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Workers' Compensation Blog

The Importance of Documenting All of Your Injuries

Tuesday, July 18, 2017

All too often when workers are injured the focus is on the most severe parts of the body hurt. Frequently the minor pains and bruises from other parts of the body are ignored. However, in a workers’ compensation claim it is very important to report every hurt, bruised, or swollen body part no matter how minor it may seem at the time. The human body is interconnected and when you fall, for instance, you may land on your knee, but your hands may have eased the impact, which can cause shoulder and arm pain as well. If you injure your back, the nerve pain and/ or damage can cause problems in your legs. You may not feel any symptoms to those other areas until a day or two later, but these are all parts of your body that could get worse over time and require additional medical treatment. It is important in a workers’ compensation claim to document every part of the body that was affected by the accident no matter how small it may seem. It is more difficult to try and convince a Commissioner or insurance company that another body part was also injured in the same accident if there is no documentation of it within a few days of the accident.

What’s In The Injury Report Matters

This rule is important to remember when filling out your accident report at work, your workers’ compensation claim form, and any forms you are given at every medical office you visit after the accident. In our practice, we frequently read emergency room reports where an injured body part is left out or the wrong body part is documented. We all know hospitals are busy places and not everything is always documented with 100% accuracy, but insurance companies will use this to discredit your injury or the cause of your injury. It is important for you to check that how the accident occurred and that all injuries are clearly described and documented. Make sure to tell the medical professional you are dealing with every ache, pain and/or discomfort that you are feeling as a result of the accident.

Contact Us With Questions

If you have any questions about a new pain or problem that developed after your injury it is always best to contact an attorney. Our attorneys have years of experience and know the right questions to ask to ensure that you receive the full coverage, you are entitled to for your injuries.

Key Differences in the Vocational Rehabilitation Process in Maryland and the District of Columbia

Friday, September 23, 2016

VOCATIONAL BENEFITS

The Workers’ Compensation Statutes in both the State of Maryland and the District of Columbia offer a benefit to injured workers called Vocational Rehabilitation, often called “Voc Rehab” for short. Vocational Rehabilitation arises in a workers’ compensation case when the injured worker’s medical treatment is complete, or near complete, and he/she is given restrictions from his/her doctor that prevent him/her from physically performing the work he/she was able to perform before the accidental work injury. During the Voc Rehab process, the injured worker receives assistance from a licensed vocational expert so that they can, together, strive towards getting the injured worker back to full-time work with another employer and within the injured workers’ permanent physical limitations. The injured worker receives pay from the workers’ compensation insurance company while he/she is applying for jobs, taking classes, or going through retraining.

One scenario in which an injured worker would be able to receive Voc Rehab benefits would be, for example, if the injured worker was employed as a security officer at the time of the work injury, and had work requirements of standing for 6 hours a day, and lifting up to 50lbs. Yet, because of his permanent back and right ankle work injuries he is now only able to stand for only 2 hours a day, and lift up to 20lbs. The injured worker in that example would be entitled to receive Voc Rehab benefits in both the District and in Maryland. By contrast, if that same security officer was released to full-duty work, and had no permanent limitations on his ability to lift or stand, then he would not be entitled to Vocational Rehabilitation and would be expected to return back to his pre-injury work, even if it was now physically harder to do that job and his work activities caused him some physical discomfort.

Often times, the permanent work limitations are given by the treating physician at the time the injured worker is being discharged from his doctor’s care. There is a test called a Functional Capacity Evaluation (FCE) that offers a more detailed analysis as to what the injured worker can and cannot do. The FCE usually takes place at a physical therapy facility, although not all physical therapy facilities perform FCE’s. The FCE typically lasts approximately 4 hours. Upon completion of the FCE, the FCE facility will issue a detailed report stating how much the injured worker can lift, push, pull, and carry, and for how long he can sit, stand, walk, and run. If the FCE evaluator feels the injured worker has permanent work restrictions that keep him or her from returning back to the job they had at the time of the work injury, then vocational rehabilitation will begin.

