Nevada Workers' Comp and Social Security Disability

     I asked attorney Gerald Welt, Esq., if he would provide me with a guest blog post on how workers' compensation interacts with the receipt of Social Security Disability benefits, and his office sent me the following general explanation.   Gerald is an excellent attorney who handles Social Security cases if you need one.: 

 You are entitled to Social Security Disability or Supplemental Security Income benefits if you have physical or mental health problems or a combination of problems severe enough to keep you from working in a regular, paying job for at least 12 months.  It does not mean just your regular job but in general any job that exists in substantial numbers in the national economy including a sit-down or sedentary job.  As a practical matter it is not enough to just present medical records, you will need the support of a treating physician in the form of a written statement indicating your specific limitations . If you have been denied benefits by the Social Security Administration for Social Security Disability or Supplemental Security Income you have the right to file for Reconsideration or a Hearing. You may be entitled to benefits and you have the right to legal representation to help you analyze your case file an Initial Application, Request for Reconsideration or a Request for Hearing and prepare for a Hearing. Fees are normally paid directly to the attorney out of past due benefits from the Federal government when your case is settled. There is no charge for your initial consultation.

 Those claimants that receive or may receive Workers' Compensation have other concerns as well.

 Nevada is an offset state meaning that any Workers' Compensation benefits that are received for compensation can offset Social Security Disability benefits.

 In simple terms Social Security Disability pays approximately 80% of your average monthly wage up to a maximum of approximately $2533.00 per month.  Workers' Compensation pays approximately 66 2/3% of  your average monthly wage up to a maximum of approximately $3527.00 per month.

 So a claimant receiving Workers' Compensation benefits at the same time as receiving Social Security Disability benefits would only be entitled to an additional 13 1/3% per month.

 It becomes more difficult if there is a Permanent Partial Disability settlement.  In that case Social Security Disability awards offset future disability benefits on a monthly basis until the complete settlement (minus attorney's fees) is offset.  Generally there is not an offset for vocational rehabilitation buyout or settlement amounts. If you are receiving only Supplemental Security Income benefits, the monthly amount of your SSI benefit will be directly reduced by the monthly amount of your worker’s compensation benefit. This usually means that there are no SSI benefits for the months you receive worker’s compensation benefits.

  by Tiffany G. Welt Doctors, ADR

Gerald M. Welt, Chtd.

703 S. Eighth Street

Las Vegas, NV  89101

(702) 382-2030 ph

(702) 684-5157 fax

tgd@weltlaw.com

 https://www.facebook.com/GeraldMWelt

https://twitter.com/geraldmwelt

http://www.linkedin.com/in/geraldmwelt

 

  

National Workers' Comp Trends

 

   Las Vegas again hosted the annual Larson's National Workers' Compensation Advisory Board Meeting at the National Disability and Workers' Compensation Conference  in November..  Advisory board members are attorneys though out the United States who either post blogs, or write expert commentary on the laws in their home states.  These attorneys also participate in discussions and debate with each other about current developments and practice trends in workers' compensation law.       Lex Larson, on the Executive Committee for the Advisory Board,  is one of the current authors, and the publisher of the most authoritative multi-volume treatise on workers' compensation law.    Representing Nevada, I was mostly surrounded by attorneys who represent employers and insurers in their states.   This is always a good opportunity for me to hear a more balanced view of what is happening nationwide to workers' compensation laws. 
     We discussed that while each state has its own system to address the needs of injured workers, the following trends were important in almost every stated:  1. Use of outside utilization review companies to review requests for medical procedures and expensive diagnostic testing, 2. Problems with opioid medication to control pain, 3. Medical marijuana, 4. So-called evidence based medicine, and 5. Increased medical costs of claims.   
    The discussion really became interesting though when the Texas defense attorney suggested that studies showed higher injured worker satisfaction with their claims experience overall under Texas' opt-out system.  In Texas, an employer is not required to purchase workers' compensation insurance to cover injuries and occupational diseases of their employees.  An employer can instead purchase a type of health insurance and can choose the rules.  ( There are no permanent partial disability awards in Texas.)  Texas exported its opt-out philosophy to Oklahoma, whose legislature decided that it didn't want Texas' economy outpacing Oklahoma's economy.
     Debate between the claimants' attorneys and the defense attorneys was  whether employers were shifting the cost of workplace injuries more directly to society and taxpayers without first paying for work injuries as a cost of doing business. Some argued that our Medicare and Medicaid systems should not bear the cost of work injuries.        While most states were not ready to hop on the opt-out band wagon, there is a trend is for other statutes to experiment with "carve-outs" to its systems.   In California and Illinois, for example, unions have successfully obtained legislation allowing for the same benefits, but different administrative processes that are supposedly more favorable to union members.  A New Jersey attorney spoke about an iron workers' union in his state wanting a carve out from their traditional laws to afford union members greater choice of physicians and higher benefits.  Nevada passed a carve-out law for unions years ago, but not much has come of it. 
      Final comments from Lex Larson were that the traditional workers' compensation systems in the various states were threatened by a sense of competition among states for new business, and opt-outs and carve-outs were becoming more attractive.  He also attributed this trend to the recent dominance of conservatism in our county.  
-Written by Virginia Hunt, Hunt Law Office

