work include:
Cold weather can be relative. Some climates are known for their cold weather and people there understand what steps are needed to protect roads, pipes from bursting due to freezing, and most of all people. Other climates including southern climates often don’t understand how to respond to cold weather and the city crews with their meager supplies and equipment are quickly overwhelmed when extreme winter weather takes over. It is not their fault; it is simply such a rarity that it is not worth the expenditure to purchase the extra equipment.
As with all worker’s compensation claims, there is no requirement to prove fault. If an accident at work causes the employee to be injured, the employee has a right to demand wage loss benefits and payment for the medical costs to get healthy again. The employer is generally liable even if it did everything it could to prevent the accident.
Employers and employees should both understand the risks of working in cold weather and to how to minimize those risks. The Occupational Safety and Health Administration does have some guidelines on what employers can do to help any worker who works outside in extreme cold or a combination of cold and wet weather.
Still, employers are required to comply with “hazard-specific safety and health standards.” Employers must also “provide their employees with a workplace free from recognized hazards likely to cause death or serious physical harm.” Employers should also use standards that are commonplace in their industry.
Cold weather includes more than just looking at the temperature. It also requires looking at how wind chill makes it feel colder.
In addition to wind, the following factors can make cold weather more difficult to manage, according to OSHA:
Cold weather places stress on the body by shifting blood flow, over time, away from the extremities to the body’s internal organs, the chest, and the abdomen. This shift plus any exposure of the extremities increases the body’s risk for hypothermia, frostbite, and trench foot.
Hypothermia is a dangerous condition which happens “when body heat is lost faster than it can be replaced.” Another factor is that the body’s temperature drops to below 95 degrees F instead of its normal temperature of 98.6 degrees F. Hypothermia normally occurs at very cold temperatures. It can, however, happen even at temperatures above 40 degrees F if other elements exist. These elements include exposure to rain, sweating, or being submersed in cold water such as falling into a lake or pond.
Hypothermia symptoms. Mild symptoms include shivering and stomping one’s feet to try to get the blood circulating. More serious conditions include a falling body temperature. The worker will stop shivering and may become confused and disoriented. He/she may show signs of losing coordination. Workers may not be able to stand. Their pupils become dilated. Their pulse and breathing slow. Workers with hypothermia may lose consciousness. In tragic cases, they may if they don’t get immediate help.
Treatment for hypothermia. Any worker, supervisor, or helper should call 911 or seek immediate medical help. Some of the many common steps OSHA recommends include:
If the worker isn’t breathing or doesn’t have a pulse, a call to 911 for emergency help should be made immediately. Additionally, OSHA recommends:
Frostbite occurs when the skin freezes and the tissue beneath the skin is affected. The lower the temperature, the greater the risk of frostbite. The hands and face are normally the parts of the body affected. In severe cases, amputation may be required.
Frostbite symptoms include red skin with gray and white patches. There’s numbness in the body part affected. There can be a feeling of hardness in the hand, foot, or body part. In severe cases, there may be blisters.
Treatment for frostbite. Generally, the treatments for hypothermia should also be used to treat frostbite. Additional treatment considerations include:
Attorney Joe Miller Esq. fights for injured workers in North Carolina and Virginia. He’s been helping workers get just recoveries for 30 years. Attorney Miller works with your doctors and independent doctors to fully understand your medical needs. To make an appointment, call 1-(888) 667-8295 or fill out my contact form.
Posted on Wednesday, January 9th, 2019 at 5:01 pm
In this video, Attorney Joe Miller explains why you should NEVER obtain a side job or other “under the table” job while receiving workers’ compensation benefits:
Posted on Wednesday, January 9th, 2019 at 4:56 pm
Here’s our third series in common questions and answers about North Carolina and Virginia worker’s compensation.
Employers have the right to appoint a nurse case manager to help injured and ill workers with their medical needs. Employers will say that the nurse case manager is just trying to help the worker get healthy. That’s not always the case, in fact it is mostly not the case. While a nurse case manager can help coordinate your appointments and help get workers to their treatment or therapy sessions; nurse case manager’s main goal is to show that you are ready to return to work. They are agents of the insurance company and one of the defense professionals usually hired to do the insurance company’s dirty work.
