June 2012

Commissioner Hall Cracks Down on North Carolina Workers’ Compensation Insurance Violations

June 28, 2012, by Michael A. DeMayo

Employers who violate the North Carolina workers’ compensation laws may one day find themselves standing before Deputy Commissioner, George R. Hall III, and other officials at the North Carolina Industrial Commission, pleading for mercy – that is, for the privilege to pay massive fines in lieu of jail time.

Could the times really be a changin’?

In two recent blog posts, we explored the fallout of a Charlotte News & Observer story that found that a ridiculous number (up to 30,000) of state businesses may lack adequate workers’ compensation insurance. Governor Beverly Perdue (among others), apparently found the statistics disgraceful – even terrifying – and put pressure on the North Carolina Industrial Commission (NCIC) to step up to the plate.

The Industrial Commission appears to have gotten the message.

Recently, for instance, the Commission fined the owners of a trucking company in Beaufort County over $100,000 – extracting assets that the owners had actually deeded to their children in order to pay the workers’ compensation claims of two widows who lost their husbands in crashes while working for the company.

Back in 2004, Gregory and Joyce Nixon dropped their workers’ comp coverage to streamline costs. Ironically and tragically, less than two weeks later, one of their drivers, David Murray, died in a truck crash. Three year passed – and Murray’s wife still had not gotten workers’ comp coverage – when a second driver, Richard Maynard, lost his life in a truck crash.

Murray and Maynard’s widows ultimately had to bring suit to get their workers’ comp money.

Although the NCIC brought the hammer down on the Nixons, the Commission has shown sympathy for other business owners, who’ve come up with every excuse under the sun to explain why they lacked proper coverage. Explanations cited included:

•    Economic problems
•    Bankruptcy
•    Unemployment
•    Foreclosure
•    And beyond

It’s important to recognize: some of these explanations are not only legitimate excuses but also deeply tragic in their own right. Even though the team here at the Law Offices of Michael A. DeMayo often needs to go to battle against recalcitrant employers and insurance companies — those who block our clients from getting fair recoveries for their medical bills and other needs — we recognize that it is unfair and unproductive to paint people on the other side as villains.

We’re ALL struggling to come to terms with difficult financial and medical issues. We all need a little more empathy and understanding as we try to meet our various needs.

If you need help dealing with your workers’ comp benefits, connect today with our team for a free and confidential consultation.

A Compassionate Look at the North Carolina Workers’ Compensation Insurance Problem – Part 2: Employers – And Everyone Else

June 26, 2012, by Michael A. DeMayo

In a recent blog post on the state of the North Carolina workers’ compensation system, we explored the implications of a disturbing survey recently conducted by the Charlotte News & Observer, which found that nearly 30,000 businesses operating in NC may be uninsured or underinsured.

We talked about how employees need to recognize the inherent dangers of working for a company that lacks good insurance coverage. If you or someone you care about worked at a company that lacked coverage, you may want to talk to someone at the team here at the Law Offices of Michael A. DeMayo immediately to understand your best next steps.

Beyond the tactical implications of the investigative article, what are some deeper points to consider? Here are a few insights the study can tell us:

1. The message is not getting through to business owners that they need adequate North Carolina workers’ compensation insurance.

Approximately 140,000 businesses have insurance, while 30,000 or so might not.

That’s a huge disparity! It suggests that there is a massive breakdown in the system. It’s not enough to blame business owners or to blame insurance companies. Some deeper, core constraint must be to blame. It’s incumbent on everyone who has a vested interest in the health of the workers’ compensation system to explore that constraint and figure out how to eliminate it or make it irrelevant. For instance, maybe business owners need to be notified about their responsibilities in a different way – or rewarded or/punished differently.

2. The “underinsurance problem” suggests that there could be other large scale problems with the system that might cause drag, inefficiencies, and excess costs.

Assuming that the Charlotte News & Observer did their homework properly, it’s hard to contextualize this problem as a “fluke.” Odds are that there are other gaping inefficiencies in the system that could possibly be surfaced and eliminated to everyone’s benefit.

3. We collectively need to do more “holistic thinking” about how to serve all the clients in the North Carolina workers’ compensation system better.

All too often, the discussions about how to reform workers’ comp become trivialized. It becomes law firms versus businesses, employees versus employers, employers versus insurance companies, etc, etc. In other words, there is this mentality of “the pie is only so big, so let’s grapple for our slice, tooth and nail”.

A more generous view: every stakeholder can benefit from positive reforms and improvements and efficiency.

So let’s expand the pie, instead of just slicing and dicing it.