 

Is Your Work Comp Insurer Broke and Belly Up?

      On April 19, 2013,  S &C Claims Services, Inc., sent a letter to all injured workers insured by Builders Insurance Company that their checks due that week wouldn't be sent as scheduled.  A Las Vegas District Court ordered the Commissioner of Insurance to act as Temporary Receiver for the company while future payments were scheduled to be made by the Nevada Insurance Guaranty Association.

     When an insurance company that underwrites the workers compensation policies for Nevada employers goes broke and files for bankruptcy, as did Builders Insurance Company, Nevada law provides for a continuation of claims benefits through the Nevada Insurance Guaranty Association.

     Nevada law (NRS title 57) provides that when an industrial insurer in Nevada files for bankruptcy, all claims of injured workers  under workers' compensation policies issued by that insurer should be eligible for payment by the Nevada Insurance Guaranty Association.  In the instant case involving Builders Insurance Company, while compensation checks will be issued through the Guaranty Association, S&C Claims Services, as their third-party administrator, will continue to make determinations on medical care,  PPD awards, and vocational rehabilitation.  

   Fortunately, I do not have any clients i with  injury  claims against Builders Insurance Company  right now.  I don't know how long the Guaranty Association is taking to send out compensation benefits.  I can only tell you that in the past, when I've had to go through this with clients with bankrupt insurers, it was another hassle causing further hardship and delay to the injured worker.  Unless I demanded prompt action on the claim and kept on top of requests for treatment authorizations, it took months for anything to happen.  

     If you  currently have a claim under a builders Insurance Company policy and received a letter from S&C Claims Services, for now you should continue to contact S&C for authorizations for medical care and questions about your benefits.  However, your compensation checks will have to be issued through the Nevada Insurance Guaranty Association.  Their contact information is as follow:

Nevada Insurance Guaranty Association  (702) 368-0607, fax (702) 368-2455, Email: service@niga-pc.org,  web site:  www.niga-pc.org.    Click through to their website to learn more. 

 

--Written by Virginia Hunt, Hunt Law Office

Holiday Hours

Our office will be closed for the Christmas holiday on December 24, 25, and 26.  We will be open on Thursday, December 27 and Friday, December 28.

We will also be closed on Monday, December 31, and January 1, 2013.  We will be open on Jan.2.

Happy Holidays! 

Avoiding Holiday Debt

 The holidays are such a difficult time for injured workers.  Compensation checks are late due to interrupted mail service,or bad weather back East, or due to adjusters taking vacation time.  Doctors' offices cannot find appointment times for new patients as they try to squeeze in existing clients. Hospital and surgical centers are overbooked with patients wanting to avoid a new annual deductible under their health insurance.  

