|
This is quite a list.
You should make sure you read and understand the contents.
1. Always document
everything including dates and times of phone calls abo comp.
Be sure to document exactly who you spoke with and about what.
That includes doctors, adjusters, case managers, EAO personnel,
employers, and your attorney. Keep a record of everything you
get by mail including the postmark. Send all your correspondence
concerning comp by certified mail. Keep the receipt with your
other comp records.
2. Get a copy
of everything your doctor sends to the carrier as s/he sends
it. Try to take a witness to every appointment with you.
3. Be sure your attorney has a copy of everything you have.
4. Be clear on your work status with your doctor.
Make sure you understand what it is. Ask for a written
release from your doctor if s/he is telling you to return to
work, with or without limitations. Ask for a note from your doctor
each time if s/he is keeping you out of work. Make a copy of
all doctors' notes and keep it in your comp files.
5. Do not miss appointments unless there is
a good reason and be sure to notify your attorney and doctor
as far in advance as possible. Unless you are in the hospital,
I believe you have to notify the doctor at least 3 days in advance.
Have your attorney notify the carrier. Your benefits can be
controverted (stopped) for non-compliance if you fail to make
a doctor's appointment without good reason. Especially for an
IME.You do not have to allow a case manager or comp nurse
in the room while you are being examined by a doctor. If they
want to come in with, you tell them they can come in after you
are examined. If this is a problem, contact your attorney and
let him/her resolve the issue. Try to take a witness to every
appointment with you - the carrier representative is not usually
a good choice.
6. Ask if you are at MMI every time you
see a doctor. Know that you are entitled to an IME if you
disagree with a doctor. Ask your attorney if you believe you
need an IME.
Be sure that all of your comp doctors are aware
of all other comp physicians, treatments, and medications, including
any psychiatric treatments you may be under going as a result
of your injury. This will help your comp doctors to be more
aware of all conditions you are being treated for and keep a
better overall view of your total physical condition. These will
be things your doctor will have to think of when s/he is considering
your status for MMI or limitations. MMI does not necessarily
mean you will need no further medical treatment. MMI only means
you are as good as you can get. As good as you can get can mean
as good as you can get with the medical treatment or therapies
you are under going. You could need treatments for life or for
short term after you reach MMI.
7. Never count on the carrier to
send your medical records to any doctor you see. Always
take your medical records with you for each new doctor you see.
If you rely on the carrier they will pick and choose what
they send to your doctor, sending only the information they feel
will benefit them the most.
8. Be sure you know what benefits you are
entitled to and what the statute of limitations are on each benefit.
For instance, if you go for more than 1 year without being treated
by your physician for a specific injury, then the carrier can
deny any claims because if you go a year without treatment, the
carrier can claim that you are fully recovered. Always go
for a check- up every year for each specific injury you have
if you think the injury may be a problem in the future.
9. Unless your attorney is experienced in
the field of tort cases for negligence or EEOC violations, do
not depend on your workers compensation attorney to know whether
or not you have a tort case against your employer. Often injured
workers have a case and don't know it. To have a tort case against
your employer, s/he must have committed gross negligence. That
could be something as simple as failing to have all the safety
equipment installed on a machine, failure to follow proper safety
protocol and/or failure to train properly. Always check with
an attorney who specializes in the field you are asking about.
10. Don't be afraid to ask your attorney
questions. The more you know about the law and your own case,
the better off you are. Don't be afraid to ask for a second
opinion if you have doubts.
11. Remember - the year of your injury determines
your comp benefits. You cannot take any blanket statement
and be sure it applies to your case. The laws vary by state and
year for your benefits. The law also varies for federal employees.
12. Carriers cannot change your treating
physician without good reason. Often the carrier will try
to do this to get the diagnosis they are looking for. If they
do this to you, ask your attorney to file a petition for benefits
immediately to continue to see your treating physician.
13. In most cases, but not all, your treating
physician's diagnosis has the most weight at hearings. Normally,
your treating physician's diagnosis will outweigh an IME.
14. Know that when you settle your case,
your employer/carrier often has a clause in it that says you
drop any other lawsuits or actions pending. Be sure if you
have another suit in the works, you run your settlement agreement
by all your attorneys before signing it.
