What You Need To Know About Workers Compensation

Posted on February 15,2016 by lawrzwp

These are some helpful suggestions for you to bear in mind when you are seeking to recover money for a personal injury you have suffered:

How to Communicate Your Case

You should not talk with anyone about the status of your case (excluding us, your Lawyers) The reason for this is simple- like water leaking from a jug, it is easier to control the flow of information from one location than multiple locations. Also, it ensures that the time-line and historical account of your claim are always maintained, consistent and accurate. Minor discrepancies and inconsistencies always tend to arise where information is “leaking” from various sources. Usually, these discrepancies are minor, but as the discrepancies build, they can tend to create an apparent of confusion and contradiction which, a crafty defense attorney can exploit to your disadvantage. Why create issues when your primary goal is securing the compensation you so rightly deserve.

As your attorneys, we will tell you when to release information, and what issues are important and what are not. Remember, just as water leaks out of a jug, it is best for information to be release in an orderly fashion so that everything can be marshaled, assessed and categorized. If information is allows to come out in a torrent, it only leads to confusion and apprehension which again, obscures your primary goal of securing just compensation.

You should not give any written or oral statements to anyone except your attorneys, who in turn will provide this information to the other party or their insurance company. Any requests for information of you should be made to your attorney, who will ascertain whether the request is legitimate and should be responded to in-kind.

Naturally, as you obtain treatment, your attorneys must be kept “in the loop” regarding you day-to-day progress towards recovery. But, equally important are your doctors, who from a medical standpoint, should always be kept informed regarding your health matters, including your history, complaints, treatment and progression towards recovery.

How to Handle Medical Payments before Your Case Is Settled

As you obtain medical treatment, you will be generating a host of changes for medical services. As has been mentioned before, as your attorneys, we would want you to discuss with us the various methods for securing payment of your bills. A consistent strategy should be employed to make sure all your bills get paid so that you do not suffer out-of-pocket exposure and resultant financial hardship. Remember, as you are treating, your medical providers want to be paid. They do not want to wait until the day finally arrives when your claim is finally settled, since that may not occur for some lengthy time period in the future.

You May Be Watched and Photographed

While it is not common, some insurance companies like to conduct a clandestine investigation of an injured person’s background. They may obtain videotapes of you engaged in various activities of daily living, such as leaving your home to go grocery shopping, gardening/lawn cutting activities or other activities. While this is a significant intrusion into your right of privacy, when you are attempting to secure money out of an insurance company, these efforts are justified where they find you engaged in activities which are inconstant with your apparent allegations of impairment and disability. So, you should be cautious as you go about your daily activities and discuss the prospect of surveillance with your attorney. If you encounter surveillance, you should act naturally and contact us to discuss the implications of this type of activity.
Subrogation and Medical Liens You Need To Understand

After you’ve been involved in an accident or injury, you will learn that, while you may have your own automobile and health insurance benefits available to you to cover your bills, in the event you make a cash settlement with the party that caused your injuries, most of these companies are entitled to be repaid. This right is called “subrogation”, and while the historical development of this right is one of significant controversy, it is a matter which must be dealt with directly when you are attempting to secure a settlement from the at fault parties insurance company. Subrogation means, that your auto insurance and health insurance company “stands in your shoes” and can recover directly from the at fault parties insurance company moneys which they have paid on your behalf.

This is a very important consideration since the pot of money from which you are seeking recovery is generally limited to the amount of insurance the at fault party maintained at the time of the accident. Where there are multiple claims against this single pot of money, the prospects for your overall recovery are reduced substantially. Therefore, it is imperative that you coordinate your settlement efforts to take into consideration all subrogation rights so that your entitled can be secured.

Finally, sometimes an injured person cannot secure payment of their medical providers billings while their claim is pending due to their own failure to maintain automobile insurance or health care insurance. In these circumstances, many doctors refuse to provide a continuation of treatment since they believe that securing payment for their medical services is impaired. However, many doctors are willing to continue providing you with treatment, provided you make a separate promise to pay them at the conclusion of your claim. This can be done on a separate, contractual promise from you to the doctor which is acknowledged, in writing, by your attorney. Another name for this document is a “Letter of Protection or Lien Letter”. Medical providers may file this “Lien Letter” with the at fault party’s insurance company which will make it a prominent issue at the time when settlement discussions commence.
Uninsured or Underinsured Drivers Need To Read This

