Nevada Workers' Compensation Law Blog : Nevada Workers' Compensation Lawyer & Attorney : Virginia Hunt Law Firm : Las Vegas Job Injuries & Worker Accidents

Let's face it.  The insurers and employers have a huge advantage over the injured worker who is caught in the claims process, because they know the rules and you don't.   And if you are a carpenter or a bricklayer, or a nurse, it isn't your business to know what the law says about light duty employment, or when an injured worker can change doctors.   However, you can even the playing field by educating yourself about what employers and insurers can and cannot do. 

I have condensed the most important laws into a guide booklet for injured workers, and this guide is free for the asking.  Just call my office and give us your mailing address, or stop by and pick one up.   If you need more information, or need a question answered  immediately, chances are that I have already written about the  topic and have an article posted on this blog or in the Information Center on my website.  If not, and it is a general question about the law, feel free to send me an email at attorneyhunt@huntlawoffice.com.  While I cannot give legal advice over the Internet to people who are not my clients, I can often provide valuable information to lead you to the correct answers to your problem. 

What you don't know  can  hurt you.  Arm yourself with reliable information so that you can make intelligent decisions affecting your future. 

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One type of physician that injured workers commonly encounter is the physiatrist,  also known as a physical medicine and rehabilitation (PM & R) physician.   While the name  sounds similar to a psychiatrist,  a  physiatrist  treats physical injuries as opposed to mental or behavioral problems. A surgeon may refer her patient to a physiatrist after a surgery when additional physical therapy is recommended.  Or, a physician who sees an injured worker in a clinic setting for the first couple of visits may refer the patient to a physiatrist when it appears that the injury  may require  more care over several weeks or  months.  

Physical medicine and rehabilitation (PM&R), or physiatry  is a branch of medicine which aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. Physiatrists must complete four years of medical school,  one year of internship and three years of residency.   Physiatrists specialize in restoring optimal function to people with injuries to the muscles, bones, tissues, and nervous system. 

A physiatrist who treats an injured worker usually coordinates the medical care if several specialty physicians are required to treat different injured body parts.  If surgery has already occurred, or no surgery is necessary, the physiatrist may order physical therapy or may prescribe medication while the patient recovers from his injuries. When the patient is stable and does not need more treatment, the physiatrist may then order a functional capacity evaluation (FCE) to assist him in determining the patent's permanent work restrictions.  Finally, the physiatrist tells the adjuster whether the injured worker should be rated for permanent impairment or not. 

 If you are not satisfied with the physiatrist that is currently treating you for your work injury, you may be entitled to change physicians. Click here to read more about changing physicians.

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Effective February 10, 2010, the cost of a permanent partial disability evaluation on a Nevada workers' compensation claim is $650.99 for one or  two body parts.  An injured worker who does not agree with the percentage of impairment found by the assigned rating doctor may obtain a second rating evaluation by paying this same fee for a second rating.   However, if the injured worker does not think an exam is necessary in order for a second rating doctor to conclude that the first rating doctor made an error, he may pay the assigned second doctor $324.85 for a records review and report.  Click here for the  form to request the name of a second rating doctor from the rotating list maintained by the Division of Industrial Relations.  Read my earlier blog post on how to contest PPD awards.

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I have included a graphic to clarify what happens when the treating doctor tells the injured worker that he is "stable and ratable".   I have divided injured workers who are stable and ratable into two groups, depending on whether the injured worker is released to go back to work full duty, or whether the injured worker has permanent work restrictions.

If the injured worker has permanent work restrictions, then he is assigned a vocational rehabilitation counselor if the employer does not offer a permanent light duty job within 30 days of receiving permanent work restrictions from the treating physician.  Vocational rehabilitation benefits are started also.  (They are payable every two weeks and are the same amount as the temporary total disability check the injured worker has been receiving while out of work.)  Even though the vocational rehabilitation counselor will not know how much retraining the injured worker will receive until after the permanent partial disability percentage is determined, the counselor will start meeting with the injured worker to discuss potential programs.  Alternatively, the injured worker may receive a vocational rehabilitation lump sum buy-out instead of participating in a vocational rehabilitation retraining program. How much the insurer will offer will depend on the percentage of impairment.