I hope that  injured workers resist the temptation to get a loan on their car's title in order to buy gifts they can't afford.  These payday loan companies  and title lenders have sprung up like weeds on every block, with the Review Journal counting 43 in Las Vegas.  Apparently one-third of Las Vegans use these predatory companies instead of banks.   They exist and multiply because Nevada has few laws regulating how much these companies may charge as interest.  These loans are almost impossible to pay off without the borrower paying at least  twice as much as the original amount borrowed. 

Send me an email if your are an injured worker.  Let me know how you found a way to celebrate the holidays without incurring more debt.  I will enter you in a drawing for $300.  You don't have to be a client to enter.  The drawing will be on January 1, 2013.  Happy Holidays.

Injured Workers' Facebook Friends Not Always Friendly

 Last week I had two cases involving two different workers' compensation insurers trying to use an injured worker's social media online presence to deny benefits.  In the first case, the adjuster sent the hearing officer  copies of photos from my client's Facebook page showing him playing softball.  The issue at the hearing was whether my client had legitimate medical excuses for not attending vocational  school.

 The softball photos suggested that my client was lying about his worsened back injury and ability to attend school.  The insurer didn't see anything wrong with giving them to the hearings officer without knowing when they had been taken.  My client had actually posted these photos to his Facebook photo page months ago, before his claim was reopened for more medical care.  While my client had a credible explanation about his activity in the photos, he never expected the insurer to attempt to use his photos against him. 

My other client had been employed over fifteen years with the same employer without any disciplinary complaints when he had an accident at work causing a serious neck injury.  After his claim was accepted, he was directed to treat with a particular doctor who has an ignorant attitude toward injured workers.  During an office visit, the doctor accused him of being able to move his neck better than what he was showing the doctor.   The doctor had been sent a link to the client's youtube video showing him playing a guitar in a amateur band after the date of his accident.  

This second client  is an older gentleman who has MRI findings that show an objective injury  to his cervical spine that may require a surgery.  Yet, the treating doctor was more interested in the youtube clip of the client cradling and strumming a guitar, and found that reason to send the client back to a job that required him to lift 80 lb. bags of cement.    

The following day, this client was humiliated further when he received a disciplinary notice from his employer.  The employer apparently intended to terminate him for allegedly falsifying the extent of his neck injury,  based on this same youtube clip.  The client then hired legal help.  He did not lose his job, and his care is being transferred to another doctor.  

Both of these clients did nothing wrong, and neither had any idea  that what they had put  up for friends and family  to view on  the internet  would result in such problems on their workers' compensation claims.  The lesson for injured workers is to be aware that employers, adjusters, private investigators, co-workers, nurse case managers, opposing attorneys, doctors, physical therapists, vocational rehabilitation counselors, and anyone with access to your social media sites may misinterpret, intentionally or not, something you post as being inconsistent with your work injury.  Be aware that in addition to photos you or your friends post of you, your friends and you  might comment about recent activities or trips that are entirely innocent, but that could be twisted and used against you.  It may be wise to deactivate all of your social media sites while your claim is pending.  

Retired Police Officer Paralegal for Work Comp Claims

I'm pleased to introduce a new staff member, Garth Baker,  to the firm's clients and the many other injured workers who rely on this law blog for information about Nevada workers' compensation law.  Garth became a paralegal after retiring  from the  Las Vegas Metro Police Department  as a Detective.   He served as a police officer in the capacity of patrol, field training officer, property crimes detective, financial crimes detective, and finishied his career as a robbery/homicide violent crimes detective.  He is also an entrepreneur in network marketing and a radio talk show host.

Garth explains his decision to begin a second career as a paralegal as follows: 

"In 2002,  I was involved in an officer shooting where I was injured by gunfire.  I lost a good portion of my hearing, leaving me to rely on amplification for the remainder of my life.Three years after my injury  I was still in a continuous battle with my workers' compensation provider and my employer over medical care and benefis.  I  decided to empower myself  to do something about that fight, and went to school to become a paralegal.