What is that “dirty work.” The insurance company’s interest is to get you back to work as soon as possible. In Virginia, if you are not yet under an Award, and you get released to light duty— that means ANY light duty—even with a one lbs lifting restriction—then the insurance company does not have to pay you a penny, even if your employer does not accommodate your restrictions.
Employees should review with their worker’s compensation lawyer exactly what the nurse case manager can and cannot do. Nurse case managers do have the right to know about your appointments. They do have the right to go the doctor’s office or therapy office. They do have the right to obtain bills and reports from the health provider’s office. They do have the right to discuss your medical condition (including the diagnosis, necessary treatments, and prognosis) with the health professional. They can help you get transportation to the medical office.
They don’t have the right to be in the examination room with you the entire time, if you do not want them in there. At least some portion of your examination with your doctor should be private so you’re comfortable explaining exactly why you’re hurting. Your doctor should know you can’t lift objects or that it hurts when you move. You also have the right to be present when the nurse case manager discusses your case with the physician. The nurse case manager and the doctor are supposed to be there to help you – not bow to the insurance company’s desires. They do not have the right to “manage” your medical care by deciding where or with whom you will treat. Those decisions belong to the authorized treating physician.
For the most part, the nurse case manager’s access to your physician will be dependent on how open your physician is to dealing with the nurse case manager. Some are more open to allowing the NCM into the examination room, while others are less open to it. Our interpretation of the law is that their only obligation is to provide the records to the NCM. Beyond that, your physician is under no legal obligation to talk to the NCM. The issue is that many physicians realize that if they completely “shut out” the NCM, it is less likely that the physician is going to get any further referrals from the insurance company. In other words, it’s bad for business. Most patient advocate type physicians will walk a fine line of communicating with the NCM, but maintaining their own independent medical judgement, despite the pleas of the NCM to return you to work before you are ready.
Sometimes, the employer or your own lawyer will request an independent medical examination (IME). An IME is a physical and oral examination of your current health condition. It is performed by a physician who is not one of your treating doctors. In North Carolina, you are entitled to an IME with a physician of your choice respect to your permanent impairment rating if you do not like your treating physician’s opinion in that regard, at the defendant’s expense. In North Carolina, you are also entitled to an IME at the defendant’s expense for general issues as well; however, there must either be an agreement by both sides as to who will perform the general IME, or the Industrial Commission will have to order who will perform the IME via a motion filed by the attorney.
In Virginia, you have no right to obtain an IME at the defendant’s expense; however, you are entitled to see any doctor you like at any time at your own expense. In North Carolina, it is not advisable to do this, as the IC will generally ignore unauthorized examinations and opinions.
On the other side, the employer’s insurance company also has the right to request an IME at any time in both Virginia and North Carolina. The defense may request an IME to try to show you are ready to go back to work, or when there is a question as to whether a procedure or surgery recommended by your physician is medically necessary. The doctor is hired by the employer’s insurance company which means he/she is not your friend. The employer physician normally only sees you one time at the IME. He or she will take an oral history and then conduct the physical exam.
You and your lawyer have the right to challenge any report the IME doctor makes that suggests you can return to work or that you can go back to work with some restrictions. Your lawyer will normally seek to have one of your own doctors review the IME doctor’s report – and explain where the report is not accurate. Your treating doctors can show what the IME doctor misses because he/she only sees you one time and why any conclusions about your ability to work are not true.
Some workers can’t return to the type of job they did before their accident. For example, construction workers who needed to be able to lift 50-100 pounds or more to do their job may now not be able to lift much more than a few pounds. Going back to work with restrictions may not be an option – either because there are no suitable restrictions (you just can’t do physical labor any more) or because the employer doesn’t have a job that matches your abilities.
Since you can’t do the job you’ve been trained for, you may be eligible to be retrained to do a new type of job. The new job is often more clerical and administrative if you were a physical laborer. Your North Carolina or Virginia work injury lawyer should then explain that you may be eligible to go back to school or to attend a training program so that you can be qualified to do more work.
That being said, the process of vocational rehabilitation, unless it is a simple payment for school tuition (rarely the case), is generally not what it sounds like. In our experience, it is generally an unpleasant and difficult process designed to strip you of your benefits. It is generally not designed to find you suitable employment but trip you up and find you out of compliance and hence no longer entitled to your workers comp benefits.
