Posted on Tuesday, March 6th, 2018 at 11:14 am
If you or someone you love is disabled from a work injury, the disabled worker can receive 2/3rds (.66667) of their average weekly wage loss benefits on a weekly basis for up to 500 weeks. This is called temporary total disability or TTD. In some very narrow categories of permanent and total disability injuries, that can be extended to lifetime payments, often well beyond the 500 weeks.
Many employees prefer though, to settle their case rather than continue to receive weekly checks. As part of the settlement, they will ask for some or all of the future wage losses in a lump sum benefit as well as an estimate of the value of their future medical care, rather than continue to receive their wages and medical care from the workers compensation carrier on a weekly basis. That way, the employee has immediate access to their funds and can also invest the funds and even pass the money on to his or her heirs. If the worker gets another job or dies, then the payment stops and there are no funds to pass on to one’s children or grandchildren. Experienced North Carolina or Virginia worker’s compensation lawyers understand how to properly value your case so that you or your loved one gets all that he/she deserves.
The amount of the lump sum that needs to be calculated as to your future comp payments is essentially 2/3rds of your average weekly wages up to 500 weeks; however, there may be initial discounts to consider if it is anticipated that you will return to work sometime before the end of the 500 weeks. In addition, there is no guarantee that you will live for the entirety of the 500 weeks. You could, in fact, die from unrelated causes and if that happens, or if you return to work at the same or higher wages, then the weekly payments would stop.
Another consideration is that if you get paid in a lump sum, in North Carolina, your calculation as to future payments must be discounted because you can invest your settlement funds into interest bearing accounts. This is called figuring out the PRESENT VALUE of the future amounts.
We typically do not do this in Virginia, because Virginia provides workers under Awards with the right to COLA payment increases whereas North Carolina does not. Do in Virginia, if we simply take out the anticipated future COLA payments when figuring out the future lump sum amounts, then any gains are really offset by inflation, so there is no discount rate needed.
North Carolina, on the other hand, does not provide COLA as part of its compensation scheme, so you give nothing up when figuring up future lump sums. So you must therefore reduce to present value.
Present Value and the Discount rate.
The discount rate is a way of figuring what the present value of your future income should be in North Carolina. For example, if your Average Weekly Wage (AWW) is $900.00, your compensation rate is 2/3rds of that, or $600.00. If you elect to be paid weekly over 500 weeks, you will ultimately receive $600.00 x 500 weeks= $300,000.
If the interest rate is calculated at three 3 %, the present value of your money is approximately $260,500.00. In other words, if you invest $260,500.00 at 3 percent yearly interest, you will generate $300,000 in money in 500 weeks. In this example, your $300,000 in income is being discounted about 13% down to the $260,500 figure.
While financial experts understand how much money a settlement will earn if it obtains, for example, three percent per for 30 years, the experts don’t know whether the interest rates may change over time.
Generally what is done is that the parties argue and usually compromise over the discount rate during negotiations. The defense obviously wants to pay less so they will use a higher discount rate, where the injured worker’s attorney will argue that while higher interest rates are available, the investments that produce them are often more risky and volatile, and less safe. The injured worker’s lawyer will argue that something safe would be something like treasury bonds or other such instruments, which typically pay something like 3-4%, depending on the year. Defense attorneys will argue for investments in the 6-8% range or higher.
In both North Carolina and Virginia, while most employees are limited to TTD payments up to 500 weeks, that is not the only component that goes into figuring up the value of a potential settlement. There is also the lifetime medical award, and this is where it is important to understand your life expectancy. For instance, if you are on certain expensive prescription medications for your injuries, and it is likely you will have to remain on them for the rest of your life, this could be a huge component and “exposure” to the workers compensation carrier which may motivate them to settle your claim.
As an example, let’s assume you are a 55-year-old male injured worker in Virginia. Using the table for Virginia below, we are entitled to assume your life expectancy is 24.3 years. Let’s say that you are taking an expensive prescription that is costing the comp carrier $500.00 per month. That translates to an annual cost of $6000.00 x 24.3 years, which is a future prescription cost of $145,800.00. Along with future potential surgeries, or other treatment as recommended by your doctor, this future medical treatment can form a significant component of any demand to fully and finally settle your claim.
North Carolina uses the following life expectancy figures for worker’s compensation cases (just the first few years and then increments of five years are provided):
Virginia uses the following life expectancy figures (for both genders, for just men, and for just women)
There are other factors that are crucial in determining the amount of any full and final settlement. Some of these factors are:
After the future TTD estimates and Future Medical costs are added up, we will typically then present a figure that we request for our demand in the case. Other components that might go into the demand are future medical travel costs, future x-rays, MRI’s or other medical monitoring. We also always ask that the carrier pay any outstanding, related medical costs that have not yet been paid. In addition, ongoing weekly payments typically continue until issuance of the Settlement Order by the Virginia Workers Compensation Commission or Industrial Commission.
