Can I get assistance at home if my work injuries prevent me from taking care of myself?

November 19, 2014 by · Comments Off
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I get a lot of calls from injured workers wanting to know how they are to go about their day-to-day lives while they are recovering from a serious work injury. Most people do not realize this, but the injured worker is entitled to home health care if his or her treating physician indicates that it is medically necessary and related to the work injury. This means that, if your injury is so bad that you cHome Healthcare Worker brushing hairannot dress yourself, cook for yourself, or take care of yourself, and your doctor agrees that you need the help, you can have the insurance company pay for home health care assistance. However, be careful what you wish for. The Carrier can decide who provides the home health care and can send any qualified person of their choosing into your home. Additionally, the Carrier can determine that it is more cost-effective to have the care provided in a nursing home rather than have 24 hour care, so the insurance company can force you into a nursing home, regardless of your wishes. However, if all you need is help for a couple of hours a day, and your doctor agrees, we can help get you the help you need so long as the doctor is willing to put this request in writing and will support it as being medically necessary and related to the work injury.

If you would like more information on the Virginia Workers’ Compensation system, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.

~Author
Michele Lewane, Esq.

EBOLA is a huge threat to our health care workers – PLEASE protect yourself!

October 30, 2014 by · Comments Off
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I certainly hope the Ebola virus does not spread anymore than it already has, but what if it does? What happens to all of those dedicated healthcare workers who are exposed to and could possibly contract this horrible sickness? The way the current workers’ compensation laws in Virginia are written, healthcare workers who come into contact with this nasty virus may not be covered if they are infected. Currently, if you are exposed to a virus (Aids, HIV, Hepatitis or even Ebola) and you can PROVE the exposure came from work you can be covered but PROVING where and when the exposure happened can be the hard part. If you can’t prove you were exposed at work, the workers’ compensation insurance carrier could argue that you picked up the virus somewhere else (a friend or neighbor or maybe you came into contact with an infected person at the grocery store or at the airport).

So how do you show when and where exposure took place? DOCUMENT, DOCUMENT Ebola strandand DOCUMENT some more! Document when, where and the type of contact you had with the infected patient or sample. Make notes on the instructions you were given by the healthcare authorities at the facility and what protective gear you were supplied with (did it fit? Was it damaged? Did you have skin exposed?). Take notes and update them every time you interact with someone who is infected, or may be infected and do the same for any lab work or tissue samples that could be infected. You can never be to careful dealing with such a deadly outbreak and I want to educate folks NOW on how to help themselves if this virus continues to be a threat to our society.

The only thing that could be worse than an Ebola diagnosis, would be getting an Ebola diagnosis after performing a public service and then having your workers’ compensation claim denied. I don’t want to see this happen to anyone! Please protect yourself folks!

If you would like more information on the Virginia Workers’ Compensation system, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.

~Author
Michele Lewane, Esq.

NEVER EVER take someone’s word that your injury will be covered!

October 2, 2014 by · Comments Off
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I always get concerned when injured workers tell me that their employer (or the insurance carrier) has made them all these promises that they will be taken care of after a work injury.  In fact, I had an injured worker call me today who had an injury several years ago; for conversation sake, we will call him Mark.

 

Mark was injured in January of 2012 and because his employer told him his medical bills would be taken care of because he was injured at work, Mark did not pursue anything further.  For the first 2 years, Mark’s medical bills were paid so he didn’t have any worries, but fast forward to August of 2014 and now Mark is having medical problems related to the work injury and now, whenever he goes to the doctor he is getting the unpaid bills in the mail.  He called the employer about this and his employer directed him to the insurance carrier for the workers’ compensation claim.  The insurance carrier told Mark that he did not have LIFETIME MEDICAL BENEFITS so they no longer had to pay for his treatment.  Mark is now having to pay for his treatment because there is nothing in writing from the state of Virginia dictating that the insurance carrier is responsible for his injuries.Emergency Room Bed

 

The sad truth is, Mark missed the 2 year deadline in Virginia (also called the Statute of Limitations) to file with the Commission and now he can never undo this mistake.