While engaged in vocational rehabilitation, you still have the right to be paid your compensation checks (generally 2/3rds of your average weekly wages) and treat with you doctors. The insurance company is supposed to pay for your tuition or course costs, your books and training materials in connection with any vocational rehabilitation, but in our experience, they will typically take the cheapest road and enroll you in free courses if any re-training is required. If you need help getting to the course programs or school, vocational rehabilitation is supposed to either help or reimburse you for your transportation costs as well.
This is someone who is trained to say what type of work a person can and can’t do based on the worker’s education, past job experience, current skills, and current physical and emotional abilities. Employers sometimes employ a vocational professional to say that – while you can’t do your current job – you should be able to find suitable work in the area where you live. These professionals usually review Department of Labor standards and other guidelines to help make their determination.
They will typically start with an initial session which goes through your entire work history to determine your current transferrable skills. They will also review any FCE’s and your doctor’s records to determine your current work restrictions. After that, the vocational rehab professional will often meet with you on a weekly basis to provide job leads for you to apply to. These job leads are supposed to be pre-screened, meaning they job must be within your physical restrictions, within your skills, and also at least some significant portion of your pre-injury wages. In other words, if you were earning $1500.00 per week pre-injury, having you apply for a minimum wage job would not be suitable employment.
Experienced work injury lawyers understand how to question vocational professionals. They also understand that most of the time, their job is not to find you suitable employment, but to trip you up so that you are stripped of your workers compensation benefits. They work to make sure the vocational rehabilitation counselor follows the rules and guidelines which govern what they can and cannot do. In some cases, they may consult with another vocational professional who has a different opinion about the work you can and cannot do.
Attorney Joe Miller Esq. has been a strong advocate for injured and ill workers for more than 30 years. He’s helped thousands of North Carolina and Virginia employees get just recoveries when they’re hurt on the job or suffer an occupational illness. To speak with a lawyer who fights for injured workers, please call 1-(888) 667-8295 or fill out my contact form.
Posted on Friday, January 4th, 2019 at 12:41 pm
Some more answers to commonly asked questions when workers are injured in North Carolina or Virginia include the following:
The maximum insofar as the weekly checks are concerned is generally up to 500 weeks, but other than the most severely injured workers, most will stop receiving benefits long before the end of the 500 weeks.
When a worker reaches maximum medical improvement, then an analysis is made of the worker’s physical health. Maximum medical improvement is the time when additional medical treatment isn’t expected to improve the worker’s health or physical capacities any further.
During the analysis, referred to as a Functional Capacity Exam (FCE) a judgment will be made whether the worker has a permanent disability of any kind such as hearing loss or the loss of a body part and whether the worker is suffering from permanent physical restrictions. If a worker has a partial permanent disability, the worker may be entitled to additional wage loss benefits, even if he or she is able to return to work.
Workers can receive medical benefits for as long as they need medical help. Even if they have reached maximum medical improvement, they can still treat with doctors so their health doesn’t get any worse. Many injured workers who hurt their back, for example, may benefit from continual physical therapy or pain management.
Workers may be entitled to a pension, to social security, or to a personal injury accident settlement or award. If you are undergoing ongoing treatment and disability, you should NEVER settle your personal injury case before your workers compensation claim is fully settled and resolved. Doing so will essentially end your workers compensation case because of very harsh setoff rules.
Insofar as Social Security Disability, there are sometimes when it is advisable to make a claim, such as when your comp claim is denied and it may take a long time to get you money. In either event, a workers compensation attorney who knows what he or she is doing can make sure you’re your settlement will only minimally effect your rights to file and still obtain Social Security Disability benefits. Your North Carolina or Virginia worker’s compensation benefits lawyer can explain if any of these benefits affect your worker’s compensation case.
Generally, worker’s compensation benefits are not taxable. If you receive Social Security disability insurance (SSDI) or Supplemental Security Income (SSI) or Social Security Disability (SSDI) and worker’s compensation, then some tax issues may arise depending on the amount of the combined income.
The main requirement is that the accident occur during the scope of your employment. This can be complicated sometimes. If you are commuting to work, you may not be eligible unless you were doing a work chore for the employer or you are picked up by a supervisor and transported to the job site. If you are a sales representative, then it’s pretty much a given that you won’t be at the company site during work hours and you would still be covered. You are generally covered if you are on the employer’s premises, even if you take a brief break from work and your employer agrees to such breaks. There are many just reasons for a worker to be away from the main job site and still be considered working on the job, such as being sent on an errand for the employer.
