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Archive for September, 2017

Fact or Fiction: Important Information on Workers’ Compensation, Part Two

workers compensationWading through the waters of Workers’ Compensation can lead to a lot of confusion and misinformation. By understanding ahead of time what the common myths and the real truth behind them, workers can better advocate on their own behalf when it comes to filing for benefits. In the last post, we covered two myths and one truth, continuing with other common misconceptions below.

Fiction: Technology Will Solve All Problems

While technology has certainly helped the claim process and made it simpler, it won’t solve everything. The advances that have been made in recent years have worked wonders in making things operate smoother and creating a faster and more efficient way to file claims. However, there are now too many companies that put their focus on decisions based on technology selection rather than looking at the end result.

Having foresight is not something technology can accommodate. Instead, technology should be used for identifying what needs to be accomplished and tracking solutions. However, technology should not be relied on for creating goals and individualization of solutions.

Fact: Private Sector Case Management Practice Work, even in FECA

Many believe that due to the differences between state Workers’ Compensation systems and FECA, the best practices associated with private sector case management won’t work as well. Evidence, however, suggests that the best practices work in both, despite the often-cited differences such as federal agencies’ inability to choose a third-party administrator, no settlements, 45 days of continuation of regular pay, a lack of system for routine utilization review, free choice in the treatment provider, and the limited clinical resources.

However, the best practices include agency directed case management over the phone, intervention at an early time, a focused approach to case management, initiatives for stay-at-work and return-to-work initiatives, and trend analysis for metrics and audits. These practices can be applied to both FECA and private sector case management as they address many of the same issues they both have.

The best course of action when it comes to Workers’ Compensation claims is to find the right legal counsel. At Vanasse Law, we understand the Workers’ Compensation process in Pennsylvania and will put our experience to work for your claim’s success. Contact us today to find out more.

Fact or Fiction: Important Information on Workers’ Compensation, Part One

workers' compensation disabilityUnderstanding the system in the benefits being part of the workforce makes available shouldn’t require a law degree. There is a lot of misinformation about Workers’ Compensation benefits out there, which leads to many injured workers not filing for benefits when they should. By separating fact from fiction, it is much easier to navigate through the myths that surround Workers’ Compensation.

Fiction: The Best Bet in Workers’ Compensation is Using Large Networks

The price might be right, but large discount networks can be unsustainable. There has been a plateau, for the most part, in which these networks can control medical cost. Having a layered approach to coverage is a better way to see what is being spent and where. Every employee is unique, so every company won’t need the same one-size-fits-all approach. While that approach can work well with vehicles, human beings don’t all face the same dangers that cars do. Instead, we all have different occupations and are at risk for different injuries. While each car drives on the road, risking collisions, there is a major difference in the occupational diseases that may befall a desk worker compared to a miner.

Fact: Employers Have a Continued Role, Even After a Claim is Paid

In fact, it is after the claim is paid when an employer plays the most pivotal role. The employer must make regular contact with the employee to stay abreast of the changes in the healing process which can help inform the approach to the employee’s return to work. While 86% of companies have a return to work program, very few have finessed a program that helps workers slowly return to work based on where they are in their recovery. By maintaining regular contact, it is much easier to know when the right time is to reintroduce them slowly into the workplace.

Fiction: Claims Get Better Over Time

In most cases, they can actually become more complex. Many adjusters assume that the person will go through a healing process, leading to fewer and fewer expenses until the bills end. But this is more often false than true. In the past decade, medical costs have inflated by 48% which means the same medical treatments will increase in cost, even if the treatment doesn’t change. In some cases due to inflation, someone could receive less care and cost more down the line. Further, the longer someone is out of work, the more likely it is that they won’t return.

Getting the most out of your claim can come down to having the right legal counsel on your side. Contact our team at Vanasse Law today to find out how we can help guide you through the Workers’ Compensation process.

Difference Between Scheduled and Unscheduled Permanent Work Injuries

permanent work injuriesWhen you get a permanent work injury on the job, the category the injury falls under is likely the last thing on your mind. However, understanding the key differences between scheduled and unscheduled work injuries can help you understand how to better apply for benefits and understand why you received or didn’t receive certain benefits. The two have one major component in common: they are both permanent injuries. However, there are very important key differences in the type of injury, as they each cover a different section of permanent injuries.

Depending on the injury, permanent injuries can be full or partial, leading to a lifetime of impairment that keeps workers out of the workforce or a change to position and duties. Workers’ Compensation breaks permanent injuries into two categories to better understand what type of permanent injury has occurred and what benefits are available.

Scheduled Injuries

Permanent work injuries that involve a part of the body are considered scheduled injuries and include injuries to eyes, arms, hands, feet, ears, or legs. With this type of work injury, there is a set amount of time in which compensation can be collected as per state law, legal precedent and insurance company policies that are preset. After a percentage of disability is determined by the physician, there is a formula that is used that will calculate benefits for your permanent disability which pays out awards over a predetermined number of months that is shown in the formula.

After this amount has been delved out, benefits end. This is where being prudent comes in handy. Often, there will be miscalculations that are common but they are often in favor of the insurance company. Also, be sure to find out if you are eligible for vocational training that can help with a career after recovery.

Unscheduled Injuries

This type of injury often describes the more “general” types of disabilities such as occupational diseases, hip injuries, shoulder injuries, and two scheduled injuries. Those who have filed for Workers’ Compensation are usually eligible, even when the claim for Workers’ Compensation was filed in a different state. With an unscheduled injury reward, benefits tend to be based on the reduction in the ability to earn rather than strictly the percentage of a disability. This can be tricky for those filing as it can be possible to be denied the award even if you have a disability.

Regardless of the type of injury, having the right legal counsel is essential in reaping the rewards you deserve. Contact us at Vanasse Law today to find out more.

Who Chooses the Doctor When a Worker is Injured?

work injury worker injuredAfter an injury, most workers want to see their own doctor. However, this might pose a risk later when trying to receive Worker’s Compensation benefits. However, workers are not required to go to one specific doctor, even if one is specifically provided by the employer or Worker’s Compensation insurance carrier. In fact, an injured worker has the right for a least that contains a minimum of six different medical providers.

With that in mind, once a list is provided, the insurer is only required to pay for treatment if one of the medical providers is chosen for the first 90 days of treatment. After that time, the worker has the ability to choose any medical provider. Further, the worker does have the right to switch between medical providers, even during the first 90 days. If they don’t like the first doctor they see, they can choose another from that list. After the first 90 days, they can switch to their own doctor at any time and for any reason.

In fact, a worker can technically be treated by every physician on the list provided by the employer and the insurer. This is to help workers get the treatment they need following an accident while also protecting the rights of the employer. After all, the physician of the worker could be biased or could charge more. By providing a list, the worker gets a choice in their treatment and the employer will have their own rights protected.

In the case that an employer does not provide a list of medical providers, the worker has the right to go to any doctor of their choosing. Additionally, if a specialist is needed, such as an orthopedic surgeon or neurologist, the worker won’t need a referral as they would through their own insurance and family doctor. The worker’s employer’s insurance carrier is required to pay for the treatment.

In many cases, the employer and the insurance carrier decide not to inform the worker of these rights. This is what makes it important to find the right legal representation when pursuing a work injury. Contact us today to find out how we can help get the compensation you need.