June 2011

North Carolina Workers’ Compensation: Fear of Going Back To Work

June 29, 2011, by Michael A. DeMayo

Whether you’ve been out on North Carolina Workers’ Compensation for years, and you are beginning to think about how and when to return to your old job (or train for a new one); or you just got hurt last week, and you’re thinking about what will become of you now that you’re saddled on the sidelines for months, odds are you have swirling emotions. You might feel scared, excited, overwhelmed, anxious, relieved, overjoyed, and terrified – and these emotions may intermingle, coming and going as you anticipate that day when you finally return to the job.

This kind of composite, pastiche of emotions among North Carolina Workers’ Compensation claimants is actually quite common. And the reasons aren’t that surprising. First of all, chances are one of the last memories you have of work involve the injury or illness that led you to lead the job. Maybe you slipped and fell on a construction site and tore a ligament in your knee. Maybe you spent one afternoon typing a memo and developed a pinched nerve that was later diagnosed to be severe thoracic outlet syndrome. Or maybe you got into an accident while driving a company delivery van. In any case, that last dramatic memory is likely still relatively fresh in your mind’s eye.

Also, making the transition back to your old job means in some ways reflecting on everything that’s happened to you since you’ve left work. Much like holidays like New Year’s Eve in a sense force you to reflect on your life – where you’ve been, how far you’ve come, your shortfalls – so too does the return to work compel you to reassess your life milestones.

Finally, in the event that there has been any bad blood or friction with your employer or with your company over your claim, you might worry about whether there will be drama at work – and, if so, how you should respond. You’ll also spend a lot of time thinking about the relationships that you have or you did have with the people at work and how those relationships have evolved and will evolve once you return. Finally, you will likely spend some time thinking about the fear of re-injury. Will going back to work lead again to a problem? If so, how will you know? What should you do if you see warning signs or develop a subconscious fear that something might be going wrong?

To prepare best for the return, talk to an experienced North Carolina Workers’ Compensation law firm, so you will understand your rights and responsibilities and make the transition back as seamless, stress-free and simple as possible.

More Web Resources:

Overcoming fear

Going back to work after a long absence

North Carolina Workers’ Compensation Fraud Case: NC Man Accused of $2.7 million Scam

June 27, 2011, by Michael A. DeMayo

The Friday before last, a Wake Forest man, Carl Delmas Fuller was charged in a North Carolina workers’ compensation scam. Fuller was arrested in Florida after the Florida Department of Financial Services Division of Insurance Fraud investigated fishy business practices and concluded that Fuller had scammed National Employment Services (NES) out of a whopping $2.7 million in premiums. NES slowly awakened to the duplicity. The company had believed that had bought insurance from an North Carolinian agent named David Walters who had been serving them through a company called Southeast Services Incorporated. But the company investigation realized that the certificates “Walters” provided were useless, that “Walters” in fact did not exist, and that there was no such entity as “Southeast Services Incorporated.” And indeed, all the checks sent to Southeast Services Inc. wound up in a Myrtle Beach mail box owned by Carl Delmas Fuller.

Both the FBI and the United States Attorneys’ Offices assisted the Florida Department of Financial Services in the investigation to North Carolina workers’ compensation fraud. Fuller faces two decades behind bars if he is convicted of all charges.

As this blog has discussed many times, when individuals like Fuller siphon money out of the system and destroy trust among the various parties (insurers, employers, employees, etc.) everyone suffers in an indirect way. At first blush, 20 years behind bars for a white color crime like fraud might seem “over the top” especially when you consider that rapists, murderers, and violent gang leaders often get a fraction of that jail sentence. The consequences of this kind of fraud can be far reaching and devastating. When the money leaves the system like this, beneficiaries who desperately need funds to pay for medical care, rehabilitation, emergency surgeries, etc. may not have access to the funds or may be unfairly challenged by insurance companies who’ve been “once bitten twice shy” when it comes to dealing with the workers’ comp system.