In 2010, after more years of fighting with my employer and workers' compensation insurance managers,  I retired from Metro. As a paralegal,  I sought employment with personal injury and workers' compensation firms so I could take my personal experiences and put them to work for those injured workers who are going through similar situations on their claims. My recent association with the Law Office of Virginia Hunt in 2012 affords me the opportunity to fully embrace the injured worker with my passion of making sure they are taken care of medically and legally.   I know what it's like to be denied coverage and what it's like to go through the adversities of getting proper medical treatment.  I'm excited to be working behind the scenes assisting Attorney Hunt  in providing the best possible service on a client's case. "   Garth Baker

Senior Ride Program

A client brought to my attention that there is a Senior Ride Program with the Aging and Disability  Services Division of the State of Nevada.  Persons 60 years of age or persons of any age with a permanent disability should bring a letter from their doctor stating that the person has a permanent disability. This program provides discounted taxicab coupon books of $20 worth of cab fare for only $10.  For more information on the program, please call 702-486-3581, or visit their website at www.nvaging.net.

--Written by

Health Care Directives Are Necessary for Everyone

Attorney Laura Stubberud is an experienced estate planning attorney who wrote the following guest blog post.  I thought it was important information for injured workers.  For more blog posts on estate planning and elder law, please visit  Attorney Stubberud 's blog at www.nvestatelaw.com.             

By Laura Stubberud

I am often asked what is the one thing that every person needs in an estate plan.  The answer is easy:  Health Care Directives.   Regardless of whether you have any money or property, you need to address decisions to be made during your life in the event of serious injury, illness or incapacity.  I tell all of my clients that as soon as their children turn 18 years old, they need to sign a durable power of attorney for health care. 

 They are almost always surprised until I remind them of that funny law known as HIPPA (the Health Insurance Privacy and Accountability Act - http://www.hhs.gov/ocr/privacy/).  You know what that is.  Every time you go to a new doctor or are admitted into the hospital, you must sign a HIPPA release.   Under this law, health care providers are not allowed to share your medical information with anyone who is not legally entitled to receive that information, including family and friends. 

 Imagine if your adult child were in a car accident and unconscious and you were denied information about his or her medical condition.  A durable power of attorney for health care allows you to specify who can receive your medical information.  In addition, the power of attorney allows you to set forth your desires regarding medical care if you are unable to communicate those desires yourself.  These directives allow you to specify your decisions regarding end-of-life matters as well as  religious provisions, decisions regarding nursing home care, surgeries, etc.  

Everyone over the age of 18 needs a durable power of attorney for health care.  It may be a matter of life or death, but it is definitely a matter of love.

 The Law Office of Laura E. Stubberud , 2831 St. Rose Pkwy., Suite 303, Henderson, NV 89052. Phone 702-589-4804,  email at laura@stubberudlaw.com.

Nevada Workers' Comp Fraud You Don't Hear About

Nevadans have  been convinced over the years that there are many workers who try to take advantage of the system, either by filing false claims or by prolonging their time off work, or by collecting undeserved permanent partial disability awards.   What the public in Nevada rarely  hears or reads about however, are the employers caught committing  workers' compensation fraud, or the insurers who intentionally fail to pay legitimate claims.   This type of fraud may be far more prevalent than fraud by employees. 

In October, 2011, a national, non-profit group of mostly claimants' attorneys, the Workers Injury Law and Advocacy Group  (WILG), published a paper entitled "Employer and Insurer Fraud:  Boosting Bottom Line profits at the Expense of Workers and Society".   The premise of the report is that workers' comp insurers and their administrators have successfully misinformed the public and elected lawmakers that employee fraud costs the insurance industry more money than employer or insurer fraud in uncollected taxes and uncollected premiums.   WILG states that the insurance industry writes or funds most of the reports on workers' comp fraud, and therefore wants the public to believe that injured worker fraud is rampant.  Insurers are able to charge higher premiums  and advocate for legislative changes to reduce compensation benefits to injured workers if the public is convinced that injured workers are defrauding the system. 

