Do Not Take All Workers Comp Internet Advice to Heart

The Internet Contains Unlimited Amount of Advice

 

You can find answers to most of your problems on the Internet these days.  From general medical issues, to building things, to current events, it is all out there for public opinion and consumption.

 

Everyone knows that not everything you see online is the honest to God truth.  But what about the reputable websites?  Shouldn’t those be taken more seriously than just random Google searches about whatever topic you are researching?

 

The answer to that question is possibly.  Recently I was looking for a plaintiff attorney I know, as I heard he had switched law firms and I wanted to say hello.  While navigating through this new firm’s website, I came across a workers compensation advice area, where the firm gives some pointers on what to do if you have a workers compensation claim.  I decided to take a look, and honestly the advice they were giving made me a bit uneasy.  Some of the pointers they discuss were fine, and some were a little questionable in my mind.

 

Below is the content of the webpage, word for word.  Underneath each topic, I decided to give my two cents as well. Remember, plaintiff law firms do not make money unless you take your case to them, and good firms will do anything to get you in the door.  Obviously that is how they remain in business and I would say business is booming these days given the state of the economy and the overall general fear that injured workers have when dealing with an insurance carrier or TPA. Take a look for yourself and you con formulate your own opinions:

 

 

 

Example of Advice from Plaintiff Attorney Website:

 

What Should You Not Do?

 

Just as important as what you should do, there are a number of things you should avoid doing, including:

 

·         Giving a recorded statement to an insurance company

 

Take this advice with a grain of salt.  Most adjusters will have to perform a recorded statement as part of their investigation on the claim.  But the reason is not to use it against you.  It is more for transcription purposes.  Adjusters cannot catch every single grain of detail, and to make sure they do not leave anything out they record the phone call with your permission.  The tape is then transcribed and placed into the claim notes.  That way, you the claimant can tell the story in your own words, without the adjuster paraphrasing or leaving out any information that could be pertinent to the compensability of the claim.  Some adjusters will not complete your injury statement without recording it, and if you refuse to allow it to be recorded, they may file a dispute on the claim, and your claim will not go forward.

 

·         Seeing an insurance company doctor before seeing one of our lawyers

 

This depends, you have to get treatment if you are injured, and if you have to go to the occupational clinic, these doctors do not work for the insurance company.  IME doctors as well do not work for the insurance company.  A lot of claimants think the occupational doctor or an IME doctor work for the carrier, and receive monetary bonuses for denying claims, and nothing could be further from the truth. So proceed with caution if you heed this advice.  The longer you wait to get treatment, the less credible your injury could be perceived.  

 

·         Releasing your records

 

Your adjuster cannot do anything without medical records.  HIPPA laws require a signed release in order for a carrier to obtain your medical chart. If you refrain from signing this release, medical records cannot be sent, and your claim will stall out.

 

·         Signing off on your injuries without being compensated

 

I don’t think anyone should sign legal paperwork ending their claim unless they are comfortable with the results.  A medical release is not a signed document that can end your claim, so do not confuse a medical release with a legal redemption waiver meaning you can no longer pursue your employer or the carrier for benefits.

 

 

 

Summary

 

Beware of the advice you find on the internet when it comes to insurance issues.  Even from what seems like a credible website, the advice contained within sometimes does not have your best interests in mind.  Do your research, and consult legal advice if that is what you feel like doing.  But in the end the decision is yours, and you have to weigh the pros and cons for each decision you make in regards to your work comp claim.

 

 
Author Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 


Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional about workers comp issues.

Workers Comp Insurance Idiots

The above title refers, according to a Google search, to a common phrase used by persons complaining about the handling of their claims.

 

Let’s put that to a test.

 

One person, several years ago, reported that she had successfully returned to work a year before. A favorable outcome? Not really, according to the worker.

 

The return to work, it was related, was not due to the wishes of the worker, nor the advice of her doctor. Instead, it was caused by “the work comp insurance idiots”.

 

The complaining worker went on to say that she was “glad to be back to work”. (After a year’s absence)

 

What sense can we possibly make of this? All the goals of the work comp system have been met by “idiots”. Was there any statement of gratitude by the worker? No, but she was glad to be back to work.

 

The person was apparently single. It would be interesting to hear what a spouse might have said about the “work comp idiots”.

 

The lesson seems to be that subconsciously the workers have adopted the negligence claim paradigm. The best outcome for disability is a large settlement figure, followed by a near miraculous cure shortly after the check clears.