The big moral and philosophical lessons of the story aside, however, if you or someone you care about is struggling with an issue such as a bad faith insurer, an uncaring boss who won’t listen to your concerns, or simply a lot of red tape regarding your benefits, a North Carolina workers’ compensation law firm can provide tremendous assistance.

More Web Resources:

Carl Fuller


Florida Department of Financial Services

Colorado Fraud Case Piques Interest of North Carolina Workers’ Compensation Community

June 25, 2011, by Michael A. DeMayo

A workers’ comp case way out in Aurora, Colorado has caught the attention of the North Carolina workers’ compensation community because of the heart breaking realities at the center of it all.

Martin Lobatos and his wife Belen Lobatos were indicted on 18-counts last Friday, after Colorado investigators alleged that the couple collected $140,000 worth of workers’ comp claims from Pinnacol Assurance. Lobatos worked as a roofer until September 8, 2008, when he sustained a terrible fall off of a ladder. He went back to work a month later but started complaining of ongoing vertigo and dizziness from his accident. Six months later, in April 2009, Lobatos’ doctors maintained that he had fully recovered.

Lobatos was fired and later collected a $20,000 settlement from Pinnacol Assurance. In the fall of 2009, however, Lobatos began experiencing more symptoms, such as memory loss, having trouble recognizing his children, dizziness, and a host of other frustrating problems. His doctors agreed. In March 2010, Lobatos claimed to be “fully catatonic.” And he allegedly acted catatonic in medical exams. But witnesses later saw him driving around, shopping, engaging in activities in a decidedly non-catatonic state. This evidence allegedly led to the investigation and ultimately to the allegations and 18 count indictment against Lobatos and his wife. If convicted of the crime, the Lobatoses could face fines of $750,000 each and a dozen years in prison.

Obviously, North Carolina workers’ compensation fraud (and such fraud elsewhere in the country) is an enormous problem, and perpetrators should be held to account. But is it really fair to slap these people with $1.5 million in fines and over 10 years in prison? Many homicide cases don’t get punished that severely. Again, this is not to say fraud shouldn’t be punished appropriately. But the punishment must fit the crime, and the context of the crime should also deeply inform the legal remedies.

What’s frustrating here is that many injuries that ultimately send people to seek the services of a North Carolina workers’ compensation firm don’t manifest immediately after an accident. A fall off of a ladder, for instance, may lead to a temporary concussion that seems to resolve after few weeks or months…only to give way to longer term, chronic, and confusing injuries months or even years after the fact.

Again, it’s impossible to weigh in on the Lobatos’ case without far more information. But victims of workplace accidents or illnesses should understand that they may go through a similar kind of rollercoaster – feeling bad after the accident, then feeling better again for a while, then feeling suddenly worse for no apparent reason. This is why it’s so important to contact professionals, like experienced law firms and good doctors, to build evidence, stay within the bounds of the law, and maximize your chances for getting the money and support you need to get back to work and support your family.

More Web Resources:

Pinnacol Assurance

Martin Lobatos fraud

Solving Problems Blocking your North Carolina Workers’ Compensation Recovery

June 21, 2011, by Michael A. DeMayo

If you’ve been on North Carolina workers’ compensation for some time, odds are that you are itching to get back to work in some capacity, either by retraining, going back to your old job, or finding some other way to be productive with your time. Unfortunately, without good guidance, you may languish and recover for far longer than you intended – and the consequences can be frustrating not only for your ego but also for your budget. After all, typically you likely can make significantly more money actually working than you can basically staying home and collecting North Carolina workers’ compensation.

To that end, let’s discuss some strategies for how to speed up your recovery.

1. Educate yourself as a patient

Being a proactive patient doesn’t necessarily mean ignoring your doctor’s orders. But it does mean researching your condition, reading books about it, talking to other patients, engaging in good Q&As with your physician, and following up on rehab and home care.