Generally, work injury disability falls in the following categories:
The other circumstance where ratings are important is if a worker has a rating to two or more ratable body parts. That could qualify the injured worker for permanent and total disability.
Yes. While employees can file their own claim, there are many reasons why it’s wise to hire an experienced North Carolina or Virginia work injury lawyer. Skilled work injury lawyers help with following:
Experienced attorneys guide you through each stage of the litigation process. They also explain when you can make a long-term settlement and what the terms of that settlement should be.
Experienced work injury lawyers understand how to question and cross-examine witnesses.
In most cases, a skilled worker’s compensation helps the client get a just recovery – one that is much better and stronger than the recovery the client would obtain on his or her own.
The injured worker and the employer both have the right to certain types of information in order to prepare their case for trial. The lawyers for each side can request:
Attorney Joe Miller Esq. has the experienced and resources to help injured workers get justice. He anticipates many of the arguments insurance adjustors and defense lawyers make. He’ll fight to help you get the wage loss benefits, medical bill payments, and other benefits you deserve. To make an appointment or have your claim evaluated in our 7-step elite and easy case evaluation process, please call 1-(888) 667-8295 or fill out my contact form.
Posted on Wednesday, December 26th, 2018 at 9:21 am
Injured workers have many questions about whether they can file a claim, how to file a claim, and what benefits they’re entitled to. Claimants worry about which doctors they can treat with. They wonder what actions the employer’s insurance company can take to force the worker back to work or to terminate his/her benefits.
For the best advice, make an appointment with an experienced North Carolina or Virginia work injury lawyer. Here are some of the many questions workers often ask and some of the answers to those questions:
Decades ago, the states agreed to a compromise in how work accident claims are handled. Injured workers used to have to prove the employer was at fault – that they caused the worker’s injuries. If a worker could prove fault, the worker would be entitled to lost wages, medical bills, and pain and suffering damages.
The compromise method helps workers get compensation quicker and helps employers avoid large jury awards. The compromise is that workers don’t have to prove the accident was the employer’s fault. They just have to show an accident happened at work. In return for waiving the liability duty, employees only get about 2/3rds of their wages instead of 100%. They also can’t make a claim for pain and suffering against the employer. Workers are entitled to have the costs for all their medical bills covered as a result of the accident—for life. This includes surgeries, doctor visits, long-term therapy, and other types of medical services. It also includes the cost of medications and any prescribed medical equipment. Workers may also be entitled to vocational retraining benefits if they can’t work at their prior job.
Generally, workers should notify their employer or a supervisor as soon as possible – verbally and in writing. In North Carolina and Virginia, workers are required to provide written notice within 30 days of the accident. This is usually done in the form of an Accident report.
Yes. North Carolina and Virginia both have a statute of limitations for when claims can be filed. You generally have two years to file your claim from the date of the accident. DO NOT BELIEVE your employer if they say they have “filed everything for you.” There is NO SUCH THING. Only YOU or your workers compensation attorney can file the appropriate paperwork to insure your rights are protected. If you were hurt at work, you should make the call to a work injury lawyer as soon as possible.
Workers aren’t entitled to compensation for the first seven (days) unless their disability is more than 21 days. If the worker is out of work for less than three weeks, then the worker isn’t entitled to lost wages for those first seven days.
As a general rule, the worker must be an employee – not an independent contractor. Some exceptions may apply. Often, an experienced work injury lawyer will fight to show that someone who the employer labeled as an independent contractor is really an employee. Whether someone is an employee or independent contractor basically depends on how much control the employer had over their worker’s job duties. Signs of control include saying when and where the worker must work, how the worker is paid, what tools the worker uses, and other factors. Some employers think they can get around this by having the employee sign some silly agreement that says the worker understands that he or she is an independent contractor and not an employee. Those agreements are WORTHLESS. The Commission will look at the facts on the ground. The employer cannot “contract away” their obligations under the law.
In general, workers are entitled to 2/3rds of their average weekly wages as long as he or she can demonstrate disability from work. The average weekly wage is determined by the worker’s salary in the 52 weeks prior to the time of the accident. Workers are entitled to the 2/3rds benefits up to the time they return to work. They may also be entitled to additional wage loss benefits if they have a permanent partial disability to a ratable body part. North Carolina and Virginia both generally limit the maximum number of weeks obtainable in comp payments to 500 weeks. The exception is if one can show permanent and total disability or in North Carolina, an entitlement to extended compensation. Then one could be entitled to lifetime compensation benefits.