A Compassionate Look: The North Carolina Workers’ Compensation Insurance Problem: Part 1 – Employees

June 21, 2012, by Michael A. DeMayo

Research conducted by the Charlotte News & Observer has found that up to 25,000 businesses (or so) in North Carolina may not have adequate (or any) workers’ compensation insurance, in violation of state laws.

In general, if a company conducts business in the state — and employs four plus people — that company must either carry insurance or have assets to self-insure to provide for the medical care and other costs of injured workers.

The North Carolina Industrial Commission (NCIC) has authority to punish businesses that do not comply with these North Carolina workers’ compensation insurance rules. But in reality, the NCIC is not exactly a stern taskmaster. This means that many businesses skate by with less than adequate coverage, and that leaves the entire system vulnerable to problems.

Say someone who works at an underinsured business gets injured and needs care. The costs of that care will get passed on to us all, ultimately, in the form of higher taxes. There is another subtle and indirect – but possibly even more dangerous – consequence of the “underinsurance” problem. Namely: when hurt workers lack guarantees of reimbursement, they may delay or defer care that they need. As a result of deferring care, then may take far longer to heal… and their injuries can costs thousands more than they should have.

Hurt workers are not without recourse, however. They can sue their companies or try to get the NCIC to mediate an agreement. But it can be a mess.

If you haven’t been hurt, but you suspect your employer is underinsured or uninsured…

Ask questions, now, before someone DOES get hurt. Document all conversations about the subject, and time and date stamp them. If your employer lacks insurance, urge him or her to investigate the proper coverage right away. Often, business owners fail to get insurance simply because they don’t know they need it… or because they’re “too busy” dealing with other aspects of running the company. Owners need to know that this is not a matter that can be deferred – in certain cases, employers can even risk jail time.

If you’re already been injured

The team at the experienced Charlotte workers’ compensation law firm, DeMayo Law, can talk to you about your situation and help you plan your next steps. We can help you stay grounded, in control, and strategically focused on getting the right benefits, connecting with quality resources, and pursuing all avenues to get fair treatment.

Counterintuitive Findings of North Carolina Workers’ Compensation Study Highlight Dangers of Simple “Policy Solutions”

June 19, 2012, by Michael A. DeMayo

Fixing the North Carolina workers’ compensation system is a top priority, not only for policymakers but also for insurers, employers, employees, and everyone else concerned about the quality of care delivered in our state.

Good intentions are one thing. Hard data is another.

To that end, a recent study conducted by the Workers’ Compensation Research Institute (WCRI) is pretty telling. Let’s dive into the details and try to extract lessons that might be meaningful, if you or somebody you care about has been recently injured in a workplace accident, and if you might need help from a North Carolina workers’ compensation law firm, like DeMayo Law.

The WCRI looked at the initial impact of something called an outpatient fee schedule reduction — a policy attempt to reduce the hospital costs of outpatient stays. Prior to summer 2009, the reimbursement rate was around 95% for most NC hospitals – that fee schedule changed dramatically down to 79%. The study looked at eight months after that fee schedule reduction.

Unsurprisingly, the payment to charge ratio went down (from 82% to 72%). But surprisingly – shockingly, even – the average charge for outpatient services spiked by 17% over the rate for a controlled period prior to the enactment of the new fee schedule.

To summarize: the overall percentage of reimbursement was lower, but the costs of services on average was higher – possibly negating the savings.

If you or somebody you love is struggling to make a claim, deal with an unfair employer, or battle your way through the thicket of an insurance company’s bureaucracy, these findings may not seem like much to you. But the lessons here are pretty broad. They suggest that “quick fixes” to problems at the level of NC policy – or even at the level of your own life – can often backfire… or at least lead to very different outcomes.

In other words, it confirms the hypothesis we proposed in another recent blog post – that the trajectory towards a workers’ comp “win” is often far from straightforward, even if your claim is simple, and even if you know precisely what you want and how you want to get it.

Four Wheels vs. Eighteen Wheels – An Interview with Michael A. DeMayo

June 15, 2012, by Michael A. DeMayo

According to Charlotte attorney Michael A. DeMayo, if you are involved in a highway accident with a tractor trailer, statistically speaking you’re likely to be either severely injured or killed. Data released by the United States Department of Transportation shows tractor trailer accidents totaling around 500,000 each year, with a high proportion ending in fatalities. In an interview with State Law TV, DeMayo explains that this is just simple physics. Your four wheel vehicle is going up against a vehicle that outweighs you 50, 60, even 70 times, depending on the load this tractor trailer may be carrying.

If you consider that you will most likely encounter a tractor trailer on the highway, and factor in highway speeds of 55 to 75 or 80 miles an hour, the potential for disaster is clear.