2. Notice when something doesn’t right or when you are stuck on snag or an optical

One of the top reasons why people struggle with chronic injuries, work problems, or other stresses is that they fail to acknowledge the reality. If something bothers you – a nagging pain in your left knee, a sliver of doubt over your diagnosis or doctor’s prescription, for instance – write down your troubles. Keep a journal or a logbook about them. And work through your struggles by surfacing the fundamental problems, talking about them with people who know and support you, and looking for shortcuts around them. For instance, if your knee bothers you every time you shovel your driveway, find someone else to shovel your driveway for you and save yourself the pain.

3. Actively seek out help

No one person or institution – even the most qualified North Carolina workers’ compensation law firm – can help you blast through all of the obstacles that are holding you back from returning to work quickly, getting back on the game, and restoring your career path. But “going it alone” almost always makes a zero sense. One’s perspective is by definition narrow. You may simply be blind by either habit or denial to some fundamental truths which, if acknowledged, could help you shortcut your process to healing enormously. It takes courage to ask for advice and for help. And there are certainly untrustworthy sources out there who might judge you or give you bad advice. So you have to be careful about whom you trust and how you solicit help. But there is no substitute for an alternative fresh perspective when you are stuck with problem in work, life, or health.

More Web Resources:

Educate yourself as a patient

Keeping a journal

North Carolina Workers’ Compensation Reform Passes State Senate

June 16, 2011, by Michael A. DeMayo

Last Thursday, a North Carolina Workers’ Compensation Reform Bill – also known as HB709 – passed the state senate. The final vote was unanimous: 46 to 0. On June 1, as regular readers will recall, the NC House passed a similar initiative by a lopsided margin of 100 to 3. The North Carolina workers’ compensation reform is the first of its kind in 17 years. Although Republican lawmakers and business groups pushed the bill, the legislation ultimately morphed into more of a compromised reform. The AFL-CIO, Employers Coalition of North Carolina, Chamber of Commerce, and countless business, insurance and workers rights groups as well as trial lawyers all collaborated to create this. For instance, Governor Beverly Perdue, a Democrat, happily reported the legislation.

What the reform will do:

• Temporary total disability benefits will be capped at 500 weeks (approximately 9.5 years)
• Injured workers may be able to petition for extra temporary total disability benefits of another 425 weeks
• Partial disability benefits bump up from 300 weeks to 500 weeks
• Death benefits to family members of workers killed on the job will also bump up from 400 weeks to 500 weeks
• When workers reach a threshold known as “maximum medical improvement,” the definition of what will then constitute “suitable employment” will change. A businessinsurance.com article summarized this new definition nicely: “a job the employee is capable of performing while considering physical limitations, education, experienced and vocational skills.”

What will these reforms mean for you and your potential claim?

In the abstract, it’s impossible to say. An experienced North Carolina workers’ compensation law firm can annualize your situation and suggest a best path forward. Even if you feel like your case is pretty cut and dry, you may nevertheless benefit from talking with a repeatable law firm to ensure that you maximize your benefits and minimize your chances of running afoul of bureaucracy, red tape, or other problems.

More Web Resources:

North Carolina Workers’ Compensation Reform Bill

Employers Coalition of North Carolina

Is Your North Carolina Workers’ Compensation Law Firm the Right One for You? 4 Tips to Help You Choose

June 14, 2011, by Michael A. DeMayo

Whether you got hurt in a lifting accident and threw out your back at work; or you came down with fibromyalgia or chronic pain syndrome due to repetitive office work, you believe that you may need North Carolina Workers’ Compensation. Some claimants forge their own way through the system, but many often seek out experts, such as attorneys who specialize in helping applicants to cut through the red tape, compel unfair or faithless insurers to abide by their responsibilities, manage companies or bosses who won’t cooperate, and so forth.

Indeed, most North Carolina Workers’ Compensation claimants can benefit tremendously by speaking to an attorney – for free and at no obligation – simply to get a strategic overview of their opportunities (and potential pitfalls) as well as a list of resources.