Note that if you are a current Medicare recipient, ALMOST NONE OF THIS APPLIES as you will have to engage in a MEDICARE SET ASIDE (MSA) and Medicare will have to approve the MSA amounts in order for you to receive any kind of medical settlement. In these circumstances, your future medical costs will be calculated by one of any number of companies who will submit a report estimating the cost of your future, injury-related care to Medicare for approval. You or your attorney will have no control over determining those estimates. The only items that will fall outside the purview of the MSA are items that would not be covered by Medicare. For instance, certain prescriptions are not approved by Medicare for treating pain.
We recommend that you do not try to negotiate your lump sum full and final settlement or clincher on your own. You can’t renegotiate the lump sum payment if you make a mistake. Any worker considering a full and final settlement (called a clincher in North Carolina) should consult with an experienced North Carolina or Virginia workers’ compensation attorney. You may be wildly underestimating what your case is worth.
Do not settle your claim without speaking to an experienced work injury lawyer. Attorney Joe Miller Esq. has been helping injured workers get justice for over a quarter century. He understands how to negotiate and what wage and medical benefits you are entitled to. To learn what your rights are, please call lawyer Joe Miller at (888) 694-1671. You can also reach him through his contact form.
Posted on Thursday, March 1st, 2018 at 4:01 pm
The amount of wage benefits injured workers receive is based on the following calculation/formula:
2/3rds (.66667) of your average weekly wage (AWW) times the number of weeks you’re entitled to benefits.
The AWW is determined in one of the four following ways:
Workers in North Carolina can only receive the state maximum. The maximum generally increases each year. The maximum North Carolina benefits, after the 2/3rds time AWW calculation, for the past 10 years are:
The state maximums for Virginia are:
In both North Carolina and Virginia, the maximum payout is for 500 weeks. Both states also have no lifetime limit for reasonable and necessary medical bills. Both states also allow a mileage allowance for traveling to see your physician. Only Virginia has a COLA (Cost of Living Adjustment). North Carolina unfortunately does not.
Your AWW includes overtime pay, bonuses, and other relevant income. Generally, health insurance benefits are not included in your wage loss benefits. However, the employer’s insurance company should pay for your medical bills that are necessary because of your injuries.
You receive the 2/3rds (.66667) of the average weekly wages if you have a temporary disability for up to 500 weeks unless and until you can return to work. This is called temporary total disability. (TTD) Of course, this is assuming that you have an Award or Accepted Claim. If you do not, then you will have to prove your claim at a hearing.
You receive 2/3rds of the AWW for a preset number of weeks if you have a permanent disability to specific body part. This is called permanent partial impairment (PPI). But in no event can you get more than the maximum of 500 weeks, unless are declared permanently and totally disabled.
Some adjustments apply if you can return to work with work restrictions and are making less money than your AWW. Then, you are entitled to 2/3rds of the difference between your AWW and your current, “light duty” wage. This is called temporary partial disability. (TPD).
Get all the work injury compensation you deserve. You have the right to be paid if you can’t work due to a workplace injury and you are an employee. Don’t let your employer short change you. Attorney Joe Miller Esq. fights for every dollar you deserve. When you’re not working, you need money to pay your bills and manage your life. To speak with a respected North Carolina and Virginia work injury lawyer, please call attorney Joe Miller at (888) 694-1671. You can also reach him through his contact form.
Posted on Monday, February 26th, 2018 at 10:42 am
Many employers will argue that emotional injuries are insignificant or even frivolous. Accident victims should understand that they DO have the right to seek compensation if they need to see psychiatrist, psychologist, or any type of mental health counselor. It is easier to be approved for emotional distress wages and medical care, but not essential, if your emotional distress accompanies a physical injury.
Workers who suffer broken bones, back injuries, spinal cord damage, or other physical injuries often quite justifiably worry about whether their injuries will heal properly. Accident victims often suffer anxiety and depression about their job prospects and how their injuries will affect their ability to perform even routine tasks like sleeping, walking, and eating. Workplace accident victims often worry about how their pain and recovery process is hurting their spouse and children. Not to mention post- traumatic stress disorder (PTSD) if the injury was violent, such as an attack or fall from heights or an amputation.
In some cases, such as when a worker suffers a traumatic brain injury, it is virtually a given that the worker will need emotional counseling to address issues of confusion, memory loss, an inability to speak, extreme anger, and other difficulties.
