May 2010

North Carolina Workers’ Compensation Analysts Debate Implications of latest NCCI Conference

May 31, 2010, by Michael A. DeMayo

If you face a personal North Carolina workers’ compensation battle – against an insurance company, employer, or even the North Carolina Industrial Commission – chances are that you are not all too concerned about the broader implications of the NC workers’ comp policy debate. But an announcement at a recent conference in Orlando, Florida may indirectly affect you by changing insurers’ fundamental attitudes about state of the workers’ comp market.

Here is the scoop:

On May 6th, Stephen Klingel, the CEO of the National Council on Compensation Insurance (NCCI) announced that workers’ comp premiums in the United States have dropped precipitously from 2007 to 2009. The decline in premiums – which has been going on for three in a row – is the worst that the industry has faced since the Great Depression, and doomsdayers argue that these numbers do not spell good news for the economic recovery.

On the flip side, if North Carolina workers’ compensation insurance premiums fall — while this certainly will not be great for the insurance industry — it might prove to be something of a boon for employers and workers. Here is the thinking. If employers can afford more coverage, they theoretically might hire more workers.

That said, you have to be careful because these things are not always one to one. Just because North Carolina workers’ compensation premiums drop doesn’t mean that employers will be incentivized to do more hiring or that this will in turn lead to brighter times for workers.

All this is to say that if you or a loved one faces a crisis with respect to North Carolina workers’ compensation policy or benefits, don’t try to work out the complex details on your own. Connect today with a veteran, experienced North Carolina workers’ compensation firm to go over your strategic options and build a battle plan. Clarifying your road ahead will reduce your anxiety and help you focus on your physical and financial rehabilitation.

More Web Resources:

National Council on Compensation Insurance

Story about plunging workers comp rates

More Burning FAQs about North Carolina Worker’s Compensation System

May 27, 2010, by Michael A. DeMayo

Here are more solid answers to questions about the North Carolina worker’s compensation process (pursuant to laws in effect as of 2006). Consult a reputable NC worker’s comp attorney for details about your case.

What forms can you use to notify your employer that you have been hurt at work or that you have come down with an occupational disease?

Three different forms may be used:

1. The NC Workers’ Compensation program has a form called SGWCP-2 that you can get from your direct supervisor or from a workers’ comp administrator. This form lets you talk about the injury or accident and fill out different leave options.
2. Form 18 from the North Carolina Industrial Commission. You can get this from your workers’ comp administrator or directly from the NCIC. You can use Form 18 even if your employer does not want to accept responsibility for paying your claim.
3. Other forms (usually internal to your company). Talk to your HR department about how to get this form or speak with an official workers’ comp administrator.

How do employers report employee injuries?

Typically, they use Form 19, which they can get through the NCIC.

Can employers opt out of covering people for workers’ compensation?

No. North Carolina is a compulsory state. With some exceptions — waivers not being one of them! — employers must provide workers’ comp insurance either through self insurance or through a private carrier.

What are the exceptions?

• If an employer has three employees or fewer
• If a saw mill and or logging operator has 10 workers or fewer
• If an agricultural, non-seasonal employer has fewer than 10 full time workers

How does Temporary Total Disability work for North Carolina Workers’ Compensation?

Temporary Total Disability, also known as TTD, can be paid for the length of the disability. TTD is calculated by taking into account the working wage. Benefits are capped at both a maximum and minimum pay out.

What payment rules govern Permanent Partial Disability (PPD)?

PPD is also calculated based on the employee’s wage and capped for maximum payouts. Injured workers can collect PPD for as long as 300 weeks – that’s nearly six years. In certain cases, such as permanent disfigurement or complete incapacitation, disabilities can obviously be extended.

What rehabilitation benefits are available under North Carolina Workers Compensation law?

Physical rehab is compensable but occupational rehab is not provided for in the current law. If you lose your hearing as a result of an occupational injury, you may be able to collect compensation for this, though strict filing protocols apply.