WILG states that the actual statistics show that both employer and insurer fraud are a far greater problem, involving much larger sums of money, than fraud by injured workers . The statistics on the number of employers who are caught misclassifying employees to pay a lower premium or to avoid paying a premium at all are usually based on employer audits conducted by state agencies that oversee each state's workers' compensation system.   Less than 2% of Nevada employers were audited in Nevada in 2010 according the WILG report.

In an effort to obtain unbiased information on whether employer or employee fraud is the greater problem in Nevada, I contacted Jennifer Lopez, Public Information Officer, of the Nevada Attorney General's Office.   I asked Ms. Lopez for figures on injured workers who were prosecuted for fraud, and statistics on employers who were prosecuted for under-reporting premiums or misclassifying employees. The Nevada Attorney General's Office is statutorily responsible for prosecuting both injured worker fraud and employer fraud under the Nevada Industrial Insurance Act. 

Ms. Lopez explained that in order to prove injured worker fraud, it is more difficult for a prosecutor to prove beyond a reasonable doubt that the employee criminally intended to cheat the insurer or self-insured employer of undeserved benefits.  For fiscal year 2011 (7/1/10 through 6/30/11), only 19 of the 93 cases that were investigated were prosecuted. In contrast,  during fiscal year 2011, the Nevada Attorney General's Office opened 246 employer cases for investigation, and prosecuted 142 of those employers. 

Ms. Lopez noted that employer cases are usually misdemeanor offenses that involve less than $250 pertaining to employee misclassification or under-reporting of payroll.  She emphasized  that it is easier to prove employer fraud using the national insurance database information.   Ms. Lopez did not elaborate on how many employer cases involved misdemeanors versus felonies.

Given the different standards of proof applicable to prosecuting employee fraud versus employer fraud,  I'm not reaching any conclusions as to which type of fraud is the greater problem in Nevada based only on statistics from the Nevada A. G.'s  Office on the the number of each cases prosecuted.  

As I was gathering this information from the Nevada AG's Office and looking at various reports from both insurance industry groups and injured worker advocacy groups, I read a recent  Fox News 5  article about the Nevada AG's prosecution of a Maryland woman for workers' compensation fraud in Nevada.   Nevada Attorney General Catherine Cortez Masto was quoted as saying, "Workers' compensation fraud is insidious.  It quietly drives up the cost of coverage, a bill that nearly every employer in every sector will have to foot, " said Attorney General Masto.  "My office will continue to aggressively prosecute these cases." 

I don't think the statistics from Attorney General Masto's office support her comment that workers' compensation fraud in Nevada, at least by injured workers, is insidious.  Over 58,000 claims were filed in fiscal year 2009 according to Nevada's DIR Research and Analysis Supervisor, and the  U.S. Bureau of Labor's website shows that 42,300 Nevada claims were filed in fiscal year 2010.  If less than 100 cases of possible fraud by employees are referred to the Nevada Attorney General's Office each year, and less than 20% of those cases are prosecuted, I don't know what information Ms. Masto was relying upon.  

It makes for more interesting reading in the media to hear about someone getting caught red-handed on surveillance video faking an injury than it is to read about an employer not paying premiums on undocumented workers,  or employers claiming that workers are independent contractors when they are really employees.  I think it is unfortunate that we don't have a true picture of the extent to which employee or employer fraud costs all Nevadans.  Exaggerating what information we do have doesn't help.

NEW YEARS' RESOLUTION: Less Negativity

 

I’m resolved this year to be so positive that those around me can’t help but to take some to use in their own battles with adversity  and negativity.   My clients come to me because they have overwhelming problems in dealing with their work injury- either medically, vocationally, emotionally, financially, or all of these things at once.   My job is to be a problem solver and a source of information and inspiration for injured workers  so that they may move beyond their injuries into a better life. That’s a tall order for me, and some days I do a better job than others. In order to help my clients with negativity, both internal and external, I’m resolved to set a better example in my own life. Here’s how I hope to do it:

1.       Write it down.

I’m setting my alarm ½ hour earlier each day to handwrite three pages of whatever comes into my mind. This is time to complain, establish a wish list, vent anger, and just write freely.  It’s cathartic. I can unload some unnecessary baggage to make myself lighter for the coming day. 