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This week I visited the Las  Vegas Professional Institute of Technology & Accounting (LV-PITA) to get a first-hand impression of the school's retraining programs, to pop in on a few classes, meet some instructors, and to meet director Laurie Clemens. I like to personally acquaint myself with the doctors, vocational counselors, nurse case managers, and even the adjusters who will be major players on my clients' claims.  LV-PITA was provisionally licensed last June and expects its permanent accreditation from the state after its first year in operation.  The school is located in the Fountain View Business Park at Decatur, near Rochelle. 

Programs offered include accounting, basic computer training, networking, various network technologies, PC repair, and software applications used by office management staff and computer software specialists.  Click on this link  for more information on on certification programs and course specifics.

Laurie Clemens is an attractive, vivacious blonde with who exudes positive energy.  I will give you her official bio later.   About half of her 170 enrolled students are injured workers participating in retraining  programs paid by industrial insurers.  The other students are mostly older individuals who are referred by various other state and federal agencies that provide funds for vocational retraining.  LV-PITA also generously provides free  computer and job search classes by appointment every other Tuesday for all unemployed Las Vegans. 

I was particularly impressed that LV-PITA was working on retraining programs suitable for Hispanics who need help learning in Spanish before using more difficult materials in English.  The school also teaches the visually impaired, and has experimented and found the best method to teach those individuals who require a one-handed key board.  One of my former clients with a  severe hand injury and permanent impairment was very satisfied with the quality of instruction he received from the school.

Laurie is a native Las Vegan with many ties to the business community.  Having those long-standing connections gives her a tremendous advantage when placing students in internships and when helping graduating students with job placement in these difficult economic times.  Stay tuned for more information about LV-PITA and other schools I intend to visit myself.

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Apparently,  the doctors who wrote the American Medical Association's Guides to the Evaluation of Disease and Injury Causation  don't know the answer to this week's question  either.  Dr. J. Mark Melhorn and Dr. William Ackerman, editors of the 2008 book designed to help workers' comp doctors answer medical causation questions, write that disability in the workplace is rampant in the United States.  These docs state in their Foreword that injured workers with poor genetic makeups and preexisting psychological problems share the blame for the work disability epidemic with plaintiffs' lawyers. They write, " The attorneys need to understand that by encouraging the worker to remain off work rather than getting back into the work place, they are actually doing damage to their client." 

I wholeheartedly agree that any Nevada attorney who encourages their client to remain off work unnecessarily is doing a great disservice to their client.  But are there any work comp attorneys in Nevada advising their clients to stay home longer than necessary?  I hope not, because there is no relationship between how long an injured worker is off work for his injury and his permanent partial disability award at the end of the claim.  

 There is no financial advantage to an injured worker in Nevada remaining  off work.  Most injured workers figure that out immediately.  If an injured worker is only getting two-thirds of his wages while he is off work, there is no financial gain to his staying at home.  Additionally,  the percentage of impairment and the final award at the end of the claim is not determined by how long an injured worker has been out of work. ( For more information on how awards are determined, see the articles in this blog on permanent partial disability awards.)

Unfortunately, some of the medical providers who treat  injured workers in Nevada do not understand that the vast majority of workers' compensation claimants are  hard-working people who want to return to work as quickly as possible.  If an injured worker is out of work for a lengthy period of time, that person will invariably lose money the longer they remain off work.   Any attorney who encourages his client to stay off work unnecessarily does not understand Nevada law.  It would be great if the doctors treating injured workers knew a few things about Nevada law also, so that they do not erroneously think that a  patient  who tells his doctor that he cannot physically return to work yet is profiting from the system. 

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Three people who met with me for a free consultation last week all told me that they thought the best time to hire a workers compensation lawyer to help them with their claim was right before they were scheduled for a permanent partial disability evaluation.   Two told me that they had had  free consultations with other attorneys in the past, and those attorneys were not interested in representing them while they were still actively  treating for their injuries.  Those other lawyers told them to come back when they  were finished getting treatment and were ready for  a settlement. The third person had relied on advice from a co-worker who thought that a lawyer was only necessary to obtain the best settlement.  Unfortunately, those three people were given  bad information  on when to hire a lawyer.  The best time to hire a lawyer, after meeting with one you like, is at the beginning of your claim.  Here's why:

1. Get More Legal Service for the Fee You Pay

Most attorneys charge a contingency fee from the permanent partial disability award at the end of the claim.  That fee  is  usually the same regardless of whether you hire the lawyer at the beginning of your claim, or right before you have the evaluation to determine your settlement.  If you hire a lawyer who actually provides a valuable service in assisting you on your claim each step of the way, you get more legal service for the attorney fee by hiring the attorney at the beginning of your claim.   If an attorney is only interested in representing you at the end of your claim, that is a red flag, and should alert you that the attorney is only wanting a quick fee for providing very little help. 