But not every North Carolina workers’ compensation law firm is the same. Unfortunately, many firms do not give their clients the requisite customized, personal attention they need to make the most informed decisions about what to do next. Clients might wind up with less than optimal (occasionally lackluster) results in difficult cases – e.g. where an insurance company or employer directly challenges your claim or tries to negate it. Your choice of law firm can prove pivotal. Experienced, results-proven lawyers can compel recalcitrant parties to treat you fairly; whereas inexperienced, overwhelmed, or simply disorganized attorneys may be unable to give you the representation you need to prevail in difficult circumstances.

To protect your interest, hew to the following principles:

1. Interview your attorneys, and prepare for the discussion by listing out questions and concerns in advance.

2. Do due diligence– research law firms online, look at client testimonials, and do objective research re: the firm’s general reputation within the legal community.

3. Listen to your gut. Your intuition often picks up on subtle factors that your conscious mind overlooks. If you get a sense that a firm is right for you (or is not right), pay attention to that sense and use it to help you make your decision.

4. Avoid “analysis paralysis.” In almost any decision in life, “over-researching” can lead to time wasting without improving the quality of the choice. Set a time limit for whom to retain, and force yourself to make a decision by that timeline, so you can move forward with your case and get the help you need urgently.

More Web Resources

Beating “analysis paralysis”

Listen to your gut?

Mass Overhaul to North Carolina Workers’ Compensation Laws Passes the House

June 9, 2011, by Michael A. DeMayo

Last week, the North Carolina house passed significant North Carolina workers’ compensation reforms by a lopsided vote of 110 to 4. This marks the first overhaul of the state’s workers’ comp system in nearly two decades. The charge was led by Republican representative, Dale Folwell, a 52-year old legislator who gained renown after driving over 32,000 miles on his motorcycle in 2006 to raise money for organ donation awareness (Folwell’s son was killed in 1999 by a motorist).

According to The Charlotte Observer, the massive changes to North Carolina workers’ compensation law will now go to the Senate for approval. The house passage ended months of marathon negotiations and years of controversy. Here are some of the big takeaways, summarized by the Charlotte Observer:

• “Caps payment for most disabled workers of 500 weeks, or 9.5 years, bringing North Carolina in line with neighboring states. Now there is no cap. The change would not affect workers currently on worker’s comp.
• Extends temporary partial disability payments from 300 to 500 weeks.
• Increases survivors’ death benefits from 400 to 500 weeks and burial expenses from $3,500 to $10,000.”

Folwell was at the epicenter of many passionate debates over the proposed legislation. According to the Observer, “one meeting lasted almost 13 hours.” Although business interest groups and Republican lawmakers drove the push for reform, Democrats, labor unions, and workers rights advocates claimed victories. As a Democrat from Durham, Representative Paul Leubke, commented “[workers advocates] feel it’s the best bill that could be developed in the context of this general assembly… it’s not as balanced as some might have represented.”

Governor Beverly Perdue lauded lawmakers for coming to the consensus: “working together, we seem to have accomplished that goal [of creating a long lasting fix to the system].”

Now that all the Sturm und Drang has passed (hopefully), workers, employers, business groups, insurance companies, trial lawyers, and other interested parties will get to sit back and watch to see how the changes to NC’s workers’ comp laws actually unfold. Will they save money? Will workers’ rights be unfairly infringed upon? Will the architects of this project objectively measure the results and change course if need be based on the data?

There are so many question marks at this point; it’s difficult to digest all the implications.

If you or a family member is receiving benefits or is seeking benefits, a North Carolina workers’ compensation law firm can help you unpack your options and develop a strategy that fits the context of this momentous and tumultuous time in the world of the state’s workers’ comp laws.

More Web Resources:

NC house sets up final vote on workers’ comp bill

Representative Paul Leubke

North Carolina Workers’ Compensation Analysts Weigh in on California NFL Claims: Could Similar Disaster Happen Here in NC?