COMPARING MARYLAND AND THE DISTRICT OF COLUMBIA

There are several key differences in the Voc Rehab process in Maryland and the District of Columbia. For example, in Maryland the Workers’ Compensation Regulations state that the Parties to the Claim may agree on the Vocational Counselor that will be assisting the injured worker with getting back to full-time work within his/her permanent work restrictions. If no agreement is reached, the Commission will pick the Vocational Counselor from a list. In the District of Columbia, however, there is no such provision, and the vocational counselor is typically selected only by the workers’ compensation insurance company, or their attorney. Therefore, from the onset of the Voc Rehab process, injured workers in DC are at a disadvantage. The manner in which the injured worker is scrutinized in Maryland versus the District during the Voc Rehab process is vastly different. In Maryland, Voc Rehab is offered to injured workers typically at three-month increments. If the injured worker in Maryland is “compliant” during those first three months, the Vocational process will be extended for another three months, and another three months, until the Maryland workers’ compensation insurance carrier no longer wishes to offer Voc Rehab to the injured worker, or finds a reason to deem the injured worker as being “non-compliant” with the Voc Rehab process. One example of how noncompliance is alleged is by stating that the injured worker was not applying to enough jobs each week, or was showing up late to their weekly meetings with the Voc Rehab counselor. In the District of Columbia, however, vocational rehabilitation can go on for years without ever having to request or wait for an extension of time from the workers compensation insurance adjuster.

And so, while in Maryland the vocational process is evaluated on a monthly basis by the insurance adjuster, in the District of Columbia, injured workers who are receiving Voc Rehab benefits are often left to their own devices. The Rehab counselors typically do not write detailed monthly reports commenting on everything that was done and not by the injured worker, and so the injured workers’ level of participation during Voc Rehab in DC is not able to be scrutinized or judged as it is in Maryland. However, the same goes for the level of participation of the Voc Rehab counselor. If the counselor is not required to write monthly reports in the District as they are in Maryland, the counselor’s own level of involvement is not recorded. For example, were classes or re-training discussed and offered officially? If so, when? Was the counselor late to meetings as well? These details control the Voc Rehab process in Maryland, and determine the extent to which Voc Rehab will take place, and how much Vocational benefits are offered to the injured worker, whereas in the District of Columbia, those details are often lacking.

In sum, there are benefits and detriments to each jurisdiction’s workers’ compensation laws. There is no perfect system. The best thing for the injured worker to do is to follow the laws and procedures of the jurisdiction in which their injury took place, and to do so with the assistance of an attorney they trust. If additional information is needed as to the Vocational Rehabilitation process, I can be reached at: LPisano@bsgfdlaw.com, or on my direct work line of: 301-740-3304.

10 things you need to know about IMEs (Independent Medical Evaluations)

Monday, September 19, 2016

The insurance company has the right to send you to a doctor of their choice for a medical opinion. This doctor is not going to provide you with any treatment or become your doctor, but rather only give an opinion. Here are 10 things you need to know:

  1. The IME is for the benefit of the insurance company, not you.
  2. The doctor is not required to keep anything you say in confidence; everything you tell him/her, or fail to tell him, will be contained in his report.
  3. Contrary to the letter you receive from the insurance company, you are not required to bring any test results or medical records with you. It is the insurance company’s responsibility to provide their doctor with the reports they want him to review.
  4. The IME doctor and his staff will watch how you walk, move, whether you bend down to tie your shoes or pick up a piece of paper you might have dropped, or how you remove a piece of clothing, and they will compare it to the complaints you tell them about during the exam and what is contained in your medical records, so be consistent. And never lie or exaggerate, but rather be specific about what pain you feel or limitations you experience.
  5. You should tell the doctor about any other accidents you were involved in, whether they happened before or after the work-related injury. Failing to inform the doctor of a prior accident hurts your credibility and makes it look like you are hiding information.
  6. Do not miss your appointment or arrive late. This could result in the insurance company terminating benefits, such as your lost wages, and the Workers’ Compensation Commission could order you to pay for the missed appointment.
  7. The doctor does not have the right to perform any invasive tests on you, such as x-rays, injections or EMG/nerve conduction studies.
  8. A female should never be alone in the examination room with a male doctor, so typically the doctor will have a member of his staff in the room during the examination for your safety.
  9. The examination will likely be very short (a few minutes), so it’s important that you be as comprehensive as possible about the complaints you have.
  10. The day of the IME is typically when insurance companies hire a private investigator to video tape you in hopes of “catching you” doing something that is inconsistent with what you tell the doctor or which reveals that you are capable to working. You should be consistent at all times and with all doctors.

 

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