No. Worker’s compensation lawyers, if they decide to take your case, are paid their attorney’s fees on a continency fee basis. This means they are paid only if your claim is successful. On successful claims, they are paid a percentage of the worker’s compensation award. If the case is not successful, then you don’t owe the lawyer for his/her time. Occasionally, on successful claims, there may be applications for small fees that come out of ongoing checks even before settlement, but these are small amounts of money, usually in the hundreds of dollars.
Most North Carolina and Virginia employers are required to have worker’s compensation for their workers. Alternatively, they may be allowed to self-insure – to pay any award from the company funds if they meet certain requirements. In order to be required to have comp insurance, there must be a minimum of three employees routinely engaged and required to perform the employer’s business.
Typically, injured workers in Virginia will be given a list or panel of 3 doctors to choose from– from their employer’s panel of doctors. This applies to general physicians, pain management doctors, orthopedists, and many other types of doctors. In North Carolina, the law is more strict. An employer and insurance carrier get to choose who the authorized doctor will be.
In Virginia, if a worker is dissatisfied with the workers compensation doctor, one can always see whomever they wish and pay out-of-pocket; however, only authorized treating physicians are required to be paid by the workers compensation insurance carrier. In North Carolina, it is not advisable to seek one’s own doctor unless the Industrial Commission approves that choice. Unapproved doctors in North Carolina are generally ignored by the Commission and will not help your case.
An experienced North Carolina and Virginia lawyer will explain when you can switch doctors. He’ll work to get approval from the NC Industrial Commission or Virginia Workers Compensation Commission.
Generally, yes but there are exceptions. As long as the injury wasn’t deliberate such as if you started a fight, and as long as you did not willfully violate a safety rule or you were not willfully intoxicated, workers are entitled to work injury benefits even if they were careless or sloppy.
In North Carolina, violation of a safety rule merely works to diminish recovery of benefits by 10%, whereas in Virginia it can operate to completely prevent a claim.
Workers often trip over objects, slip and fall, drop merchandise, or make other mistakes that can hurt themselves. Worker’s compensation will still pay benefits for this type of accident.
At the Virginia Law and North Carolina Firm of Joe Miller Law, we’ve helped thousands of injured workers get just recoveries. We’ve been helping injured workers for more than 30 years. To speak with a tough advocate, please call 1-(888) 667-8295 or complete my contact form to schedule an appointment.
Posted on Monday, December 10th, 2018 at 9:27 am
This is the second part of a summary of common medical acronyms and terms. These definitions apply to many aspects of an employee’s workers compensation case:
Don’t wait. Call the North Carolina and Virginia Law office of Joe Miller Esq., today. We have the experience and resources to help you get justice. You may have a large recovery coming your way. help now, phone 1-(888) 667-8295 or complete my contact form to discuss you work injury claim.
Posted on Friday, November 30th, 2018 at 11:21 am
North Carolina and Virginia use a lot of confusing terms in worker’s compensation cases. An experienced work injury term understands these definitions. He knows how they affect your claims for lost income, payment of medical bills, and other aspects of your case. A few of the more common worker’s compensation terms are these:
At the North Carolina and Virginia Law office of Joe Miller Esq., we answer your questions and guide you through each phase of your work injury case. We’ve been fighting for injured workers more than 30 years. To speak with a strong advocate, call 1-(888) 667-8295 or complete my contact form to schedule an appointment.
Posted on Thursday, November 1st, 2018 at 3:06 pm
Anyone injured in a workplace accident or who becomes ill due to an occupational illness has the right to request that the employer pay workers’ compensation benefits. There is no requirement that the employee prove fault. Injured workers must report their injury to their employer or a supervisor.
Once the injury is reported (sometimes after emergency medical care is obtained), the worker can seek medical help. Virginia and North Carolina workers’ compensation will normally pay for all your medical bills.
Worker’s compensation should pay all your medical bills to get better and to stay better. That includes:
The time you need to spend with chiropractors is generally covered too, within limits.