In other cases, such as workplace violence, there may be no physical injury at all. If a worker observes someone being killed, comes upon a horrifically violent scene, or if a car nearly hits the worker – then these memories can vividly play over and over again in the worker’s mind, like an insane “loop,” interfering with the worker’s sleep and destroying all emotional stability, in some cases even causing hallucinations. This may justify the need to get psychiatric help and could lead to a diagnosis of post-traumatic stress disorder (PTSD).
While many workers may think it is “macho” to tough out their injuries and the reactions to them, experienced workers’ compensation lawyers explain that getting professional help is often the best course. Speaking with psychologists and other professionals may even quicken the date when you can return to work, or in some cases, protect you from prematurely being thrown back into a work environment which is full of the very “triggers” that must be avoided in order for you to heal from the PTSD.
Emotional injuries are harder to prove than physical injuries. Physical injures can be verified by X-Rays, MRIs, CT scans, and other diagnostic tests. Often, there is visual evidence in the form of bruises, scarring, redness, or other unsightly conditions.
Emotional injuries normally can’t be seen or tested objectively, although some aspects of an underlying condition, such as memory loss or other cognitive deficits can be measured by testing. Most emotional injuries are observed. They require a review with a mental health professional who will need to document the basis for the emotional injury. The psychologist, psychiatrist, or other emotional health provider will normally complete a report which addresses the following:
The emotional health doctor or counselor should be able to document:
The doctor should prepare a detailed medical report indicating the precise diagnoses, whether the diagnoses are connected to the work injury and come up with a treatment plan, and the worker’s prognosis.
In general, an employee can’t claim emotional distress if their negative emotional state is due to standard work conditions. For example, if an employer calls in an employee for a work review or assigns a worker to a new job task, the review or assignment may cause the worker to become quite nervous. Still, reviews and work assignments are routine parts of any job. An employer is not normally going to be required to pay for the worker’s need to seek emotional counseling for standard work conditions.
Please note: This article does not address other remedies that are outside the scope of our practice, such as discrimination or other claims to the EEOC due to a “hostile work environment.” For any such claims, we suggest you consult with a competent labor and discrimination attorney.
The employer’s insurance company may send you to their own doctor who will conduct their own examination. In Virginia, if you are given a psychiatric referral, you get to pick from a panel of three doctors. Often it is up to your attorney to first make sure that everyone on the suggested panel of psychiatrists or psychologists actually accept workers compensation patients. Unfortunately, most do not, so this is very important.
Typically, a key difference between a psychiatrist and a psychologist is that the psychiatrist can prescribe medications while the psychologist cannot write prescriptions. In terms of proving your case, it is very important that you see AT LEAST a psychologist. A licensed professional counselor or nurse practitioner may be able to treat you, but they cannot offer opinions in your case about any psychiatric condition or whether it is connected to the work accident. So if you are seeing such a counselor, and you want to prove your psychiatric diagnoses are connected to your work injury, you will need a referral to a psychologist or psychiatrist.
In addition, if you have suffered a brain injury and you are attempting to prove that you are suffering from psychiatric conditions connected to that injury, you will need a psychiatrist (who is an M.D.) or other medical doctor such as a neurosurgeon to testify that your psychiatric conditions are connected to that brain injury. A psychologist can testify about your diagnosis, but he or she is not allowed to testify that your psychiatric condition is related or a result of a physical brain injury. They CAN testify that you are suffering from a condition that occurred as a result of your reaction to a traumatic event, such as an attack or severe fall. But that is not the same as saying that your psychological diagnosis is the direct result of a physical injury. For that, you need an M.D.
If you can’t work due to emotional difficulties relating to your work injury, be wary of nurse case managers trying to convince your health care providers to return you to work before you are ready. We have found that on many occasions, the residual emotional issues relating to a traumatic injury are the last to disappear after a bad injury. Many times, it is the psychiatrist or psychologist who is the only health care provider who can protect a severely traumatized worker from being thrown back into a work environment that he or she is nowhere near ready to handle.
Attorney Joe Miller Esq. has been fighting for North Carolina and Virginia workers for more than 25 years. He’s helped thousands of work injury victims get justice. He’ll work aggressively to help you get all the wage loss and medical coverage you deserve. Call his office now at (888) 694-1671. You can also reach him through his contact form.