June 7, 2011, by Michael A. DeMayo

The New York Times and other media outlets – including niche North Carolina workers’ compensation blogs! – have spent months reporting about a crazy series of claims out of the Golden State. According to California Labor Code Section 3600.5(b), employees who are temporarily assigned to the work in CT can make claims for long-term injuries.

Section 3600 may not seem like an overly fascinating piece of law, but injured former NFL players (and other ex-athletes) have been leveraging Section 3600 to file for a rainbow of out of state claims. Recently, a Republican in the California state legislature demanded an overhaul to CA workers’ comp rules to prevent “retired professional athletes with no significant nexus to California to file claims for long-term injuries in the state.”

According to an article in the Insurance Journal, Republicans like Curt Hagman believe that “retired professional athletes who never play for California based teams should not be afforded remedy for claims of cumulative trauma under California’s injured workers statutes.” Technically, California taxpayers may not be responsible for paying the out of state claims. But the jurisdictional issue has raised more than a few alarms, especially now that California is practically drowning in a horrific, multiyear fiscal crisis.

Could something similar happen here in the North Carolina workers’ compensation system? Probably not. California’s uniquely structured laws and history have combined to create this Section 3600 debacle. There is no equivalent law on the books in NC. In fact, it’s far more likely that injured North Carolina athletes will file for claims in California than vice versa.

The debacle raises even bigger and broader questions, such as: how can we systematically determine whether injuries occur from cumulative or single traumatic events? How can the workers’ comp system more fairly and accurately divvy up costs among taxpayers and among states? If ex-NFL players are all reporting chronic injuried stemming from their time in the league, how deep does this problem go? And will the newer generation of NFL stars – who play bigger, faster, and more aggressively – suffer even more cumulative damage in the years and decades to come?

For help with a specific question regarding your potential benefits, struggles with an insurer, or debate with an employer, connect with a reputable North Carolina workers’ compensation law firm.

More Web Resources:

Curt Hagman

Section 3600

Workers, Business Owners, and Others Sound Off on North Carolina Workers’ Compensation Reforms

June 7, 2011, by Michael A. DeMayo

Last Wednesday, the NC house passed sweeping and massive reforms to North Carolina workers’ compensation law. The overhaul, led by Republican Representative Dale Folwell, stirred passionate emotions on both sides of the debate. This blog post will examine some of the reader comments in the June 6th issue of the Winston-Salem Journal to give you a sense of the flavor of the debate going on.

The Journal quoted Fletcher Steele, the President of Pine Hall Brick Company — a business owner. He shared very enthusiastic comments about the legislation: “North Carolina workers’ compensation law should be focused on taking care of injured workers and helping them return to work when they are able. Thanks to Rep. Folwell’s leadership, our state may soon have a modern, effective workers’ compensation system that works for both employers and employees, and that is also good for jobs.”

The responses to his editorial reveal a complex debate.

For instance, one commenter who claimed to be a “CEO in a field that… sees more than its fair share of WC claims” said “it’s not surprising Mr. Steele would say WC insurance has contributed to slow job growth. From a macro view, I feel that the state’s cutting of education money will do far more harm to NC’s future job prospects than… this legislation will be able to overcome. The 2009 HS grad rate was only 70%. Hate to see what rates will be in the future. No education equals no jobs.”

Another anonymous commenter, who went by the handle “AJV,” laced into Mr. Steele’s suggestion, even suggesting that the NC Chamber of Commerce “ghost wrote” the editorial. AJV wrote: “so let’s see: he is CEO of a brick company. Potentially a very hazardous work environment… those pesky worker bees having bricks fall on them… breathing in caustic dusts, et cetera. Let’s say that a worker is paralyzed when a pallet of bricks falls on him. What’s a CEO to do? Cut profits. And then what? They expect his company or insurance carrier to take care of that unfortunate worker whose [labor has helped the company profit]?… They busily craft their solution: Limit the worker to no more than 500 weeks of compensation and then dump them for the tax payers to directly support. Sweet! Win! Win! Win! (that is the company, chamber and insurer). “

As these comments clearly illustrate, the debate is passionate and not necessarily civil. Such is the nature of modern politics, perhaps.