How do NC workers’ comp death benefits work?

State law requires that the spouse and/or children of an employee will collect death benefits calculated by looking at the employee’s wage and estimating a percentage from that. Death benefits include funeral allowances and insure a minimum payout no matter what the employee made.

How can you get more specific information what to do about your North Carolina workers’ compensation claim?

Given all the legal complexities that go into these claims, it may behoove you to retain a pre-qualified and experienced North Carolina workers’ compensation attorney. Most attorneys will provide free consultations (in confidence) to give you a better idea of how they might be able to serve you.

More Web Resources:

Permanent Partial Disability (PPD)

Temporary Total Disability (TTD)

Answers to Your Burning Questions about North Carolina Workers’ Compensation

May 24, 2010, by Michael A. DeMayo

Pursuant to North Carolina worker’s compensation laws as of the beginning 2006, here are some brief answers to FAQs you may have about worker’s compensation benefits and restrictions. Please speak with an attorney before making any decisions about your claim and coverage.

How long can you wait after you get hurt before filing for benefits?

One full week (seven days).

How long do you have to be out of work for an injury before you get retroactive North Carolina worker’s compensation benefits?

Three full weeks (21 days).

Who decides what physician you can see?

Your employer does, in general. But the North Carolina Industrial Commission can change your physician selection in certain cases.

What employees do North Carolina worker’s compensation laws cover?

• NC government workers
• Officers and employees of universities
• Elected officials of North Carolina
• Most temporary, part time, and full time employees

What does the North Carolina Worker’s Compensation Act say?

A worker hurt by accident that occurred during the course of or out of employment can get compensations. Not all work injuries will be compensable. Some event had to cause the harm. One exception: hernias and back injuries may be compensable even if the claimant cannot identify a specific traumatic event stemming from work that caused the problem.

The Act also says that so-called occupational diseases can be compensable. These are diseases or illnesses that occur more frequently in a particular occupation. For instance, stenographers tend to suffer higher rates of typing injuries than do people in other professions. So, carpal tunnel syndrome may be classified as an occupational injury for a stenographer. However, say a stenographer comes down with diabetes. That may not be a compensable occupational disease, since being a stenographer does not typically predispose to getting diabetes.

What must an injured employee do to get compensation?

First, you must tell your employer as quickly as possible after the injury happens. If you wait 30 days or more, the employer may be able to refuse to pay out North Carolina worker’s compensation benefits. The injured party must also file a claim with the North Carolina Industrial Commission within two years from the injury or from the time that the injury was recognized.

Should you get legal help for your claim?

It never hurts to discuss your matter for free and in confidence with a qualified and proven North Carolina Worker’s compensation attorney. A free consultation is non-binding, meaning that you don’t have to pay for any services if you choose not to retain the lawyer after speaking with her.

More Web Resouces:

North Carolina Industrial Commission

North Carolina Worker’s Compensation Act

Astronomical Cost per Claim for Prescription Drugs Leave North Carolina Workers’ Compensation Experts Scratching Their Heads

May 20, 2010, by Michael A. DeMayo

The Workers’ Compensation Research Institute (WCRI) released a study at the end of April suggesting that North Carolina worker’s compensation claimants may be paying much more per claim for prescription drugs than claimants do in other states. The Cambridge-based Institute found that the NC rate was 14% higher than other states. On average, each claim cost $467. WCRI analysts suggested that the hike in prescription costs might be due to certain kinds of drugs prescribed, such as the muscle relaxants Metaxalone and Cyclobenzaprine. The study found that NC rates of consumption for these two muscle reluctants was nearly 20% higher than the average rate for the 16 states studied.

WCRI analysts had theories to account for the higher cost. For one, in North Carolina, physicians do a lot of direct prescribing of medications (instead of urging patients to get drugs filled at pharmacies). This may have had a cost impact, since physician dispensation typically results in slightly elevated costs.