Posted on Thursday, February 22nd, 2018 at 10:04 am
Posted on Wednesday, January 31st, 2018 at 11:02 am
As a general rule, a worker must be an employee in order to qualify for work injury benefits in either North Carolina or Virginia. Workers who are independent contractors are not eligible for either lost pay benefits or for medical bills through worker’s compensation. This means that any worker who wants to receive workers’ compensation must show he/she was employee when the accident occurred. It also means that the insurance company for the employer will want to show that an injured worker was not an employee but worked independently.
Employers are required to have workers’ compensation for all their employees and are required to know the difference between an employee and an independent contractor. Typically, an employer pays an employee payroll taxes and unemployment taxes for the employee – in addition to paying for worker’s compensation insurance and sometimes even healthcare benefits.
Our firm has handled many of these kinds of cases, and prevailed in all of them by proving that the employee was, in fact, an employee as opposed to an independent contractor. We see many employers attempting to get away with this “misclassification” of employees, particularly in industries such as construction, cable installation, or transportation, where it can be costly to maintain workers compensation insurance. Also, as mentioned previously, classifying employees as independent contractors frees the employer from the obligation to pay payroll taxes or health insurance if there are more than 50 such employees. The problem is, when one of these employees gets seriously injured, he or she has no way to pay for the hefty hospital bills.
We have often found that these employers often do have workers compensation insurance. They just refuse to extend that insurance to cover certain workers that they wrongly classify as independent contractors. Once we have proven those workers are, in fact, employees, then the insurance coverage steps in and covers the employee.
Neither the worker nor the employer gets to make the decision as to the employee’s work status. This is true, even if the employer forces a worker to sign a statement saying he/she is an independent contractor before doing any work. Even if the worker receives a federal 1099 form, that is not conclusive to show the worker is an independent contractor. The state workers ‘compensation commissions make the decision which means, for all practical matters, that the Deputy Commissioner makes the call.
The Virginia Workers Compensation Commission and the North Carolina Industrial Commission typically review a variety of factors to determine if you are an employee or independent contractor. Many of these factors are based on the guidelines set forth by the Internal Revenue Service. The key issue tends to be who controls the worker’s hours, labor, and manner of performance. If the employer has control, then the worker is usually an employee. If the worker has control, the worker is usually an independent contractor. Some of these factors are:
Some additional questions a judge will review to determine employee vs. independent contractor status are:
If an employer doesn’t have workers’ compensation for an injured worker and that worker is judged to be an employee, then the employer can be required to pay all the work injury benefits, including temporary total disability, medical bills, and vocational rehabilitation expenses out if its own pocket.
If the worker is found to be an independent contractor, then the employer has no obligation to the independent contractor. An injured independent contractor will then look to his/her own health care policy to pay any medical bills. The contractor will lose wages unless he/she also had some sort of professional disability insurance policy or his own workers comp policy.
If the employer was negligent and the negligence caused the worker’s injury, then the injured independent contractor may be able to sue the employer for his/her medical bills, lost wages, and also for any pain and suffering. If it is clear the employer failed to follow the local building codes, OSHA standards, or common sense work safety conditions – then the employer will be more likely to agree that the worker is an employee. Injured workers should consult with their work injury lawyer before agreeing to this because they make more money by bringing a personal injury lawsuit.
Employers who intentionally classify a worker as being an independent contractor, when they certainly know that the worker is an employee can be subject to fines and penalties – and for the payment of the worker’s employment taxes.
We have come across a few larger employers who have attempted to get away with this misclassification. Rather than upend their entire business model by being exposed in a formal Judicial proceeding, many have desperately agreed to settle the claim instead, which, of course, has worked to our client’s benefit.
Understand your rights. In many cases, the employer misclassified your work status. Attorney Joe Miller Esq. understands the difference between employee and independent contractor status. He’ll fight to get you approved for employee status if you were injured on the job. He’s helped thousands of injured workers get justice. To speak with an experienced workers’ compensation lawyer, please phone (888) 694-1671 or fill out the contact form.
Posted on Monday, January 29th, 2018 at 3:03 pm
If your physicians make clear that you are unable to perform you prior job because of permanent physical or emotional limitations, (i.e. you are placed on permanent Light Duty), if you are under an Award in Virginia or an Accepted Claim in North Carolina, AND your employer is not willing or is unable to accommodate your restrictions, the employer’s insurance company will often seek to get you some employment that you can do. There are basically two ways to get you to work with restrictions:
Initially, the employer will assign a vocational rehabilitation counselor to your case. Even though they may be nice, the vocational counselor is often not your friend. He or she is working for the employer and trying to get you any job so the insurance company doesn’t have to continue paying North Carolina or Virginia’s worker’s compensation benefits. More importantly, the vocational rehab counselor will schedule numerous meetings and job leads for you to attend and follow up on. If you fail to “jump through their hoops,” particularly in Virginia, then you will likely be cut off of your benefits for failure to comply with the vocational rehabilitation plan.
