Attorney Blog

Workers' Compensation and the Current Health Care Debate

Fri, 04 Sep 2009 00:00:00 GMT

I have recently watched the healthcare debate swarm into a frenzy of near violent confrontations at Town Hall Meetings across the nation and have become increasing perplexed by what is transpiring around our great nation and have come to think it time to put something on this page. As my website says, I concentrate my practice in the field of workers' compensation law where I fight employers and insurance companies and try to get my clients benefits they may be entitled to under NC Law.
I am proud and honored to do this work and care deeply for every one of my clients.

the following is a fact pattern that is typical of what I see on a day to day basis in my practice (this is not based on any real client of mine):

Ms. X is 32 years old, single mother of 2, 10th grade education living in Eastern NC working for Employer Y; she's worked there for 10 years and with good work, solid attendance and time on the job she's been able to increase her wages to $13.00 an hour. This is enough to pay the rent and bills and keep her kids fed and clothed. The plant she works at does not offer health care or if they did, she'd have to pay half, which she cannot afford. One day, Ms. X is on the floor at her job, bends down to lift a heavy box and she feels her back pop and experiences serious pain in her low back.

She reports the injury to her supervisor who takes her to the plant nurse. Nurse says, it's just a sprain, take some Advil and go back to work. Ms. X does so and guts it out for another week or so, continuing to seek help from the plant nurse who tells her the same thing over and over. Finally, after continuing to complain, she's sent to an urgent care and Comp. pays for this visit. She goes 2 or 3 more times and the Workers' Comp carrier continues to pay and the Dr. continues to note an injury at work and continued pain and weakness and thinks she has a problem with a disc. Eventually, the Urgent Care doc says Ms. X needs an MRI and a visit with an orthopaedist. He restricts Ms. X to light duty work with lifting, bending restrictions and notes that she needs to take a break every 15 minutes.

Soon after the recommendation for the MRI, the carrier denies Ms. X's claim for benefits for whatever reason and refuses to provide any more medical care for her. The employer says they cannot accomodate the restrictions and Ms X goes out on FMLA, only to be terminated at the end of that period. An MRI will cost $2,000.00 and an ortho wants $500.00 for a consult. No way she can afford this. She tries to get Medicaid but they look at earnings and she made too much when she was working to qualify for benefits. Ms. X is injured, in constant pain, out of a job and has no source of income. She does not have health insurance, cannot qualify for medicaid and is in desperate need for medical care. All Ms. X wants is to get better, get back to work and provide for her family.

How is it that we can say people like this (who I see every single day) do not have a right to get the care they need, do not have the right to get the diagnostic testing and access to a proper medical provider? I fully understand and appreciate the fact that we cannot make a perfect system and we do not live in nor can we create a utopian society, but certainly, we can do better than the system we have now...it's time to stand up, fight through the muckraking, fog, vitriolic hate and spew being propogated by the TV and radio "analysits" and stand up, side by side, regardless of party affiliation to do something right for those in need. If we continue down the insanely divisive path we are on as a nation, God help us all.

Underage Workers, Repetitive Motion Injuries and Rights of Undocumented Workers

Thu, 20 Nov 2008 00:00:00 GMT

The article below was published in the Raleigh News and Observier on Novemebr 9, 2008 and although it mostly deals with the issue of underage workers, there are a number of issues that relate to workers' compensation as well.

http://www.newsobserver.com/news/story/1287863.html

UNDERAGE WORKERS

The article in the N&O discusses a situaton where children under 18 were working in the plant. Federal and state laws dictate that due to the hazardous nature of the job, people under the age of 18 are not to work on poultry processing lines. In North Carolina, this does not prevent an underage worker from seeking workers' compensation benefits as the NC Workers' Compensation Act applies to minors, whether lawfully or unlawfully employed.

UNDOCUMENTED WORKERS

The NC Workers' Compensation Act also applies to undocumented workers. For the most part, undocumented workers are entitled to the same benefits as any other injured worker; however, there are some exceptions. For example, in terms of providing vocational rehabilitation, an undocumented worker is entitled to received benefits up to the point where he would find suitable employment, but for his undocumented status. As with any legal matter it is advisable to at least consult with an attorney to discuss and be informed about your rights, this is especially true here.

REPETITIVE MOTION INJURIES

The article also discusses that the line Ms. Gayton worked on had workers standing "shoulder to shoulder, making as many as 20,000 cuts a shift." The article also mentioned how Ms. Gayton's hands would burn for hours and that her fingers still hurt even weeks after losing her job.