Another commenter, who wrote under the handle “native heal” responded to AJVs point: “I have known Fletcher Steele for many years and have had a good business relationship with him for many years as well. He is a good man in an imperfect work situation, as are many others who’ve run large corporations. I am also quite certain that Mr. Steele has a vast more amount of knowledge about workers’ compensation issues than you or I will ever have. I [would rather] light a candle to illuminate the shadows rather than stand in the shadow and throw rocks.”

The rancorous debate notwithstanding, you and your family likely have significant and serious questions about how these laws might affect your potential benefits. An experienced, reputable North Carolina workers’ compensation law firm can answer those questions and help you feel relaxed, prepared, and in control to meet the challenges ahead.

More Web Resources:

North Carolina Senate passes workers compensation reform bill

Pine Hall Brick Company

Commentators Lash Out Against Proposed North Carolina Workers’ Compensation Reforms

June 2, 2011, by Michael A. DeMayo

Advocates of hurt and injured workers have been lashing out against North Carolina House Bill 709 and Senate Bill 544, two proposed reforms to the North Carolina Workers’ Compensation Law currently being debated in the NC General Assembly. A May 13th editorial in the Winston-Salem Journal (“Dismantling the Rights of Workers” by Michael A. Fryar) voices a variety of concerns about the proposed legislation:

• “The bill will remove workers’ rights to privacy with treating physicians and allow insurance companies to talk directly to the patients’ doctors, without the patient even knowing that this is happening or being a part of the conversation.”
• Except under certain circumstances, disability payments will be limited to 500 weeks (approximately 9.5 years)
• “Insurance carriers will have full legal authority to force injured workers into jobs paying only minimum wage without giving any consideration to the pre-injury financial responsibilities.”
• Fryar argues that his research suggests potentially devastating consequences – a wage reduction of up to 75% that will “devastate the average family structure.”

Both advocates and opponents of North Carolina workers’ compensation reform have been putting forth grand pronouncements about how the legislation will impact the state on many levels. Fryar’s attack on the legislation – likely grounded in good statistics – suggests that hurt and injured workers will lose significant rights if the new law passes.

Advocates of the law, on the other hand, say that the state simply cannot afford to finance the entitlement system, at least in its present state. Both sides seem prone to speak in catastrophic terms. And while professionals at experienced North Carolina workers’ compensation law firms are obviously very concerned about the potential fallout that the legislation might have on workers, it’s important to look at the situation with a cool head and an open perspective.

When you are caught up in a debate over any sensitive topic, it’s easy to think catastrophically – or, conversely, manically. But this way of perceiving events may not only be inaccurate but also destructive. Obviously, hurt workers should advocate forcibly for their rights and benefits. But workers, attorneys, and advocates have far more tools and resources at their disposal than many people realize. For instance, disabled workers bumped off their benefits after 500 weeks (if the legislation passes) will not be simply left to starve on the streets. They will be picked up by some other social safety net, like Social Security or Medicare or Medicaid. Not that this is necessarily a good thing – it shifts the burden of their care from insurance companies to taxpayers, according to critics. But it’s not as nearly as catastrophic as some might fear.

Conversely, North Carolina workers’ compensation reformists might be vastly overestimating the beneficial effects that the passage of the legislation would create. Yes, according to best projections, the state could save substantially. But would the state really put those savings to best use? What about the long-term repercussions of curtailing certain workers’ rights in terms of longer recuperation times and greater chronic frustration among the hurt/injured population, which could translate into reduced spending. Etc, etc.

Over the long-term, the best fixes to the system will likely involve identifying and solving major occupational health issues, such as obesity, diabetes, repetitive stress syndrome, stress at work, and “distractedness.” These issues are apolitical, but they are real, and they likely anchor the system in ways that statisticians, lawmakers, and analysts are only beginning to understand.

More Web Resources:

North Carolina House Bill 709

Dismantling the Rights of Workers

 
 

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