The first step is to review your rights with an experienced worker’s compensation who can inform you about:
When it becomes certain that the injured employee simply isn’t going to find a suitable job that meets the work restrictions, then retraining and education is the next likely step. Many employer insurance companies still prefer to pay for retraining rather than to pay for extended work loss wages. Sometimes, this is determined after the first meeting with the vocational rehab counselor.
Retraining usually means one or more of the following:
Retraining can also mean counseling for people with learning disabilities, blindness, deafness, or mental illness.
Many manual workers can be retrained. Retraining isn’t just limited to high school. Some college education and same trade school education may also be available. Of course, any costs must be borne by the employer.
The employer’s insurance company should pay for:
A vocational rehabilitation counselor will also be assigned to work with you. A good counselor will help your choose training that will help you find a job in your location. A good counselor will also monitor your work not just to see if you taking and passing the classes – but also to review how you are doing and if you need any additional assistance. A bad counselor—which unfortunately is the majority of them— will look to see if you’re missing meetings or performing poorly so he/she can say you’re not cooperating and get you cut off of benefits.
Workers who are fully disabled or who can’t be retrained because of age or other problems shouldn’t be forced to go through a re-education process. If there’s no point to retraining – meaning that completing your studies won’t lead to suitable work, then you should get your benefits on the basis of a total disability.
Your Virginia or North Carolina worker’s compensation attorney can explain when retraining isn’t worth the effort, i.e. would be futile, and how you should proceed. For example, the lawyer may work with a vocational expert who can certify that the retraining simply won’t lead to a real job – given your current work limitations and the known job market in your locale.
On the other hand, if retraining can help and the employer’s insurance company refuses to pay for it, an experienced work injury lawyer will file the proper paperwork and hearing request to force the employer to pay for your vocational rehabilitation.
North Carolina and Virginia lawyer Joe Miller Esq. has been fighting for injured workers for almost thirty years. He has helped thousands of employees get the lost wages they deserve and get their medical bills paid. He has also fought and prevailed against bad vocational rehabilitation counselors who recommend inappropriate jobs as a means to attempt to get the worker cut off. The goal is always to work towards what is hopefully a good settlement his clients’ work injury case and a chance at a new life and a decent job. For help now, please call (888) 694-1671 or complete my contact form.
Posted on Tuesday, January 16th, 2018 at 5:09 pm
North Carolina Workers’ Compensation Lawyers keep abreast of recent legal decisions. Understanding how cases of other workers are decided helps a good lawyer prepare your case. If there are similar issues, an understanding of the legal decision indicates which arguments and what kinds of evidence a Deputy Commissioner will consider and which arguments and evidence types will not be persuasive. Experienced work injury lawyers regularly review the latest decisions and research them when an issue in your type of case is not clear.
A couple of recent cases in North Carolina:
The claimant/employee was required to attend the three-day conference, could not bring family members, and was paid his regular salary for attending. The employer created networking and social events that employees were also required to attend. One such event was a laser tag event. The employee felt pain in his right knee while participating in the laser tag event. He sought treatment, after the conference was over, for the right knee. The treatment ultimately required that his right knee be replaced because he suffered a torn meniscus and severe cartilage loss. Mr. Holliday filed a Form 18 , but the employer denied the claim. A hearing was held, and the North Carolina Deputy Commissioner approved the employees claim, including the medical treatment and temporary total disability payments.
The employer appealed the Deputy Commissioner’s decision claiming that:
The employer appealed to the Full Commission, which upheld the Deputy Commissioner’s decision granting benefits. The employer then appealed to the North Carolina Court of Appeals.
The NC Appellate Court denied all three appeal issues based on the following reasoning:
It can thus be seen that under NC workers compensation law, there are sometimes circumstances where employees can be injured during so-called “company events” that will be deemed compensable by the Industrial Commission, assuming that the employer requires that the employee attend and that the event serves some business purpose. It is not necessary that the activity which injures the plaintiff fit the plaintiff’s job description, and in fact, it is helpful when it doesn’t.
The employee filed a Form 18 about four months after the accident, which the employer/defendants denied. The Deputy Commissioner and on Appeal, the Full Commission denied the employee’s claim because he failed to demonstrate that he suffered an injury by accident. The employee appealed from those decisions to the Court of Appeals of NC.
