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At the core of the workers’ compensation system in America is the compromise between the employer and the injured employee: That the employer won’t face civil litigation, for which it would potentially be liable for big payouts for pain and suffering and other damages, while the worker doesn’t have to be fault-free and the process to get benefits is supposed to be faster. ironwork

Based on these principles, there are a number of presumptions that are made that are supposed to tilt the scales slightly in favor of the worker. Among those is that workers’ compensation acts are supposed to be liberally construed to accomplish the purpose of providing injured workers benefits. So doubts are supposed to be resolved in favor of the worker.

This does not mean the worker will necessarily have benefits handed to them or that he or she won’t have to fight for them.  Continue reading →

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A 2015 report by the National Safety Council, “Prescription Pain Medications: A Fatal Cure for Injured Workers,” details the fact that 25 percent of workers’ compensation prescription drug claim costs were for opioid painkillers. Although the percentage of workers using prescription drugs for treatment has increased in recent years, treatment outcomes haven’t improved.pills2

In fact, one study in Washington State revealed that a worker who receives more than a one-week supply of powerful drugs soon after an injury has double the risk of still being disabled a year later. Plus, pain medication of this nature can cause serious harm to workers, including addiction, overdose and even death.

There have been numerous court cases in which a worker died of an opioid-related drug overdose.

In the recent case of King v. CompPartners, out of California, the worker thankfully did not overdose. However, he did suffer numerous seizures when an anesthesiologist abruptly withdrew him from powerful medication after deciding it was no longer medically necessary. Continue reading →

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Recently in Las Vegas, reporters described a scene of great excess: Thinly-clothed acrobats performing from ceiling swings, dancers in lingerie on poles shaking to the techno music, actors dressed as aliens looking for a photo op, a live alligator, rock stars performing, waitresses passing out free chocolate truffles and cocktails, designer handbag giveaways, free Hummer limousine rides and more.vagas

These individuals were attending the National Workers’ Compensation Disability Conference Expo – one of about 150 such conferences held annually by the “middlemen” of workers’ compensation. These companies are hired by employers and insurance companies to conduct “cost containment” in workers’ compensation cases.

Services offered are varied, and include claim management and negotiation of medical bills. These firms promise to cut costs for all involved, but in reality, many say they are in fact increasing costs and worse, raising the burden of those who have been hurt at work.

Workers’ compensation is supposed to be straightforward. Worker gets hurt on-the-job. Worker receives immediate medical and wage benefits through the course of recovery. But these firms work to fight claims tooth-and-nail, reducing the amount workers receive – if they receive anything at all. They have culled networks of high-powered defense lawyers, expert medical opinion providers, medical bill review services, occupational medical clinics, labs that drug test injured workers and outside claims shops.  Continue reading →

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In Georgia workers’ compensation cases, proving one is totally and permanently disabled is not easy. Unless claimant has suffered a severe traumatic brain injury or a condition like quadriplegia or blindness, it will require substantial evidence from medical experts to prove the case. backinjury

As pointed out by a recent ProPublica article on, “The Demolition of Workers’ Compensation,” the state ended the promise of lifetime medical care for work injuries in 2013, capping it at eight years for all but the worst cases.

Per Georgia Code Section 34-9-263, guides to percentage of disability or body loss ratings follow the guide published by the American Medical Association. Only if a person suffers the loss of more than one major member (i.e., both arms, hands, legs, feet or any two or more of these members OR loss of vision in both eyes), there is a rebuttable presumption of permanent total disability, as defined in Georgia Code Section 34-9-261. That means the burden of proof shifts to the defendant in the workers’ compensation case to show why plaintiff shouldn’t receive benefits (instead of the other way around).  Continue reading →

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Workers’ compensation is the exclusive remedy for employees injured on-the-job. That rule is applicable only insofar as employers and workers’ compensation insurance companies are concerned. When a work injury is due in full or in part to the negligent actions of a third party, the worker may pursue a personal injury lawsuit against that party – in addition to collecting workers’ compensation benefits. brakelights

However, it is crucial for employees to understand that if they do pursue a third party action, their employer and/or insurance company may be entitled to something called “subrogration.” In this scenario, it would mean the entity that paid workers’ compensation benefits would have a right to reimbursement from the third-party litigation damage award. That hold that an employer has on the third-party damage award is called a “subrogration lien.” The statute under which this is permitted is O.C.G.A. 34-9-11.1.