2.    Thank someone for something every day. 

 I don’t get around to sending a written note to someone every day, but I really have no excuse not to do that, as I have a staff to help me.  As an injured worker, you will need a lot of help from a lot of people while you heal physically and financially. A simple handwritten thank you note to someone who has extended a kindness or good service to you says so much about you as a person, and produces wonderful surprises. 

3.   Clarify what I want and what I don’t want.

This may sound obvious, but it isn’t. It is incredibly difficult, for example, for many injured workers to tell me what they would like to do for a living if they could choose anything at all.   For me, taking a few minutes to get away from external noise and all the busy things going on around me, helps me focus on what my goals are. When I am able to identify exactly what I would like to happen, it is more apt to happen. 

4.    Take more responsibility for my happiness.

Some days it takes almost a constant mantra of,  “ I can choose to feel differently about this”, in order to stave off the negativity others are heaping on my head.    In order to make room for the good that is ready to happen, we need to clear ourselves of the resentments we hang onto and the false focus on the unfairness of life. This attitude adjustment needs a lot of work, but I can resolve to keep trying to improve upon it daily.

5.       Volunteer more

On days when absolutely nothing is going right, perhaps I simply need to give more time, attention, or money to someone else.  I often recommend volunteer work to those clients who are unemployed. And if you don’t have time, energy, money, or attention to give away, then just extend some small act of kindness to another. 

6.       Be more patient and forgiving with myself

Best Wishes for a Safe and Happier New Year Everyone!   Virginia

 

Holiday Specials- Reduced Attorney's Fees and Gift Cards

Simply wishing injured workers "Happy Holidays" isn't enough when I know that for most of you the holidays bring added stress financially.  I'm therefore running two Holiday Specials.  The first five injured workers who post a helpful tip or some positive words of encouragement to injured workers on my office Facebook  wall page will receive a $50 gift card.  You don't have to be a client of mine to qualify.  Simply show my staff some documentation that you are a Nevada injured worker when you stop by to pick up your gift card.  Please call ahead to verify that you won.

Secondly,  I am offering reduced attorney fees to any new clients who sign with me between now and December 31, 2010.  I will reduce my fee by 10% of what I would ordinarily charge you.   For example, if you are a union member, and I would ordinarily charge you  25% of the permanent partial disability award at the conclusion of your claim, I will reduce my fee to 22.5% of the PPD.   Or, for example,  if I would ordinarily charge a  fee of 33.33% of the PPD,  I will instead agree to a contingency fee of 30%.  I try to quote an attorney fee that reflects the amount of work I may need to do now, as well as in the future.  An initial consultation with me is free, and you are welcome to openly discuss an agreeable fee with me after I know what your claim entails.  My staff cannot give fee quotes over the phone.

I will be staying in Las Vegas over the holidays, riding my horse, and enjoying some time with my two sons who will be home from college.  My office manager of sixteen years, Vanessa, hasn't told me yet when the office is closed for Christmas and New Years' Day, so I'm not sure of holiday office hours as I write this.  However, I do check my emails and often work from home even when the office is officially closed.  You can write to me at Virginia@HuntLawOffice.com.   My hope for you this holiday season is that good health is restored to you quickly.

Caring for an Elderly Parent

I got behind in my blogging while I made a quick trip to North Carolina for a week of helping to care for my father.  He is undergoing radiation for throat cancer for seven weeks, and needs help with transportation to the oncology center, help with nutrition and self care, and coordination of other doctor appointments.   Fortunately, his prognosis is good, and I have many siblings with wonderful spouses who can also spend a week helping to provide necessary unskilled care. I mention this very personal experience, because I just  read in elder law attorney James M. O'Reilly's newsletter that more than 75% of Baby Boomers are providing unpaid care to an elderly parent.  Several of my clients have mentioned the difficulty they are having providing financial and similar care for their parents as they struggle with their work injuries and reduced income.  This blog post is to let you know that I found the resource section of Attorney O'Reilly's website to be helpful as I educate myself about Medicare, VA benefits, and options for care when a family member or friend cannot help.