Unlike the Deputy Commissioner and Full Commission, the appellate court did find that the injury was caused by an accident and found there was insufficient evidence to say it was not so caused. They reversed the lower decisions and remanded for consideration of Mr. Barnette’s benefits. An accidental cause of injury is “inferred where the work routine is interrupted and the introduction of unusual conditions is likely to result in unexpected consequences.” The appellate court found that this inference carried extra weight when it is clear that employee had to do something physically unusual – which was the case here since the stairway was too narrow and they had to return back down the stairwell, unable to make the final turn to the kitchen, which was on the 3rd floor of the beach cottage.
The bottom line is that the appellate court did find that the employee did suffer a work-related injury and was entitled to worker’s compensation benefits. The key is that the worker was not just doing his or her usual routine and felt an injury. In North Carolina, there must be something out of the ordinary or unusual that is likely to result in unexpected consequences. Otherwise, there is no case.
Contrast this with Virginia, where the focus is more on risk of employment. In Virginia, you would not need the unusual occurrence of the narrow stairway to prove an accident. The risk of injury from carrying a very heavy refrigerator would likely be enough. So this is a good example of where North Carolina’s law as to proving a compensable injury by accident are slightly more strict than Virginia.
Attorney Joe Miller Esq. keeps current with the latest legal developments. He understands the arguments defense lawyers and what evidence workers’ compensation lawyers find persuasive. He has helped thousands of injured victims get justice.
Posted on Tuesday, January 16th, 2018 at 5:09 pm
When a workplace accident causes an injury, the best course of action is to meet with an experienced North Carolina or Virginia workers’ compensation lawyer. A respected lawyer will explain your rights, what practical and legal steps you should take, and how the litigation process works.
Workers, who act on their own, often make the following mistakes which can cause them to lose their case, to lose certain benefits, or to fail to properly get all the compensation and medical care they deserve.
Some of the more common mistakes employees make are:
Many employers have written guidelines or manuals for what to do when a workplace accident occurs. Employees should follow the procedures set forth in these documents. These typically involve filling out some kind of accident report. If there is no written policy, then you should tell a manager or supervisor– and as many other people as possible. Employers need to know about the accident promptly so they know your claim is legitimate. Good employers will also take steps to correct whatever may have caused the accident so other workers aren’t injured too.
Employees who fail to give prompt notice may still be able to file a claim – especially if it is clear the employer had actual knowledge of the accident – such as being told by one of your co-workers.
Employers even have the right to hire nurse case managers who, in theory, are used by the employer to help you make your appointments and have all your questions answered. In practice, the nurse case managers work for the employer and not you. They will be monitoring your medical appointments and treatments. If you fail to see your doctors or follow-through with the recommended treatments, the nurse case managers will alert their employer who may, then, seek to terminate your benefits. In Virginia, once an Application to terminate benefits is filed, your benefits stop IMMEDIATELY, and it may take months or even years to re-activate them.
Attorney Joe Miller Esq. has been helping injured workers get justice for over 25 years. He’s helped thousands of clients get a strong recovery. He’ll guide you through each step of the claims process and make the right arguments on your behalf. To speak with a strong advocate, please phone lawyer Joe Miller at (888) 694-1671. You can also reach him through his contact form.
Posted on Wednesday, January 10th, 2018 at 11:44 am
Light duty work is a legal term of art that you should review with your North Carolina or Virginia workers’ compensation lawyer. “Light Duty” typically means that your authorized treating doctor has released you to some kind of work with physical restrictions, but not your usual job. An example might be “no lifting over 10 lbs, no bending, stooping, no climbing ladders or working at heights.” If you work as a roofer, that is going to knock you out of your job, at least for now. Alternatively, if your injuries and restrictions are more severe, you may be restricted to a sedentary or seated job.
What happens to your case as a result of that light duty release depends on many, many factors that are extremely complex. In many instances, particularly in Virginia, a light duty release by your doctor should be treated like a hydrogen bomb that has just been dropped on your case. You could be cut off of all benefits immediately, if you are not already under an Award for Comp Benefits that has finalized.
Accommodation by the Employer-The Kiss of Death
Oftentimes, employers will say that they simply do not have any such thing as “light duty.” We will discuss your obligations in that regard soon. That is where the Award issue becomes important; however, if the employer decides to accommodate your restrictions by giving you a “made up” job, then it does not matter whether you are under an Award or not. If your doctor is made aware of the exact type of light duty work you will be doing and the doctor states you can do the work as long as it meets his medical restrictions, then you need to try to do the light duty work. Failure to try the work may result in the loss of your benefits AND the loss of your job.
We are sorry to say that most of the time, accommodation of light duty work by the employer is usually a veiled attempt to harass you and make you trip up and do something insubordinate, so that the employer can fire you. Then, your workers comp case is basically over. Unfortunately, there is no mechanism under the law to do anything about it. You basically have to tough it out unless and until your doctor pulls you back out of work completely.