 

But the worker above coped with the mishandling of her disability claim, even to the point of being “glad to be back to work”.

 

Everyone in the comp process knows that they too are one of the “idiots”, especially the workers’ lawyers who, perhaps not surprisingly, get the brunt of most of these comments. Notice, no one in the above received credit. Why should the worker thank the treating doctor and her lawyer for failing to stand up to the other “idiots”?

 

From one idiot to another, let us all push on and do our best to produce such failures.

 

 
 

Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100. medsearch7@optonline.net

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.


Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional about workers comp issues.

Picking the Wrong Workers Comp Doctor Can Be a Big Mistake for Employers

The wrong doctor treating the employee for a workers compensation injury is one of the biggest mistakes an employer can make.  It is a very fast way to incur higher than necessary medical expenses and higher than necessary indemnity cost.  The proper selection of the medical provider is crucial to the overall outcome and cost of the workers compensation claim.

 
While most employers are blissfully unaware of the importance of the medical provider selection, it is a fact very well known by the plaintiff’s bar association.  When the concept of workers compensation was being adopted by the states nearly a hundred years ago, the employer always provided the medical provider.  Over the years in approximately half of the states, the plaintiff’s bar has wrestled control of the medical provider selection away from employers and put it in the hands of the employee (who normally allows the attorney to make the medical provider selection). (WCxKit)
 
 
Why is the selection of the medical provider is important to the plaintiff’s bar association? The answer is simple:  money.  The television attorney holding a fistful of money while soliciting the injured employee got most of that money by controlling the selection of the medical provider.
 
 
The plaintiff attorney representing the employee works for a percentage of the indemnity benefits paid to the employee.  The more indemnity benefits paid to the employee, the more money the employee’s attorney makes.  Hence it is in the best interest of the employee’s attorney to keep the employee off work as long as possible and for the employee to get the highest possible disability rating (regardless of whether or not it is accurate). 
 
 
The large majority of medical providers are honest in the assessment of the employee’s ability to return to work light duty or full duty and are honest in the assessment of the employee’s permanent partial disability rating.  Some of the doctors in this large majority are more liberal and some are more conservative, but even within those parameters they remain honest.
 
 
Unfortunately, there is a small minority of doctors, concentrating primarily in the chiropractic field and the orthopedic field, that sold off souls to the plaintiff’s bar. Whether it is by collusion with the plaintiff attorney or a silent agreement, the plaintiff attorney sends as many of his clients as possible to the “doctor” who in return keeps the employee off of work as long as possible.  The employee remains off work until the employee wants to go back to work, or the doctor can no longer justify keeping him off work.  The doctor then consults the disability rating guide used in that state, and gives the employee the highest possible disability rating out of the possible range of disability ratings. 
 
 
This is a win-win situation for the attorney and the doctor.  The doctor increases the attorney’s income, and the attorney increases the doctor’s income.  The employer loses.  The higher the amount paid to the employee in temporary total disability and permanent partial disability, the higher the eventual workers comp insurance premium will be for the employer.
 
 
What should the self-insured employer or insurance company do?  The employer cannot conspire with a doctor to put the employee back to work before he is physically able to return to work and will not conspire with a doctor to falsify the disability rating.  The answer is to consult with the workers compensation defense attorneys in the area where the employer is located.  The defense counsels who have had extensive experience dealing with the various doctors in the areas can advise who are conservative, moderate or liberal in disability ratings.  They can tell you which doctors get the employees back to work timely.  They can also warn of doctors who work solely for the plaintiff’s bar.
 
 
We would recommend consulting with defense counsel and learn the precise requirements of the state. In some states, the employer only has to post one medical provider, while in other states the employer must post a list of medical providers (also referred to as a panel in some states). The list of medical providers should include both general practice doctors for the minor injuries, the orthopedic specialists, the emergency care facility and/or hospital and, any other specialties required by the state.
 
 
Not only should the employer ask defense counsel what the posting requirements are for the particular state but should also ask the names of conservative, reputable doctors.  Employers need doctors who will provide the employee with all necessary medical care, but will also work to get the employee back to work on modified duty or full duty as soon as practical. Also doctors who will give the employee a fair, objective disability rating, if one is needed, are ideal.
 