If the party which caused your accident was uninsured, in Ohio, you may pursue a claim for uninsured motorist benefits. This assumes that you maintained this type of coverage with your own insurance company. Basically, when you have a claim for uninsured motorist benefits, your own insurance company is called upon to pay you for the damages which were created by the at-fault party. As such, your own insurance company takes the posture that you are an adversary seeking to deplete their accumulated wealth, and as such, they will fight you accordingly. It makes no difference to them that you are their “customer”, or that you have been their customer for many years and have never filed a claim. You are now viewed as a liability which cuts into their profit margins and every effort will be made to minimize and reduce your claim so that your insurance carrier’s profits are enhanced. Also, where the at fault party maintains insurance coverage, but your damages are so substantial that the limits of their policy are exceeded, in some instances you can file a claim against your owner insurance company for something called “Underinsured Motorist Benefits”. Again, just like the claim for Uninsured Motorist Benefits, you are viewed as an adversary and you claim will likely be contested.

Filing a claim for Uninsured or Underinsured Motorist Benefits requires strict compliance with your insurance carrier’s terms of coverage, and you must bear in mind that your insurance company will employ any method to which they are contractually entitled to assert to minimize and reduce your claim. So, it is very important that you provide your attorney at your earliest opportunity a complete copy of your automobile insurance policy for their review and consideration.

The Facts About Medicare & Medicaid Assistance

Where you are a Medicare/Medicaid recipient, your medical bills for injury must be submitted to these agencies on a timely basis for payment. As I have mentioned to you earlier, it is important for you to understand that when you apply to have your medical bills paid by Medicare or Medicaid, these benefit programs create a Super Lien against your claim which much be acknowledged and addressed prior to final settlement. The failure to repay a Medicare or Medicaid lien can result in a loss of benefits, termination or revocation of coverage and liability for repayment from you, and the parties you released from liability. It is of great concern to everyone involved that Medicare and Medicaid interests are taken into full consideration at this time of final settlement.

A Time For Healing & Recovery

No two accidents are the same, regardless of whether the injuries and similar. Every insurance carrier has differences in coverage provisions and limits, and the ability to assert an injury claim takes into consideration so many factors as to defy short explanation. But, generally speaking, after taking into consideration the circumstances and complexity of your injury case, your various physical injuries and impairments, the degree of suffering and emotional hardship, medical expense, both in the past, present and future, and the apparent willingness of the opposing insurance company to act reasonably, the time to resolve your case can vary, but it is rarely fast. You should not expect an insurance company to settle your claim quickly, unless of course they are getting a bargain in the process.

Insurance companies routinely contact unrepresented injury victims and lavish them with money in order to make their claim go away within the first few days after an accident. To an insurance company, paying a little more in the beginning is justified if they can cut off an injured victim’s ability to secure payment from them for future medical treatment. Furthermore, insurance carriers know full-well that most of the time when they are making a payment within days of an accident that the injured person has their own health insurance coverage available and that after they settle the claim with the injured person, future medical bills will be submitted by the injured victim to their own health insurance company for payment, and since the injured victim has signed a “Full Release of Claims”, the injured person’s health insurance carrier has no right of subrogation since, as they stand in the shoes of their insured, the claim has been fully settled and released by the own customer.

It is a type of “Silent Fraud” which is not generally discussed in Boardrooms of the Automobile and Casualty Insurance Industry, and for reasons unknown is allowed to profligate by the Health Insurance Industry which insists on maintaining it’s right to claim for subrogation under circumstances where they have no control over the timing of their own insured’s execution of a “Full and Final Release” and the resultant termination of subrogation rights. The instances of Fraud permeating the field of subrogation rights is so massive as to be incalculable by any reasonable measure accounting.

Bear in mind, that your assertion of an injury claim is serious business when it calls upon someone else to lighten their own pocketbook to your benefit. As such, it will take time to meander forward so that all competitive interests are balanced. Your patience is a requirement, and although you may not understand why the delays seem to drag on, your attorney is working hard to promote your interests until that eventual day of recovery arrives. In our modern society, much of what an attorney does relates more to balancing the various competitive claims vying for priority of payment than real advocacy. Your attorney must beat down the demons which bite at your heals, while looking upward to the heavens for salvation, and as the ramparts part and the storm clouds clear, having someone in your corner shouting into their bullhorn to make way for your public entitlement to financial reparations is incredibly important and cannot be understated.