That is not to say that all employers are out to get you. Some legitimately do want to help you. It is said that allowing you to come back to work on light duty helps you in the following ways, for example:
As an experienced work injury lawyer, however, I must tell you that more often than not, employers often try to use light duty work as a way not to help you, but to try to cut off your benefits. If you fail to follow proper procedures and the recommendations of your doctors as to whether you can do light duty work – you may lose your job and your benefits.
When the employer does not have light duty work or cannot accommodate your restrictions
As discussed previously, many times, the employer will not have anything for you to do within your restrictions. The reason for this is that by returning to the job site, especially if you are in a delicate state, you present a risk to the employer and the workers compensation insurance company of re-injury on the job. Then the employer will have to deal with a whole different injury date and possibly additional injuries. If this occurs, there are two completely different scenarios that can occur, which we will now explain.
Scenario A: You have a finalized, Open Award in Virginia or an Accepted Claim in North Carolina
This is where your Award comes in. If you have a Virginia comp case, whether or not you are under a finalized, ongoing, or Open Award (more than 30 days have passed since entry of the Award) when you are released to light duty will dictate what happens next.
If you are under a finalized Award which says that you are to get comp checks every week without an end date (i.e. Open or ongoing checks), this means that the Virginia Workers Compensation Commission has proclaimed that you have a right to those benefits unless and until the employer can show that you are capable of returning to your pre-injury work. So your checks will not stop.
What may happen at that point is that the comp carrier may hire a vocational rehabilitation expert to attempt to find you work within your restrictions. Be aware that some of these folks can be extremely aggressive. You must be careful, because typically their real job is not to find you a job but to have you trip up and miss meetings and fail job search requirements so that you can be cut off of benefits.
But sometimes, particularly if your injuries are severe, you are older, and your education level is limited, the workers compensation insurance company realizes that vocational rehabilitation will likely be a waste of time and your checks may simply continue until such time as either the parties can come to a settlement agreement, your doctor releases you to full duty, or your 500 weeks of benefits expires.
In North Carolina, a claim is accepted when the employer files a Form 60, indicating you are entitled to benefits; however, that Form 60 does not have the same force that it has in Virginia. Yes, if you are released to light duty, you are likely to continue to receive benefits if there is a Form 60 filed by the employer; however, we always counsel our North Carolina clients who are receiving such benefits to search for a minimum of 3-5 jobs per week within their physical restrictions and skill set, if the employer will not accommodate your restrictions. This is because if something comes up in your case, you may have to prove that you were entitled to these ongoing benefits. And an injured worker on light duty in North Carolina is technically only entitled to those benefits when he or she can prove that they have sought work within their restrictions but have been unable to find such work.
Scenario B: You do not have an Award in Virginia or your claim has been denied in VA or NC
If you are not under a finalized, ongoing, or Open Award for benefits in Virginia, it may be for any number of reasons. The most common reason is that you simply were not aware that you were required to get one. Many employers will pay you benefits voluntarily while your authorized treating doctor is holding you completely out of work. That is, until the day when you are released to light duty. The unfortunate reality is that when that day comes, you may suddenly discover that your employer has cut you off of benefits. How can they do that?
You will recall above that we said that an ongoing or Open Award for benefits issued by the Virginia Workers Compensation Commission is a proclamation that you are entitled to ongoing weekly checks and medical benefits. The checks will continue unless and until you return to your pre-injury work.
Well, here, there has been no such proclamation issued by anyone. You therefore have no rights and the workers comp insurance carrier is not under any obligation to do anything for you.
Your only remedy at that point is to file a Claim for Benefits and ask for a hearing and also vigorously market your residual capacity to work. The idea is that when you get to the hearing, you will be able to prove to the Commission, without any shadow of a doubt, that you have sought work—we recommend a minimum of 7-10 jobs per week–within your physical restrictions and have been unable to find any such work. You must present this evidence at the hearing in an organized, overwhelming fashion. If you do not do this, the Deputy Commissioner will likely reject your evidence and not Award you benefits.
If you do present the evidence properly and the Deputy Commissioner decides that you adequately looked for jobs, you will be awarded backdated workers compensation checks from the date that you can first prove that you do adequately looked for jobs within your restrictions and skill set.