Another theory is that the price per pill of certain medications was simply higher for several medications, such as the aforementioned Metaxalone and Cyclobenzaprine.

What might be the policy implications for North Carolina worker’s compensation from this latest WCRI Study?

Assuming the data are correct, policymakers may want to consider changing the system to encourage physicians to dispense fewer medications directly and to leave that job to the pharmacies. Policymakers might also examine whether market incentives could depress prices. They may also consult pharmacists and physicians directly for suggestions.

If you or a loved one is on prescription drugs as a result of a North Carolina workers’ compensation claim, it may help to take the time to consult with a respected North Carolina Workers compensation lawyer regarding your options. Patients who understand the rules and protocols of the NC workers’ comp system and who follow these guidelines strictly tend to do better over the long term in terms of getting rehabilitated and regaining their financial footing.

More Web Resources:

Workers’ Compensation Research Institute (WCRI)

Full story on how/why NC rate was 14% higher than other states

North Carolina Workers’ Compensation Experts Debate New Workers’ Comp Fraud Case out of Quakertown, PA

May 18, 2010, by Michael A. DeMayo

A sad and disturbing fraud case out of Pennsylvania has North Carolina workers’ compensation policy makers and analysts furiously debating a number of moral and ethical quandaries.

Background

On April 29, authorities arrested 43-year-old Christina Gamble for workers’ comp and insurance fraud stemming from a claim she made in November 2007 that she allegedly made under false pretences.

The PA Attorney General’s office alleges the following:

Gamble had been working for the restaurant Red Robin, when she fell on November 9, 2007 and hurt her back. The restaurant alerted its insurance carrier. In November 2008, a judge awarded her benefits for workers’ compensation. She collected over $22,700 in disability benefits and $4,100 in medical expenses before being caught working in a new capacity – as an exotic dancer for C.R. Fanny’s Gentlemen’s Club and Sports Bar. A private investigator tipped off an agent of Highmark Insurance, which had been representing Red Robin. Since Gamble made her claim on the basis that she could barely move her back, her work as a dancer for hire obviously completely undermined her claim.

Gamble is due in court on May 7. If she is convicted of both accounts of insurance fraud and theft, she could face 14 years in jail and $30,000 in fines.

Workers’ comp and insurance fraud are obviously reprehensible. Enforcement of North Carolina workers’ compensation laws must be strict to ensure that people who do play by the rules get treated fairly and that system-wide costs don’t get out of control. Nevertheless, this case illustrates – or at least implies – how difficult it can be for some people to recover from bad injuries or occupational diseases. Here is a story of a waitress who presumably hurt herself and then did a wrong thing by stealing from her employer’s insurance carrier. But (likely) the news story does not give us the full human dimensions of Gamble’s struggle. As anyone who has personally dealt with North Carolina workers’ compensation issues can tell you, it’s not easy to handle insurance companies or to figure out how to correctly and efficiently get your life back on financially solid ground.

To that end, before you or a family member does something dumb like try to defraud an insurance company or misreport numbers on your workers’ compensation form, connect with an ethical, reliable, and results-proven North Carolina workers’ compensation attorney to discuss your situation in confidence. A free consultation can give you the strategic guidance you need to make wise and ethical decisions about how to move forward and recover from an injury, both medically and financially.

More Web Resources:

Christina Gamble fraud saga

Strip club no cure for her bad back

North Carolina Workers’ Compensation Experts Abuzz about Albany Felony Charge

May 12, 2010, by Michael A. DeMayo

A relatively small felony case is turning the heads of top North Carolina workers’ compensation specialists. According to news sources, a 48-year old man named Richard Scepkowski pled guilty to felony workers’ compensation fraud after being caught working at an auto repair center. Scepkowski worked for the Transportation Security Administration (TSA) at Albany’s airport before claiming injury around July 4, 2004. He filed workers’ comp paperwork with the Department of Labor and collected a payout of nearly $20,000 from September 2004 through August last year. This amount is (relatively) minor as far as workers’ comp fraud cases are concerned. But since Scepkowski pled guilty to making false statements, he now faces an array of strict penalties.