15. Know that in most settlements, you have
to settle out your medical unless otherwise specified. Also know
that in most cases today, lump sum settlements are done in structured
settlements - meaning that the carrier gives you your money in
payments. This prevents you from being able to collect interest
on your money. You do not have to agree to a structured settlement.
Also be aware that there is a Medicare set aside
law. That means that Medicare will set aside an amount of
your settlement for your medical expenses and you cannot use
Medicare until that full amount has been used up. It can take
up to 2 years for Medicare to review your settlement thus holding
up the settlement agreement.
16. Know that in most settlement offers,
you agree to resign your position
even if you have been fired or laid off. This will relieve
the employer/carrier
of any case you may have for discrimination or EEOC violation.
Your case
will be nullified if you sign the agreement.
17. For most things, there is a 1 year
statute of limitations. That would mean that if you felt
you had grounds to sue for negligence and you failed to file
your case within 1 year of the action, then you cannot file at
a later date. There are some exceptions to this rule but they
are very limited.
18. You can ask that the carrier
pay for all your attorney fees in a settlement offer or when
you go to court. The carrier may decline to pay your attorney
fees in a settlement offer but you do not have to agree to the
settlement if you think it is unfair. The carrier has to pay
in the event you go to court and win your case. Be sure they
do.
19. Most people go through all the money
from their settlements within three years of receiving their
settlement. Be sure if you settle that you get enough to cover
the medical costs of your injury. You do not have to settle out
your medical if you choose not to. However, if you don't,
you may not be able to settle your case. Be sure that you either
have another source of income, know the extent of your injuries,
and/or are able to return to work at a rate of pay near your
before-injury pay. Remember that many employers will not hire
you if you have ever filed a claim on workers compensation even
though it is against the law.
20. When carriers are settling cases, they
use what they call "present day
value" of your claim. That is not near what your case is
worth in most cases.
21. When considering settlement offers,
ask your attorney to get a payout of your expenses paid including
medical costs. You can get this from the carrier. It will
give you some idea of how much your injury is costing you. If
you need a surgery or any medical treatment after the settlement
be sure you know the cost of the treatment. You will not get
the discounted rate the carrier gets with comp. Be sure you
know how much your prescriptions are if they are for an extended
period of time. Prescriptions are very expensive and you will
not get the discounted rate the carrier gets for them.
top
Important Info On Retraining
Provided by A Retraining Specialist
On tort lawsuits: also look at third party
lawsuit potential - examples: you were injured because of a faulty
design in a ladder; the cleaning company left slippery residue
on the floor; another driver was at fault for hitting you. The
many complexities of the law are why I discourage anybody from
going through W/C without an attorney.
On settlements: if you have been given limitations
that prevent you from returning to the job you were doing when
injured, you have a right to apply for retraining through
the Florida State Bureau of Reemployment and Rehabilitative Services
(BRRS). If you can't do the old job but know you will not
be able to survive the rest of your life without additional income,
you should consider applying for retraining before settlement.
If approved, the Bureau will pay tuition,
books, and supplies for up to two years and obligate the carrier
to pay you benefits for up to one year. To someone whose Average
Weekly Wage was $600 per week, that could amount to over $23,000
in benefits and training. An approved retraining plan (by the
Bureau) could add that much or more to the value of your settlement.
Value added is in addition to whatever other value your case
holds.
If you settle before approval of retraining,
the carrier is NOT obligated to pay any retraining benefits.
If another agency, such as the Division of Vocational Rehabilitation
(DVR), takes you as a client and sponsors your retraining, that
WILL NOT obligate the carrier to pay your benefits. Only BRRS
has the statutory authority to do this.
Keep in mind, this applies only to workers injured
under Florida law after October 1, 1989. It will not apply to
a worker injured in another state, who later moved to Florida.
I don't personally know of any other state that has a similar
retraining benefit; especially one not under carrier control.
If a carrier refuses to pay benefits, they go to a hearing under
the Department of Administrative Hearings (the name may have
changed) and the state will send an attorney to defend their
position. And, their position will be your retraining plan.
|