Talk with a trusted North Carolina or Virginia workers’ compensation lawyer now
Understand what light duty work really means and the consequence of being released to light duty. You must make sure that you always know what your physical restrictions are. Depending on the status of your claim and the inclinations of your employer, a release to light duty can either be a destructive atomic bomb, or your benefits may continue uninterrupted. An experienced workers comp lawyer can explain when and how your release to light duty will impact your case. Your lawyer can also make sure your doctor is fully aware of what your return-to-work scenario looks like, so that he or she knows what is being approved for you to do. For strong advocacy, please phone attorney Joe Miller Esq. at (888) 694-1671 or use his contact form. He’s been helping injured workers get justice for over 25 years.
Posted on Wednesday, January 10th, 2018 at 11:41 am
In North Carolina and Virginia, may times the insurance company for the employer will want to take your deposition. A deposition is on oral question and answer session which is recorded so that it can be transcribed and the discussion can be preserved. It is done under oath, just like you were in the courtroom. In most work injury depositions, the insurance company attorney will question the worker and your worker’s compensation attorney will prepare you for the deposition. Preparation means explaining what questions the employer’s lawyer will likely ask so that you aren’t surprised when the real deposition takes place and also going over some general tips to help the deposition go smoother. By reviewing the deposition with you in advance, and using the attorney’s experience to prepare you for the deposition, the lawyer will also explain many practical suggestions so you can express your answers in a way that can best help your cause.
In most depositions, that lawyer for the insurance company is polite and the questions are fairly straightforward. Occasionally, that is not the case. Either way, you should treat the deposition as a business meeting. No matter how nice the defense lawyer is, he or she is not your friend. Defense lawyers will try and derail your case, if given the opportunity to do so.
The deposition normally takes place either at your lawyer’s office or the law office for the attorney for the insurance company/employer. The questions and answers are usually in a lawyer’s conference room and just you, your lawyer, the insurance company lawyer, and the stenographer or court reporter are present. Occasionally, particularly if your lawyer will also be deposing your supervisory personnel, a company representative may be present. Sometimes, albeit rarely, the insurance adjuster is present, but they will not be able to ask you any questions under oath. Only the defense lawyer and your own attorney can do that.
If you don’t currently have a lawyer, we strongly suggest retaining an experienced worker’s compensation lawyer before heading into a deposition. Please do not do that on your own. You may very well risk causing tremendous damage to your case.
Remember, it does not cost you any money up front to hire a workers compensation lawyer. You will not have to stroke a check. Attorney’s fees in workers comp cases are controlled by the Industrial Commission in North Carolina or the Virginia Workers Compensation Commission.
In addition to thorough preparation of you prior to the depo, your lawyer may object to some of the questions that are being asked. You lawyer can also ask you questions that can help clarify your answers once defense counsel has finished his or her line of questioning.
When you answer the questions, you will be under oath. Testifying under oath means that you swear to tell the truth and to answer the questions to the best of your ability. The court stenographer is the person who will swear you in.
What is the purpose of the Deposition?
The deposition of a Claimant or Plaintiff in a Workers Compensation Case Generally has Four Purposes:
The insurance company lawyer will generally ask you the following:
And even though the employer does not have to be at fault, sometimes there needs to be a defect if you were injured in a way that is a common way to get hurt. For instance, in Virginia, if you simply missed a step while walking down a set of stairs, that is not a risk of employment and you have no case, unless your shoes were slippery from work materials, you were rushed with work items in your hands, or the step on which you slipped was somehow defective. The bottom line is that in a contested case, it is very important to go over these facts with your attorney so that you do not inadvertently say something that could ruin your claim.
In North Carolina, there are somewhat stricter provisions that generally require some type of slip, trip or fall—something unusual, that must occur in order for you to have suffered an “accident.” This will be explored by defense counsel, particularly if you have a contested claim.
What is often most important here is what you told your doctors or other health care providers about your injuries. If there are inconsistencies in the statements you made to doctors and hospitals about how you were injured, or which body parts you injured, then these inconsistencies, if not properly explained, can ruin your case. A good workers comp attorney will point out any of these inconsistencies and go over them with you in preparation for the deposition so that they do not derail your claim.
The defense lawyer will begin questioning with the first treatment and then go through your treatment, usually in chronological order or by physician, until the current time. He/she will also go over your long-term prognosis and how you are feeling now, as well as your plans going forward.
Some of the guidelines your worker’s compensation lawyer will go over with you before the deposition are:
Preparation is the key to most work injury cases. The more you and prepared and the more your lawyer has all the necessary information, the better chance you have of winning your claim. A skilled worker’s compensation lawyer like Joe Miller has handled many depositions. He can firmly guide you through the deposition process. He’s helped thousands of injured workers. For help now, please phone lawyer Joe Miller at (888) 694-1671 or use his contact form to schedule an appointment.