In Virginia, unless you have already established a course of care with someone, you are able to choose from a list of 3 doctors (called a “panel”) provided by your employer. This applies for each type of specialist and care. If the doctors aren’t helping you or your employer doesn’t work with the medical providers you need, an experienced work injury lawyer may be able to help get authorization to see doctors of your own choosing.
In North Carolina, there is unfortunately no provision for a panel of three doctors. You must usually go to whomever you are directed by the workers comp insurance company; however, unlike Virginia, there are other provisions for a second opinion in the event you disagree with the findings of your authorized treating doctor.
If you need prosthetics, a wheelchair, braces, or other medical equipment; the cost of those devices is normally covered, too. Additionally, workers’ compensation should cover all your prescriptions and medications too.
In some cases, workers need to be retrained because they’ll never be able to return to the type of work they did before the accident or illness. Skilled work injury lawyers help you get the funds you need to be to be retrained or reeducated if you need vocational help.
Employees, in general, are entitled to a percentage (66 and 2/3rds, or .66667) of their average weekly wages while they can’t work. The percentage is a compromise that ensures workers get a good part of their pay. Workers don’t get 100% because the compromise in the law that was agreed upon long ago was and is that the worker doesn’t have to prove the employer was at fault for the accident. There are some limitations such as that there is a one week waiting period and there is a maximum rate on how much a worker can be paid for work injuries. There is also a minimum amount, if your wage exceeds the minimum amount.
There are several different types of disability payments depending on the severity and the type of injury or illness:
Most workers receive temporary total disability. Their medical bills are covered for life as long as it can be proven that the treatment is related to the work injury, and reasonable and necessary to treat the condition.
It bears noting a very important difference between North Carolina and Virginia in this regard. In NC, the highest ratable body part for impairment is the back, which really includes the entire spine, even the neck. That comes in at up to 300 weeks.
In Virginia, not only is the back on the highest ratable body part, it is not considered a ratable body part at all. In other words, in Virginia, a back or neck injury is not eligible for an impairment rating at all. The spine is not a ratable body part.
Tragically, some workers die due to falls, explosions and other causes. As a general rule, states like North Carolina and Virginia pay a significant part of the funeral and burial costs. Additionally, spouses and dependents normally entitled to a percentage of their loved one’s average weekly wages up to 500 weeks. It may be possible to obtain a lump sum payment. An experienced workers’ compensation lawyer can explain if stepchildren, adopted children, and other dependents, parents, and other relatives may qualify.
Contact a respected Virginia or North Carolina workers’ compensation attorney immediately
Delay can absolutely hurt your case. We have had to turn down many, many cases simply because the caller waited too long to contact a lawyer. At the North Carolina and Virginia Law office of Joe Miller Esq., we have the experience and resources to help you get justice for your work injuries or occupational illness. We’ll fight to get you ever dollar you deserve. For help now, call 1-(888) 667-8295 or complete my contact form. He’s been fighting for injured workers for more than 30 years.
Posted on Friday, October 26th, 2018 at 4:44 pm
The title sounds good. A nice nurse case manager (NCM) will help you communicate with your doctors. They’ll help you get to your appointments and look out for your best interests. But don’t be fooled. The nurse case manager is hired by the employer’s insurance company to help you return to work – often before you’re really ready.
Nurse case managers help set up appointments with your doctors, psychologists, and therapists. They keep notes on your appointments and progress including if you missed or were late for appointments. They meet with your doctors, sometimes while you are meeting with your doctor, other times after ou have left the appointment.
Nurse case managers report back to the insurance company. They are really the “eyes and ears” of the insurance company insofar as your medical treatment is concerned and is part of what I call the trinity of “defense professionals” that are typically employed to try and derail your case. If the insurer thinks that you aren’t following your doctor’s treatment plan for you, they can seek to terminate your rights to both wage loss benefits and payments for medical treatments.
That being said, we have found that that “good” nurse case managers are a rare occurrence. Usually, spurred on by the insurance company, the nurse case manager’s aim is to encourage your doctor to release you to return to work. While employees generally do want to return to work where they can get full pay, enjoy doing a job well, and enjoy the companionship of workers – employees should know they have the right to return to work when they’re healthy and not before.