Demayo goes on to explain that there are different, very specific issues involved with a tractor trailer accident than a regular car accident or other type of personal injury claim. Eighteen wheeler accidents are by their very nature more complicated. First of all, there are a variety of government regulations that govern interstate tractor trailers on our nation’s highways. These regulations range from how many hours a driver can be behind the wheel to how much weight can be loaded on the truck, and many more.

Because the federal government’s purpose is to insure the safety of our highways, there can be stiff penalties for companies that flout these laws, and great incentive for trucking companies to try to hide this information if they are not in compliance of these regulations.

When asked who is held responsible for a tractor trailer accident, DeMayo’s answer shows just why these cases are so complicated.  In a typical scenario, he says, there are many parties who may share liability for the accident, including the driver, the carrier, the owner; possibly even the shipper. They each may have their own insurance and their own legal representation. All these layers of coverage (known as umbrella coverage) tend to complicate a tractor trailer accident claim.

Because these claims are so different than auto accident claims, an injured victim needs a highly experienced personal injury law firm such as DeMayo Law, who specializes in these sorts of cases and knows how to maneuver through these many layers to find the necessary information.

Michael A. DeMayo makes a very important point during this video interview, which is that tractor trailer accident cases need to be investigated immediately. He notes that in every tractor trailer accident his firm has been involved in that involved significant injuries, the trucking companies took action immediately. Lawyers, accident re-constructionists and teams of investigators are immediately sent to secure the accident scene and begin building their defense.

If a victim waits a week or more before hiring an attorney, they are already at a disadvantage, because the trucking company has already had so much lead time.

Watch this fascinating interview here.

Click here for more information about tractor trailer and semi-truck accidents, or contact the Law Offices of Michael A. DeMayo to discuss your accident claim.

The Tesla v Edison Debate: Amazing Implications for the Charlotte Workers’ Compensation Journey

June 14, 2012, by Michael A. DeMayo

In your quest to find good information about workers’ compensation in Charlotte, you need to be selective and savvy about what sources you trust. Which experts should you listen to? What expert advice should you ignore… or at least take with a grain of salt?

To break down these simple but ultimately subtle questions, let’s change our perspective a second. Let’s tune into a different discussion going on in the world of science journalism – one which will, indirectly shine light on these quandaries and help us make better decisions.

Telsa v Edison: Revisionist History vs Conventional Narrative

Was Nikola Tesla a heroic modern figure? And was Thomas Edison not the altruistic genius inventor that most people believe he was?

Late 19 Century inventor Thomas Edison and genius innovator Nikola Tesla both indubitably created great inventions to help the human race. But a debate rages about how, exactly, these men contributed. Have they been credited fairly by most history books?

The historical debate is obviously complex – as these things always are. But here’s a gist. The standard historical texts credit with Thomas Edison with dozens, if not hundreds, of inventions; and while Tesla is certainly lauded by history books, he is far less well known.

•    Edison made a considerable fortune leading a team of inventors, and he took a lot of credit for what he and his team produced.

•    Tesla, on the other hand, was essentially a solitary genius who died alone, with an imaginary pigeon as his only friend.

Tesla fans, such as internet comic, The Oatmeal, are quick to point out the dozens of contributions that Nikola made to fields as diverse as electronics, x-ray technology, and magnetism.

Tesla fans allege that Edison treated Tesla very poorly and unethically. For an amusing and also educational vantage on this debate, check out the back and forth between the “pro-Tesla” Oatmeal and the “pro-Edison” response from Forbes Magazine.

How the debate relates back to the workers’ comp questions we raised earlier

There are a few lessons we can learn from the Tesla/Edison dispute that can help you manage the informational chaos of researching best practices for being a workers’ comp beneficiary:

1: Don’t expect to ever achieve full clarity.

There will always be people who will disagree with your point of view. There will always be counter arguments to the arguments, and counter arguments to the counter arguments. At some point, you need to turn off the flow of information and start taking action.

2: What you think of as “true” is often not the case.

If Tesla fans are right, the conventional wisdom about both Edison and Tesla is many ways backwards. That’s certainly the case with respect to a number of issues regarding workers’ compensation. So just because you certain default beliefs about workers’ comp does NOT mean those beliefs are necessarily productive, resourceful, or true.

3: Compassionate, experienced, scholarly people can you help you – often better than you can help yourself.

The team here at the law offices of Michael A. DeMayo can provide strategic guidance for your workers’ comp quest.

Milky Way and Andromeda Galaxy to Collide: What Does It Mean for Your North Carolina Workers’ Compensation Case?