How This Small Case Relates Back to North Carolina Workers’ Compensation Concerns

1. It illustrates how persistent the government can be in terms of rooting out fraud and punishing offenders.

Scepkowski got away with collecting federal workers’ comp for more than five years before getting caught. This shows that people who attempt to defraud the North Carolina workers’ compensation system will always be at risk for getting caught and facing severe financial penalties and potentially other punishments, such as jail time.

2. Even small instances of workers’ comp fraud will be taken very seriously.

A felony conviction can result in jail time and the permanent loss of certain privileges, such as the right to vote in elections.

3. The case shows how important it is to file your workers’ compensation paperwork carefully.

In this case, a claimant willfully deceived the DOL in his paperwork. Nevertheless, even otherwise well-intentioned claimants who make mistakes in their applications can get in big trouble – or at the very least lose hard-won benefits.

If you have any questions about the North Carolina workers’ compensation process or about your paperwork, connect ASAP with a reputable and experienced NC workers’ comp attorney to learn more about your rights and responsibilities under state and federal law.

More Web Resources:

Scepkowski case

Another story about Scepkowski fraud

North Carolina Workers’ Compensation Policy Alert: Another Offender Hit with Harsh Penalties (Including Two Years Prison Time) for Federal Workers’ Comp Fraud

May 10, 2010, by Michael A. DeMayo

Those who follow North Carolina workers’ compensation policy debates often closely analyze minor court cases because these cases inform the broader discussion. To that end, we will review the implications of a recent US District Judge’s decision to sentence a former US Navy employee for workers’ comp fraud by sending him to prison for 21 months and compelling him to pay nearly $0.25 million in restitution to the Department of Labor.

Background

Mark Correnti worked for the US Navy for years as a civilian employee. In 1989, he hurt his back. Starting in the year 2000, he began collecting $2,000 a month from the Department of Labor in federal workers’ compensation for his back injury. These payments continued through 2008, during which time he accrued over $0.25 million.

According to prosecutors, Correnti violated the Federal Employees Compensation Act by starting up a small business, Safe & Sound Storage, and collecting income from this business. At seven different times, Correnti denied that he was bringing in money from this business. (These false statements allowed him to keep collecting federal workers’ comp.) After being caught, Correnti pled guilty last November to charges of making false statements, and the US District Judge sentenced him in late April to the harsh terms outlined above.

Now, obviously, most North Carolina workers’ compensation claimants work hard to understand their obligations and to avoid putting up red flags that might indicate fraud or non-compliance.

Nevertheless, claimant errors and omissions can torpedo otherwise valid North Carolina workers’ compensation claims. In other words, even if you did legitimately hurt your back lifting an object at work, for instance, your claim could be invalidated or downgraded if you don’t follow the correct protocol.

Fortunately, you don’t have to go through the rigmarole of applying for and securing workers’ comp benefits on your own. By connecting with a vetted, strategically focused, and experienced North Carolina workers’ compensation legal team, you can save yourself a lot of hassle and increase the likelihood of collecting the maximum benefits.

More Web Resources:

Federal Employees Compensation Act

Mark Correnti case

North Carolina Workers’ Compensation Bloggers Wonder about Compensation Arrangements for Deepwater Horizon Workers

May 5, 2010, by Michael A. DeMayo

On April 20th, a massive explosion rocked the giant oil rig Deepwater Horizon, which had been drilling in the Gulf of Mexico. The catastrophe, which ironically occurred on Earth Day, ultimately sank the ship and killed 11 workers. Now that the smoke is cleared, many in the North Carolina workers’ compensation community (and other concerned parties around the world) are wondering how, precisely, the British Company BP will remunerate injured and traumatized workers and staunch the environmental damage of the spill.