When a worker is hurt due to repetitive motion at the job, it is usually classified as an "Occupational Disease". Occupational Diseases are specific conditions which are listed in the North Carolina Workers Compensation Act. These conditions include asbestosis, silicosis, synovitis, tenosynovitis, bursitis, and chemical exposure.

There is also a "catch all" provision which defines an "occupational disease" as any disease where your job exposed you to a greater risk of contracting the disease than members of the public generally and that your exposure significantly contributed or was a significant causal factor in the disease’s development. A common "occupational disease" that is included under this provision is carpal tunnel syndrome.

Again, it is important to at least consult with an attorney if you think you have a work related injury. You can also contact the Workers’ Compensation Information Specialists Section of the N.C. Industrial Commission. Dial toll free (800) 688-8349 or call (919) 807-2501 Monday-Friday from 8:00 A.M. to 5:00 P.M., e-mail InfoSpec@ic.nc.gov, or write the:

Workers’ Compensation Information Specialists Section
N.C. Industrial Commission
4333 Mail Service Center
Raleigh, NC 27699-4333

REDA Claims in NC

Fri, 19 Sep 2008 00:00:00 GMT

I came accross this article the other day and thought it useful and informative. For the most part, an injured employee cannot sue his/her employer in state court for injuries sustained in the course and scope of employment. Workers' comp. claims are heard before a duputy commissioner from the North Carolina Industrial Commission.

However, if an employee is fired from their job because they filed a workers' comp. claim, they may have a cause of action against the employer unter the Realiatory Employment Discrimination Act (REDA). Unfortunately, as you will see from the article in the link below, this act does not have many teeth and most claims do not yield positive results. I see this as an opportunity for people to contact their state senators and representatives and offer support for legislation that adds some real teeth to this act to protect workers who get fired because they were hurt on the job.

If you want to initiate a REDA claim, you must contact the NC Dept of Labor within 90 days of your termination to allow them to begin an investigation.

http://www.charlotteobserver.com/573/story/191970.html

Arrest for Fraudulent Workers' Compensation Policy

Thu, 07 Aug 2008 00:00:00 GMT

This story broke this week in Raleigh. If you work in construction, you should ask your employer about where their policy came from and have them make sure you are covered.

http://www.newsobserver.com/news/story/1164818.html

Social Networking Sites and Claims Investigations

Tue, 05 Aug 2008 00:00:00 GMT

Some of this is in my frequently asked questions but I thought that I should put something here as well as I feel this is a very important issue for injured workers to know about. Our society has become a lot more open to free expression as a result of the internet. We can publish diaries to the world in Blogs, have our own websites, upload photos, share music, and make contacts with people from different countries, and cultures. I think that for the most part, this is a great concept. However, if you've been hurt on the job and your claim is being investigated, you MUST take into consideration anything that you have out there on the internet...I have run into cases where private investigators are now searching for blogs and looking on Social Networking Sites like MySpace to see if there is any information that could be used to attack someone's credibility or be used to establish that they were not injured or are no longer disabled. An injured worker must be very careful about what pictures/content he or she has on a website. The safest way to make sure that this information stays out of an investigators hands is to shut the site down; however, if you want to keep your web page, blog, etc. running, you should think very carefully about what you say and put on that site.

More Changes at the North Carolina Industrial Commission

Tue, 29 Jul 2008 00:00:00 GMT

The North Carolina Industrial Commission has made some procedural changes that will help speed up the decision making process on some motions concerning medical issues. Decisions on issues such as Motions to Change Treating Physicians and Motions to Compel Medical Treatment are going to be decided upon very quickly and there is now an expedited procedure for appals on these issues as well. In the past several months, the North Carolina Industrial Commission has been working very hard on speeding up the decision making process and this is another move in that direction.

I am a big fan of the moves the IC is taking as, regardless of the decision, we're getting to court, getting heard and have the right to appeal and have a hearing on these issues quickly.

Here is a link to the new procedure for anyone who is interested:

http://www.comp.state.nc.us/ncic/pages/ExpMedMo.pdf

There are also new and revised forms for use as well.

These include a new Form 18 which is the form injured workers must complete to give notice to the Industrial Commission of their injury. These forms are effective August 1, 2008. There is also a new Form 19 that the employer fills out after an on the job injury has occurred.

Here is a link to this information as well...just scroll down the page and you will see where it says New or Revised Forms.

http://www.comp.state.nc.us/

Milage Reimbursement Changes

Thu, 17 Jul 2008 00:00:00 GMT

The North Industrial Commission has been working to keep up with rising gas costs and have increased travel reimbursement to $0.585 per mile for travel that exceeds 20 miles round trip.

Below is a link to the revised form that must be completed and submitted to your insurance adjuster.

http://www.comp.state.nc.us/ncic/pages/form25t.pdf