 

This is exactly why I tell injured workers that filing their Claim for Benefits form and asking for LIFETIME MEDICAL BENEFITS is so so so very important.

 

What Mark should have done:

He should have filed his Claim for Benefits form and asked for his lifetime medical benefits.  If this had been done within the two year time limit, Mark could still be going to the doctor and getting treatment covered by the insurance carrier.

 

If you would like more information on theVirginia Workers’ Compensation system, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.

 

~Author

Michele Lewane, Esq.

Sexual harassment at work does not entitle you to a Workers’ Compensation Claim

September 30, 2014 by · Comments Off
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I sometimes get calls from workers who have been the victim of sexual harassment in the work place and they want to know if this would entitle them to a workers’ compensation claim.  The answer is NO.  With sexual harassment there is no physical injury and the state of Virginia has gone as far as listing a code section in the Virginia Code (65.2-301) that specifically excludes victims of sexual harassment as being eligible for workers’ compensation benefits.  However, if you are sexually assaulted while doing your job, you could receive Virginia Workers’ Compensation benefits because a physical assault took place. woman stop

 

If you have been the victim of a sexual assault at work, have questions about whether or not your situation meets the requirements for benefits in Virginia or if you would like more information on theVirginia Workers’ Compensation system, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.

 

~Author

Michele Lewane, Esq.

The VWCC sets new fines for employers who don’t carry workers’ compensation insurance

September 25, 2014 by · Comments Off
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I’m pleased to announce that the Virginia Workers’ Compensation Commission has Gavel & Legal Bookfinally made some updates to their rules and guidelines when in comes to uninsured employers.  The new fees and regulations read:

 

“The law change amends section 65.2-805 of the Workers’ Compensation Act which addresses the civil penalty for employer failure to insure. Such employer shall be assessed a civil penalty of not more than $250 per day for each day of noncompliance, subject to a maximum penalty of $50,000, plus collection costs. The amendment was approved March 7, 2014 and will be effective on July 1, 2014.”  Source:  http://www.vwc.state.va.us/content/special-notice-new-penalty-uninsured-employers

 

Hopefully these new, steeper fines will encourage more employers to make sure their employees are covered by the appropriate workers’ compensation insurance!

 

If you would like more information on theVirginia Workers’ Compensation system, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.

 

~Author

Michele Lewane, Esq.

Who is this stranger at my doctor’s appointment?

September 23, 2014 by · Comments Off
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Often times, insurance companies will hire a Nurse Case Manager (I use the abbreviation NCM) to attend an injured worker’s doctor’s appointments.  While some  NCMs will be kind and call the injured worker to let them know that they have been assigned to the case and will be attending their next doctor’s appointment, others will Case Manager Woman-with-Clipboardjust show up to an appointment and surprise the injured worker.  If a Nurse Case Manager is assigned to monitor your care, there are some things you need to be aware of (like the fact that you have the right to a private examination!).

 

If you have questions about how to deal with a Nurse Case Manager, or if you would like more information on the Virginia Workers’ Compensation system, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.

 

~Author

Michele Lewane, Esq.

My Employer called and said I need to come to work but my doctor told me to stay out of work – What do I do?

September 18, 2014 by · Comments Off
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Sometimes when your workers’ compensation doctor has you out of work, the employer, adjuster or the nurse case manager (NCM) will contact the doctor who has you off of work and convince him to let you work a light duty job; sadly this often happens without the injured worker knowing anything about it!  cartoon nurseIf your doctor has given you a note that says you are not to be working and then you get a call about returning to work, you need to contact your doctor IMMEDIATELY!  You need to contact the doctor to get some clarity on what your true work status really is. If the doctor has changed your out of work note to now read as a light duty release (this does happen often), you need to get a copy of this so you have a full understanding of what it is you can and can’t do and if you are to return to work at a light duty status.  The other reason to contact the doctor immediately is because if you truly have been given a light duty release and do not return to work, your benefits could be terminated and you could lose your job for job abandonment – this is a HUGE mess for injured workers and should be avoided if at all possible!