This does not mean a worker will get nothing by pursuing third-party action. The reality is, personal injury lawsuits tend to glean higher damage awards than workers’ compensation, and they also reimburse for losses such as pain and suffering – which workers’ compensation does not. It is imperative that injured workers in this situation employ an experienced attorney because failure to do so could mean a loss of critical benefits. Continue reading →

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In many workers’ compensation claims, the primary issue is the fact the employee can no longer work. He or she needs coverage not only of medical bills, but of a portion of the wages lost and, in some cases, the loss of earning potential via permanent partial disability.upstairs

However, there are some cases in which a worker’s injuries are so severe, a spouse or other loved one has no choice but to forego their own employment to care for the injured person full-time. This is referred to as “attendant care,” and it is something for which spouses of injured workers can be compensated.

Compensation for attendant care in Georgia is often awarded in cases where a worker has suffered an injury to the spine or loses function in the arms or legs, such that the worker requires assistance to perform daily activities of life. Although sometimes nurse assistants are called to perform these duties, it’s often more cost efficient and better for everyone involved if a loved one is to be the one rendering care. Continue reading →

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The preliminary Census of Fatal Occupational Injuries for 2014, released by the U.S. Bureau of Labor Statistics, indicates a 2 percent increase in the number of deadly work accidents compared to 2013. worker5

Early national estimates are that 4,679 workers were killed on the job last year, compared to 4,585 in 2013. Still, the rate of deaths for both years was 3.3 workers per 100,000 full-time equivalent workers.

Although revised final data from the report won’t be available until spring, it’s safe to say the increase is not a fluke or within the margin of error. That’s because over the course of the last five years, there has been a net increase 173 deaths on average a year. In 2011, it was up 2 percent from the previous year, while in 2012, the figure climbed 6 percent. Continue reading →

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In workers’ compensation case law, a “clincher agreement” is a compromised settlement between an injured worker, the employer and the employer’s insurer. mining

Clincher agreements indicate a final resolution of a case. Usually, this involves some lump sum cash settlement in exchange for release of all future liability against the employer and insurer. It will address payment of all outstanding medical bills, and may provide some stipulation for future medical bills related to the work injury.

Such an agreement can be beneficial for both parties, as it provides injured worker with necessary compensation and takes the guesswork out of future disputes. However, it’s imperative that these agreements be carefully drafted and reviewed. Failure to do so can result in signing away important rights and leaving you stuck paying for work-related medical bills with no option for further recourse. Continue reading →

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In order to obtain workers’ compensation benefits in Georgia, the employee must have fallen ill or gotten injured while acting in the course and scope of employment. There are also allowances when some aspect of work exacerbated an existing condition. foggymorning

Usually, if an employee who is injured in an auto accident commuting to or from work isn’t eligible for benefits (this is called the “coming-and-going rule), but there are exceptions to this too.

The recent case of Kelly v. Blue Ribbon Linen Supply, recently considered by the Idaho Supreme Court, is an interesting one that involves all these elements. Justices were asked to consider whether a commute from an independent medical exam, requested by the employer as part of an earlier work injury claim, may be considered an action that is in the course and scope of employment. Continue reading →

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Settlement of a workers’ compensation claim should only be entered into by workers who have had time to consult with an experienced attorney. The reason is settlement agreements are binding contracts, and signing off on one may prohibit any future claim for injuries, even if the injury or illness worsens. cooking

Careful review of these documents is imperative so that the affected worker isn’t cheated out of future benefits to which he or she may otherwise be rightfully entitled.

A settlement may result in:

  • No more weekly benefits.
  • Continued medical payments.
  • A lump sum damage award.

All agreements must be approved by the state workers’ compensation board. Continue reading →