Medicare and workers' comp

Ok, you got a letter saying you have to appear for a “deposition” in your workers’ comp case.  What do you do?  Well, first of all, make sure you show up.  You can lose your case if you don’t cooperate.  Second, as I always say in my blog, “first seek a competent, experienced workers’ compensation lawyer.”   If you are unrepresented, the lawyer for the insurance carrier may take advantage of your inexperience and uncertainty about the situation. Though I can’t give specific legal advice in this blog, since I do not know your particular case, if you have been unable to get legal help, a few tips might help: Don’t lie Only answer the question you have been asked Don’t hide your medical history Dress nice for the deposition and look your questioner in the eyes Don’t let them get you mad You are not on trial at the deposition You have the right to read the transcript of the deposition for accuracy once it is transcribed by the court reporter. The statements contained herein are for general information purposes only and are not considered specific legal advice regarding your situation as Mr. Shoen would need to meet with you individually to ensure client confidentiality and would need additional information from you personally. This article does not create an attorney-client relationship. Please consult directly with an attorney for legal advice. To learn more about the Law Office of Darren Shoen, or to speak with Darren Shoen by phone or in-person consultation, visit his website at shoenlaw.com, or call 540-586-5003.

Do not just accept an insurance carrier’s denial of your claim because they say it is a “pre-existing condition.”  Even if you have a pre-existing injury or condition related to the same body part injured in a work accident, you may still be entitled to medical benefits related to the work accident.  For instance, say (hypothetically) you had a sore knee over the course of a few weeks/months and decide to see a physician.  Your physician says you have degenerative arthritis and advises you to do home stretching exercises.  A few days later, you slip on an oil slick at work and hear (and feel) a “pop” in your knee.  You are seen by a physician shortly after and are advised that you have suffered an exacerbation of your condition and are now unable to work, or can only work in a restricted capacity.  Assuming the slip/accident at work is arising out of your employment (compensable as a work accident), your exacerbated knee injury should be covered by your employer’s workers’ compensation carrier. Remember, the injured worker has the burden to prove they sustained a compensable injury by a preponderance of the evidence.    The injured worker must show four things: 1) an identifiable incident; 2) that occurred at some reasonably definite time; 3) an obvious sudden change or mechanical or structural change in the body; and 4) a causal connection between the incident and the bodily change.”  Assuming you show these elements, you should prevail if you challenge the comp carrier’s denial of your claim. As always, make sure you contact a competent, knowledgeable workers’ compensation lawyer to discuss your claim.  You have rights under the law, don’t be fooled by the workers’ comp carrier. The statements contained herein are for general information purposes only and are not considered specific legal advice regarding your situation as Mr. Shoen would need to meet with you individually to ensure client confidentiality and would need additional information from you personally. This article does not create an attorney-client relationship. Please consult directly with an attorney for legal advice. To learn more about the Law Office of Darren Shoen, or to speak with Darren Shoen by phone or in-person consultation, visit his website at shoenlaw.com, or call 540-586-5003.

Are you wondering if you can get a settlement for your work injury? This blog can help you understand the Virginia workers’ compensation settlement process & hopefully get a better idea of what you should do.   A “settlement” of your claim can mean different things.  Some workers mistakenly think that when they get payment towards permanent partial disability (PPD), they have settled their claim, and it is all over.  Not true.  If you have a lifetime medical award or are on a wage award, your claim is still open.   In other situations, the insurance adjuster and/or case nurse may say they have “closed their file” and lead the injured worker to believe there is nothing they can do, and their case is over.  This is WRONG!  If you have an Award Order from the Virginia Workers’ Compensation Commission, your case is likely open unless YOU have agreed to a full and final settlement which has closed your claim regardless of what the insurance carrier says.   A full and final settlement usually is a situation where you receive an agreed upon amount of money in exchange for closing out your workers’ compensation claim.  If it is a complete and full settlement of your medical award and wage award, your case is over after the settlement is final.  In this case, you would no longer be eligible for ongoing medical or wage benefits from the insurance carrier even if you had a “Lifetime Medical Award.”  However, even if the case is fully settled, the insurance carrier may still be responsible for medical bills incurred before the settlement, if they have not been paid before the settlement.   In some instances, just the “wage” part of the award is settled separately from a medical award.  In this case, the injured worker would still be eligible for related medical benefits and expenses related thereto.   Most injured workers do not know how much compensation they should get for settling their claim.  If they do not have an experienced, knowledgeable attorney helping them, they are at the mercy of the “good will” of the insurance carrier.  No matter how nice the insurance adjuster may seem, you can rest assured they are not looking out for the interests of the injured worker.  Their goal is to save money.   A fair settlement should consider the severity of the injury and future medical costs, the amount of wages the worker is eligible for and how long they might receive wage benefits, and other potential future costs for which the carrier might be responsible.  Unfortunately, injured workers are not entitled to money for “pain and suffering” as they might be in a personal injury case.  Personal injury settlements and workers’ compensation settlements are different and take into account different factors. The statements contained herein are for general information purposes only and are not considered specific legal advice regarding your situation as Mr. Shoen would need to meet with you individually to ensure client confidentiality and would need additional information from you personally. This article does not create an attorney-client relationship. Please consult directly with an attorney for legal advice. To learn more about the Law Office of Darren Shoen, or to speak with Darren Shoen by phone or in-person consultation, visit his website at shoenlaw.com, or call 540-586-5003.