 

If you have questions about your benefits or if you would like more information on the Virginia Workers’ Compensation system, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.

 

~Author

Michele Lewane, Esq.

Do NOT let Adjusters, Case Managers or Vocational Counselors into your home!

September 16, 2014 by · Comments Off
Filed under: Uncategorized 

I’ve talked to several injured workers lately who have mentioned to me that either a case manager, vocational counselor or adjuster has come to their home recently to talk about their case.  Listen up folks – don’t let people who work for the insurance company into your home!  This puts injured workers in a vulnerable position by letting an employee of the insurance company into their private residence to poke around.  By “poke around” I mean:

 

Is that a stroller?

Is there a young child around who needs to be cared for or picked up?

What about that weight set in the corner?  Are you working out?

Who uses those golf clubs? insurance-companies

 

All these things can lead to ASSUMPTIONS that could potentially lead to problems down the road for someone seeking benefits.

 

My point is – even things that seem harmless could spark a conversation or hint at something that was not intended so you need to be extra careful!  I always tell people that when things are left to chance, chances are the insurance company will lean towards whatever is financially beneficial for them – not the injured worker!

 

If you are going to be meeting with someone from the insurance company or anyone working on your claim, I always recommend a public place (restaurant, library, park – pretty much anywhere but your home).

 

If you would like more information on the Virginia Workers’ Compensation system, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.

 

~Author

Michele Lewane, Esq.

 

 

 

My employer won’t let me come to work while I’m on light duty – what do I do?

September 11, 2014 by · Comments Off
Filed under: Uncategorized 

First of all, if your employer won’t let you come to work on light duty, don’t take it personally.  Many employers out there simply don’t offer light duty work and others may have some light duty work but it may only be sporadic.  Your job as the injured worker is to communicate with your employer about this and keep them informed of your work status, even if your employer says they don’t offer light duty work, call and check in every so often and let them know you are willing to work if they provide you 22880-injured-worker-helpingwith tasks that your doctor says are appropriate (and ALWAYS keep track of these communications!).  If you are not able to work for your employer while you are on light duty, you may need to be marketing (looking for light duty work) – this can be a complicated scenario so if you find yourself in this position, it is best to consult with an attorney to ensure you are taking all the necessary steps that are required of you, the injured worker.

 

If you have questions about your responsibilities as an injured worker or if you would like more information on the Virginia Workers’ Compensation system, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.

 

~Author

Michele Lewane, Esq.

Temporary Partial Disability benefits (TPD) are NOT automatic!

September 9, 2014 by · Comments Off
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Temporary Partial Disability benefits, or TPD, are wages paid to an injured worker when they are working under light duty restrictions from their doctor and earning less than their pre-injury average weekly wage.  However, these benefits are not automatic (unless there is an award order)  The injured worker has to send their money bagcheck stubs in to the insurance adjuster or their attorney (depending on their 100 Dollar Billsmoney bagmoney bagsituation) and the insurance company can then calculate the difference in wages owed (based on gross earnings) and the average weekly wage. Then, the adjuster will cut a check to the injured worker for 2/3rds  of the difference.  The trick here is for the injured worker to know that they have to send in their pay stubs to prove that they are earning less than the average weekly wage.  I have had a lot of people ask me when they are going to be compensated for the difference in pay but they have not submitted their pay stubs because they did not realize that they were required to do so.  If you don’t send in your pay stubs, you won’t get paid – like everything else, the insurance company is not going to take your word that you are making less – you must prove it by providing your pay stub.

 

If you have questions about how lost wages are paid, or if you would like more information on the Virginia Workers’ Compensation system, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today(804) 755-7755.

 

~Author

Michele Lewane, Esq.

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