A nurse case manager means that you will lose some privacy over the way you handle your recovery. For many workers, the pain and anxiety of the recovery process can be unbearable. It’s not comfortable for many workers to have to share intimate and personal information with anyone who is not fighting for them 100 %. Many people are afraid to admit how much they really hurt. With their health providers, they should be more open – but with a nurse case manager, they may not fully say all their complaints – which can hurt their case.
Nurse case managers are informed of your medical history, your disability, what caused the accident, the work restrictions you have, and other personal sensitive information.
Losing your privacy pales in comparison to some of the other things nurses can do to directly affect your benefits.
Employees should always speak with an experienced work injury lawyer as soon as a nurse case manager asks to be involved in your claim. The attorney will explain what the nurse case manager can and can’t do. The attorney will explain that the nurse case manager does NOT have the right to be in the examining room with you the entire time and that you have the right to speak with your physician in private, so you don’t hesitate to say everything that’s wrong with you.
Even if the nurse case manager can directly help, for example – help you move because you’re not mobile due to leg or feet injuries – once you are in the doctor’s examining room, you have the right to ask the nurse case manager to sit in the waiting room, assuming the doctor is agreeable.
Many workers have significant injuries that cause additional problems that are not obviously related to the original injury. For instance, workers with severe spinal injuries may be embarrassed to admit in front of the nurse case manager that they are experiencing incontinence or erectile dysfunction—and the worker may not realize that these issues are directly related to their spinal injuries. The physician needs to understand all your physical pains, issues, and emotional anxieties to treat you properly.
In addition, some workers hate to admit they can’t do their job. They may try to do more than they can to get back to work. Doctors need to conduct a full examination to understand if you can do your prior job. They need to conduct tests to analyze what restrictions (such as not lifting more than 20 pounds) are required. When the nurse case manager is out of the room, the doctor and the patient won’t feel rushed or pressured. They can review each job task that you must do to work.
You have the right to be present when the doctor or health provider and the nurse case manager review your case. The nurse case manager is supposed to be working for you, even though in fact, she is an agent of the insurance company. You have the right to know what is being discussed about your case. If a nurse case manager violates this right, you should inform your lawyer.
You also have the right to challenge any inappropriate activity the nurse case manager engages in. Despite her name, the nurse case manager MAY NOT manage your medical care. That is the job of your treating physician. For instance, your nurse case manager does not get to decide what kind of treatments you need and where they may take place. An NCM’s attempt to divert you to another facility for additional testing or away from a specific specialist recommended by your doctor is not allowed. Her refrain that such a facility or specialist is “not in our network” holds no weight with the Commission. If your treating doctor recommends a certain facility or specialist, then that is where you are to go and the NCM has no right to interfere.
If such attempts to manage your care become an issue, your lawyer may request that the NCM be removed from your case and another nurse case manager be assigned to your case.
Attorney Joe Miller has been a strong advocate for North Carolina and Virginia workers for more than 30 years. He’s helped thousands of injured workers get a just recovery. He’ll guide you through every stop of the workers’ compensation process including dealing with a nurse case manager. To make a free appointment, please call 1-(888) 667-8295 or complete my contact form.
Posted on Tuesday, October 2nd, 2018 at 4:49 pm
Police officers, firefighters, and providers of emergency medical services deserve more than just our thanks and respect. They deserve to be honored for the extremely hard jobs and often dangerous work they do. One way to honor them is to pay them the workers’ compensation benefits they deserve when they are unable to perform their jobs due to workplace injuries or occupational illnesses.
Many public servants work long hours, sometimes in the middle of the night. Injuries are a natural part of all three types of public service jobs.
Injuries and illnesses that firefighters, police officers, and EMS workers often need medical care and time off from work for
Public servants who exert themselves physically and emotionally and who work with people in distress can easily suffer an accident or attack that leads to one or more of the following injuries/illnesses:
Other typical injuries that cause a public servant to need to file for workers’ compensation include:
Firefighters, police officers, and EMS workers are very prone to develop stress-related disorders and diseases. For this reason, injured public servants should feel confident that these medical conditions will be taken seriously by the North Carolina Industrial Commission or Virginia Workers Compensation Commission.
Get help for your work injury claim today
Joe Miller Esq. has been helping public servants and all types of workers for more than 30 years. At the Work Injury Center, he represents work injury victims in both North Carolina and Virginia. He’s helped thousands of workers get economic justice. To speak with an experienced, caring workers’ compensation lawyer, please call (888) 694-1671 or fill out my contact form.