 
Occasionally there will be a plaintiff attorney who will ignore the employer’s posted list of doctors and send the employee to a favorite doctor.  The claims adjuster should immediately object and advise the attorney that any medical care the employee receives at the non-approved doctor will be at the employee’s own expense, plus if the employee does not attend the medical appointments with the employer selected doctor, the indemnity benefits will be suspended. WCxKit
 
 
In the states where the employee has the right to select the medical provider, we suggest for the employer to post the “recommended” (not required) doctors suggested by defense counsel.  While this will not stop the plaintiff attorneys from sending the injured employee to their favorite doctor, it will eliminate some of the claims that end up in the hands of plaintiff attorneys as the employee will be receiving the medical care they need timely.

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com. Contact: RShafer@ReduceYourWorkersComp.com.
 

 
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
 
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact

Using Social Media to Fight Workers Compensation Fraud

Check with an attorney if you question whether or not you are invading an employee’s privacy. The courts have consistently ruled employees in workers comp cases do not have a reasonable expectation of privacy when using social networking sites. Be aware, case law on the use of social media information to disprove fraudulent workers comp claims is still developing. The general direction of the law is any information the employee makes public can be used as evidence in the workers comp claim.
 
 
The use of social media to fight workers comp fraud is beginning to catch on when plaintiff attorney's start warning clients about social networking sites like Facebook, Twitter, LinkedIn, and MySpace. (WCxKit)
 
 
Nothing sinks a workers comp claim faster, from the plaintiff attorney's standpoint, than the picture of the employee rock climbing, while too injured to perform light duty work. It is amusing to think the employee actually posts these pictures on his (or her) Facebook page. Not so amusing to the plaintiff attorney is the date stamp on the picture.
 
 
When the employer questions the validity of the employee’s workers compensation claim a private investigator may be hired to check out the employee's personal blog, Twitter account, Facebook, My Space, Flickr (photo sharing) or LinkedIn pages. Or, the employer can do it pretty much for free with a little time and effort because the Internet has a wealth of information – yes, on just about everyone, even your employee.  Many investigators perform virtual searches in addition to in-the-field searches, a new way to investigate in the last 25 years, and there are investigative services that specialize in virtual investigations.
 
 
The employee, presenting a fraudulent workers comp claim, is usually motivated by greed but does not think a little thing like insurance fraud should interrupt his (or her) personal world. Some don't see it as a big deal. The employee continues to live the lifestyle he has been living, including posting non-work related activities, whether it is mountain biking or reading the latest New York Times bestseller. When the employee posts the pictures of his iron man triathlon, (occurring while his back hurts so much rising from bed is nearly impossible), most doctors when presented with such evidence release the employee back to work. The plaintiff attorney, of course, argues the employee was “having a good day” when he participated in the iron man triathlon.
 
 
In addition to searching social networking sites, search by the employee's name on Google, Yahoo, or Bing. If the name is a common one, add street, city, and state to reduce the number of search returns. If an employee is on one social networking site, look to see if there are links to other social media pages. Nothing is more fun than reading a “tweet” where the employee says something like, “Boy, do I have the workers comp doctor fooled.” Of course a YouTube video of the employee skydiving can also be very entertaining. Flickr commonly has photos of such events, oh so notable are these activities in the employee's life.
 
 
If you are having difficulty with your Internet search try using pay sites charging nominal fees ($1.99 or $4.95) to search the Web for you and compile the employee’s information. Search engines like Pipl.com and Spokeo.com scour the web for you and provide a lot of info on the employee. Almost all of it will be unrelated to your employee's workers compensation claim, but the occasional golden find makes it worthwhile. (Search your own name and be dismayed by the astonishing amount of information there is about you on the internet). Spokeo aggregates information about people from various accounts they open; it also includes their "wish lists" from Amazon and other sites.
 
 
Some employees with questionable injury claims do not post anything discriminating about themselves; however their “friends” do post pictures of the employee involved in their activities then append the employee's name to the photo images. When defense attorneys request information through the discovery process, employees often argue their privacy is being invaded. If the employee refuses to turn over the information on the social media sites, the defense attorney can obtain a court order and most social networking sites will provide the request information from the employee's web page. Generally, the rules of evidence are more relaxed in workers compensation cases than in criminal cases, and the social website information is admitted as evidence. (WCxKit)
 
 
Share with the claims adjuster and defense attorney any evidence you turn up showing the employee's injury is not as bad as claimed. Do not share the information with the employee, unless you want the information to “disappear.” Any social media developed evidence is used in conjunction with and to substantiate other evidence developed in the investigation.
 
 
Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. See www.LowerWC.com for more information. Contact:Info@ReduceYourWorkersComp.com .

 
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
 
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.

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