Construction Accidents

With unemployment in Nevada at an all-time high, construction workers who are injured on the job are afraid to report and file workers’ compensation claims. However, those who delay and then discover that they have a serious injury that may require surgery will regret that they did not follow the steps below. The risk of your employer taking adverse action against you for reporting an injury and getting immediate medical attention is far less than the risk of having a claim denied when it is filed late. Employers know that they can be sued for wrongful termination if they fire an employee because the employee pursued a workers’ compensation claim. Construction

When in doubt, do the following:

·         Report your injury on time and in writing.

Follow the employer’s policies on reporting job injuries. Nevada law requires that injured workers report work injuries to their employers within 7 days. However, many employers have policies that require immediate notification to a supervisor. Even if your supervisor makes a snide comment, ignore the comment, and stick to the procedure for reporting injuries immediately in writing.   

 

·         Submit to any drug testing your employer requires.

Employers often require that you immediately report your injury so that you can be drug and alcohol tested. If you test positive, in addition to your employer terminating you, your claim will probably be denied. However, there is a rebuttable presumption that the accident was caused by your being under the influence. Contact an experienced Nevada workers’ compensation attorney, particular if you test positive for marijuana, and the denial may be reversed through litigation.  

 

·         File a workers’ compensation claim when you get medical care.

If you chose not report your injury and use your private health insurance, it is very difficult to later file a claim and get it accepted.    Many workers do not want to anger their employers by reporting a job injury, and they hope that their injury is not serious. However, if the injury turns out to be serious, you will probably have your late claim denied.  You will then lose valuable benefits available to injured workers under Nevada law unless your attorney can successfully reverse the claim denial.

 

·         Appeal claim denials.

Insurers love to deny claims where the insurer can show that the injured worker treated for the same condition or injury in the past. However, with good legal representation, most of these claims involving pre-existing conditions can be won for the injured worker.

 

·         Investigate for third party liability.

If the accident was caused by someone who is not your co-worker or your employer, you may have a personal injury claim in addition to a workers’ compensation claim, and be entitled to recover additional money. Only an experienced attorney will be able to tell you whether the exclusive remedy doctrine applies to your particular facts, and advise you whether you may also pursue a personal injury claim.

Advanced Settlement Loan Companies

Occasionally, one of my clients asks me to sign a lien agreement with  a company offering to advance money to the client based on the client's potential permanent partial disability award at the end of his claim.  I have never agreed to sign one of these agreements.  These advance settlement firms have been around a long time in the personal injury world, but are now beginning to show up with greater frequency in the  workers' compensation arena. The Las Vegas Review Journal has an article today on the state's efforts to regulate these litigation finance companies, focusing in particular on the company ownd by TV reality star Rick Harrison of "Pawn Stars".

There are many reasons I refuse to get involved in any manner with these financial settlement loan companies.  I understand that many people are desparate for money, particularly when their claim is denied, and there is no income and no medical care.  However, from what little information a couple of these companies have been willing to share with me, these companies have no understanding of how workers' compensation claims are settled in Nevada.  They do not even know that legally, the only liens that are allowed on workers' compensation claims are child support judgments.  I recommend that my clients not sign agreements with these types of companies with regard to permanent partial disability award settlements.

Happy 15th Anniversary, Vanessa!

On February 6, 2010, my officer manager and legal assistant extraordinaire, Vanessa Cohen, will be with me 15 years.   Vanessa is the most organized person I have ever met, and she is responsible for making our office run like a well-oiled machine, even on days when every client seems to call at the same time and needs immediate action.  If you are one of our clients with a claim in litigation, you know her as our litigation support specialist who tracks appeal deadlines, court dates, and assists in preparing evidence for hearings.  She also tracks when settlement checks are due, and is the patient, competent voice ready to address clients' problems early in the morning before Bianca takes over solving problems for clients who phone us.  