A Little Background

On April 20th, the oil rig Deepwater Horizon caught flame after an explosion while drilling 40 miles south of the mouth of the Mississippi River off the Louisiana Coast. In the chaos that ensued, 11 workers lost their lives, the ship sank, and tens of thousands of gallons of oil leaked from a well into the surrounding ocean, threatening the coast lines of Louisiana and Texas and endangering wild life, such as local sperm whales. The explosion is the worst disaster to hit the industry in a decade, and England-based BP has launched a massive effort to resolve the continuing oil spillage and deliver compensation to victims of the disaster.

Out of the 126 workers on the Deepwater Horizon, 115 made it back to shore alive. Many were taken to local hospitals in West Jefferson and Baton Rouge. Injuries ranged from smoke inhalation to laceration to shock. Although BP is an international company, it is responsible for both the clean-up and the compensation. Nevertheless, given the complicating factors – the fact that it happened offshore, that BP is foreign-owned, that the explosion was so catastrophic, and so forth – the case will likely get quite legally messy.

If you recall, similar complications ensued after an explosion last June at a ConAgra Slim Jim plant here in North Carolina. The North Carolina workers’ compensation arrangement for employees injured in that accident is still being hashed out and still making headlines. On April 8th, 20+ ConAgra Foods employees sued the town of Garner, NC, for instance. No doubt, more legal maneuvering and suing and counter-suing may yet occur in that case.

If you or a loved one has been injured in some kind of catastrophic case – like an explosion at work or a fall – or if you’ve suffered a more mundane but no less uncomfortable condition such as a typing injury – you may benefit from the counsel of an experienced North Carolina workers’ compensation attorney. A free and confidential consultation can help you develop an effective strategy to collect the money that you and your family deserve.

More Web Resources:

Deepwater Horizon

ConAgra Clean Up

ConAgra Explosion Back in the North Carolina Workers’ Compensation News

May 3, 2010, by Michael A. DeMayo

On June 9, 2009, an explosion at a ConAgra facility in Garner, NC killed four workers and hurt dozens of others, prompting a North Carolina workers’ compensation legal brouhaha that continues to this day. The latest twist involves a lawsuit against the town of Garner itself.

Twenty employees of the Slim Jim plant have sued the town for failing to vet companies like Mid-South Industrial Refrigeration Incorporated, which did not have licenses or permits to install the natural gas line that ultimately caused the deadly explosion.

Garner town officials, including Mayor Ronnie Williams and town Manager Hardin Watkins, have been tight lipped about the matter, since the Garner town attorney has yet to review the lawsuit. Garner has suffered a series of blows in the wake of the Slim Jim explosion. Nearly half of the plant’s workforce lost their jobs in September, 2009. In March 2010, the remaining ConAgra workers were given pink slips as well after ConAgra made the decision to move the entire operation to Troy, Ohio.

This North Carolina workers’ compensation matter seems to be growing in complexity on a monthly basis. Many manufacturing, design, and installation companies have been named as defendants, and ConAgra has already paid out over $100,000 to the North Carolina Department of Labor for violating Occupational Safety and Health Act (OSHA) regulations. Another company, Energy Systems Analysts, has been cited for over two dozen OSHA offenses and fined nearly $60,000. Company officials allegedly oversaw the installation of the natural gas line that exploded on June 9th. Mayor Williams issued a statement that no one on the town council knew that town investigators were at the facility the day the explosion took place.

Timely and Effective Help with North Carolina Workers’ Compensation Matters

If you or a loved one has been injured while working in the state, either in a catastrophic or a chronic accident, consult with a reliable and results-proven North Carolina workers’ compensation lawyer. Get good answers to the questions that keep you up at night about how to file for benefits, collect them in a timely manner and deal with issues pertaining to your employer and/or insurance company.

More Web Resources:

Lawsuit against Garner, NC

Mid-South Industrial Refrigeration

 
 

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