2. A Work Comp Attorney Should Guide You Each Step on Your Claim

If you hire a lawyer who is committed to helping you on your claim, and is not solely interested in getting his fee from the settlement, you have someone who is experienced in selecting the best doctors for your care.  You also have someone to make sure that your benefit checks are the correct and highest amount, and that they are paid on time.  An experienced work comp lawyer will also guide you through any employment issues while you are treating, and will get a jump start on the retraining process if it appears that the client will not be able to return to her old job. 

3. The Most Important Decisions Are Made at the Beginning of the Claim

The most important service I provide as a workers compensation lawyer is making sure that my clients get the best possible medical care as quickly as possible.  My clients are normal, honest, hard-working people who like their jobs.  They just want to get their injuries fixed and to get back to work and their regular lives. It  is at the beginning of the claim that injured workers decide whether they need a specialist, whether they want to change doctors, whether to have surgery, whether to have a second opinion, and what other treatment options are available.   The beginning of the claim is when insurers deny additional body parts on the claim and deny treatment or surgeries that your doctor requests.  Insurers will  try to usurp control over what happens to the injured worker's body at the beginning of the claim.

4. The Best Lawyers Practice Preventative Law

It is always easier to prevent a problem from happening on a claim than it is to try to fix a problem that has happened.  By the time most injured workers consult with a lawyer on their claim, they have spent many frustrating  months  trying to handle problems by themselves. Injured workers are at a terrible disadvantage when dealing with adjusters, because injured workers do not know what their rights are and whether the adjuster is acting properly on their claim.    A lot can go wrong very quickly, and the time to file an appeal on any determination made by the insurer is only 70 days.

5. What to Do If You Have Waited Until the End of Your Claim

If you have tried to go it alone on your claim, are fed up, and want to hire a lawyer now because you are concerned about the settlement process, get a free consultation with an attorney. You might be able to negotiate a lower attorney fee if you are just about to get a rating evaluation , and  you don't have ongoing problems or potential future problems with your claim. . Be sure to ask whether the attorney will be attending the rating with you.  Also ask whether the attorney will be helping you with any vocational rehabilitation issues, and whether the attorney will be available in the future to help you reopen your claim for more medical care.  Find out whether an actual attorney is handling your claim, particularly if you hire a celebrity attorney law firm.  You might also ask whether the attorney is able to predict  what your percentage of impairment should be.  Those attorneys who are honest and who care about their reputations among injured workers will give you a straight answer.  Finally, there is a ton of information about the rating process in my blogs and on my website.  

Get Well Again Soon!

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Last week the Nevada Supreme Court unanimously decided that rating doctors evaluating injured workers with spinal injuries can add one to three additional percentage points to the permanent partial disability award if the rating doctor finds that the spinal injury has substantially impaired activities of daily living (ADL's). The Nevada Self-Insurers Association had filed a lawsuit naming the Nevada Attorney for Injured Workers and the Nevada Division of Industrial Relations, arguing that  a section of the American Medical Association Guides to the Evaluation of Permanent Impairment allowing for impairment of ADL's  violated Nevada law.  A district court judge agreed with the Self Insurers, and entered an order back in June 2008 that allowed insurers to withhold payment of that portion of an injured worker's award for ADL's until the Nevada Supreme Court decided the appeal.  Injured workers were then put in the unfair position of having to wait until the Nevada Supreme Court decided the case if they wanted to accept their award in a lump sum payment.  Most injured workers could not wait and ended up losing their percentage points for ADL's so that they could accept their permanent partial disability awards immediately.  

Click on this link to read the complete decision by the Nevada Supreme Court.  If you are an injured worker who chose to wait for the Nevada Supreme Court to decide this case and did not accept your PPD award in a lump sum, you should contact your adjuster if you do not receive a new PPD offer that includes the ADL's award within the next 30 days.  The Division of Industrial Relations has notified all third-party administrators that they are to comply with the Nevada Supreme Court's decision.   Click these links for more information on how permanent partial disability awards are calculated, or information on how to contest an award and get a second rating.

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