Vanessa and I exchanged small gifts today to honor our 15-year anniversary of working together, and she wrote in her card to me, "I still love my job!".  Vanessa has a very difficult job helping me represent people at a very low point in their lives after serious, unexpected, and often life-changing accidents.  Her compassion for our clients has never wavered, and her love for her job still shows in her devotion to excellence in her work.  Thank you so much, Vanessa.  Much love, Virginia.

Unemployment Insurance and COBRA Externsion Due to Expire

Unless lawmakers in Washington act by February 28, 2010, the jobs bill passed in December that extended long-term unemployment insurance benefits and that gave a COBRA extension will expire.  With the unemployment in Nevada at an all-time high, this is terrible news  for workers who have been unemployed for a long time.  Read more about the AFL-CIO's jobs plan to address this problem and for information on how to contact legislators to urge them to act on legislation now.

Free Training For Employees Offered By DIR

The Workers' Compensation Section of the Division of Industrial Relations has asked us to spread the word that they are offering a free training session for employees on injured workers' legal rights, how to file a claim, what to do if the employer is uninsured, claims process deadlines, etc. on Wednesday, October 14, 1:30- 3:30 pm at the West Charleston Campus of the College of Southern Nevada, Room D-101.  To make a reservation to attend, or to request special accommodations, please email Terry Simi at  tsimi@business.nv.gov.

Surviving the Tough Times

 Some questions I receive from injured workers have nothing to do with workers’ compensation law, but are instead about how to make it through the difficult times following a work accident.   Few people can pay all necessary bills for very long on workers’ comp benefits of only two-thirds of their average monthly wage. Most injured workers must dip into or deplete their savings if they have a serious work injury. Also, if medical insurance isn’t  available any longer because the injured worker can’t return to his pre-accident employer, dependent family members then go without necessary medical care.  It is even worse for the injured workers who must litigate denial of their claims in order to obtain any benefits at all after months of the appeals process.    Yet, people do survive these tough times, and they find a new appreciation for those friends, co-workers, employers, and family members that can be counted on to provide support.

Recently, a client gave me a very interesting book entitled The Survivors Club by Ben Sherwood.  This book is about survivors of various sorts of tragedies, including an airplane crash in the Andes, a failed suicide attempt from the Golden Gate Bridge, the brutal gang attack of the Central Park jogger, cancer, a mountain lion attack, etc.   There isn’t a chapter on how to physically, emotionally, and financially survive a serious work injury, but I could match some of my clients’ experiences with those in the book.   The book discusses common personality traits the survivors share. I see many of those traits in those clients who go on to lead happy, productive lives despite their life-changing work accident.  What I really found useful for my clients, however, was  its website.  This website has excellent information on how to deal with a permanent injury, how to handle financial problems following a reduction in income,  links to alcohol or substance abuse help, and divorce survival tactics.  

Depression following a work injury is common. If it becomes severe, the injured worker should discuss it with whichever doctor is the authorized treating physician so that it is documented. Then, the injured worker can request that the adjuster authorize a consultation and treatment with a psychologist. While Nevada law does not allow an award for permanent psychological injuries that do not result from a physical injury to the brain, an injured worker may at least get treatment for psychological problems that result from the work injury. 

If you need immediate help in the Southern Nevada area to deal with depression, please contact the So. Nevada Adult Mental Health Services at (702) 486-6000. You may also find other phone numbers and links for mental health services at www.mhds.state.nv.us.  If you or someone you know is having suicidal thoughts, please call the suicide prevention hotline numbers at 1-800-273-8244 and    1.877-885-467.

I’ve asked several clients to help me post some good news about their accomplishments in vocational rehabilitation programs, and tips to help fellow injured workers get through the tough times.   So, please stay tuned.