June 12, 2012, by Michael A. DeMayo

At first blush, you might think that astrophysics and North Carolina workers’ compensation have about as much in common as do Lady Gaga and Albert Einstein. But let go of your skepticism for a second, and consider the following very interesting astrophysics development. There might be critical lessons for you “from the stars,” if you or someone you care about has been struggling to deal with an insurance company, recuperate from a chronic work induced ailment, or saddled with a less than compassionate employer.

Milky Way and Andromeda galaxy to collide, new research finds

North Carolina is located on planet Earth, which resides in the Milky Way galaxy, a consortium of billions of stars. To give you some sense of comparison, if the sun were the size of a very small grain of sand, the Milky Way galaxy would be approximately the size of the earth.

It’s big, in other words!

And it turns out that the Milky Way is on a slow motion (relatively speaking) collision course with a nearby galaxy called Andromeda, which is currently about two million light years away from us. By painstakingly measuring Andromeda’s trajectory using the Hubble satellite, scientists determined that the galaxy is headed our way at approximately 250,000 miles an hour.

At this rate, Andromeda and the Milky Way will collide and merge in about four billion years. Not exactly something to fret about any time soon.

Very interesting, but how does it relate back to my North Carolina workers’ compensation concerns?

Here’s how. Many aspects of the workers’ compensation journey happened in essentially “slow motion.” For instance, if you look hard enough, data could suggest that a certain type of rehabilitation will work (or not). But if you just pay attention to what you normally pay attention to – and fail to look for the subtle, “slow motion” signals – you can wind up struggling with your benefits issues.

Thinking “long-term” does not come intuitively to most people.

Even though human beings have a relatively unique ability to plan, we are still very much “creatures of the moment.” It is very difficult for us to intuitively sense whether a physical action or a dietary change that we undertake will have long-term negative (or positive) effects on us. It’s like… when you look at Andromeda through a telescope right now — even through the best telescopes we have — the collection of stars looks basically frozen in the sky. But it’s actually moving! Likewise, when you take a look at your current habits, resources, and beliefs about workers’ comp, you cannot judge what the outcome of those beliefs, habits, etc will be just by looking at the short-term.

A way around this “perspective” problem

The team here at the law offices of Michael A. DeMayo has represented hundreds of people in situations similar to yours. Since we have a better “data set” – more experience, and diverse experience – we understand the best kinds of trajectories for workers comp cases. So we can help you figure out a strategic way to approach your mission to get benefits, heal, and feel back in control.

Progress in Your North Carolina Workers’ Compensation Case – Incremental Improvement

June 7, 2012, by Michael A. DeMayo

As someone who has been struggling with a Charlotte workplace accident — someone who needs workers’ compensation and potentially other help to manage your life — you are a bit lost and confused right now.

You are vaguely aware that there is a gap between your current reality and what you would like to achieve with respect to your benefits, your healing, your future employment situation, and your financial plans. But you haven’t identified any concrete, methodologically rigorous plans for what to do, when to do it, how to do it, and who might be able to help you with it.

The power of continuous improvement

There is an old joke that’s beautiful in its simplicity and its visual power. It goes like this:

Q: “How do you eat an elephant?”

A: “One bite at a time.”

This soft hearted joke holds a powerful lesson. It suggests that, when life dumps massive and diverse problems on our shoulders, we do not need to shrug all the problems off all at once. We all probably intuitively accept this. But when we get in the thick of dealing with a disaster, we tend to lose perspective. As a result, we then wind up stressing over the “gap” between what we want and what we can achieve.

In other words, we recognize that we are not where want to be, and we can’t get there soon enough, so this dissonance creates mental stress!

How do we deal with this stress?

If you read self-help books or talk to productivity experts, there’s a common response to questions like this: just get into gear. Start moving towards your goals.

In other words, even if you don’t have a solid plan, GO. You will develop a plan as you go along. If you just sit on the sidelines, and you try to “plan everything to death,” you are liable to organize yourself into a feeling of non-control. That sounds paradoxical. But what you essentially end up doing is creating a bureaucracy for yourself that impedes your progress.

You need to free up how you maneuver.

So whether your first step is to call your aunt to get a referral for an orthopedist, so that you can check out your injured leg; or your first step is to connect with the team here at the law offices of Michael A. DeMayo to talk about your North Carolina workers’ compensation benefits; or your first step is to simply have a bowl of soup and take a nap so that you can think better, get into some kind of positive action.

Just remember this one idea: keep moving towards your goal, and don’t worry, because you will be able to redefine what you want to achieve and how you want to achieve it as you go.

North Carolina Workers’ Compensation Momentum – Punctuated Evolution

June 5, 2012, by Michael A. DeMayo

In a recent post on how to deal with the mountain of problems associated with your North Carolina workers’ compensation claim – what we metaphorically describe as kind of a “big elephant” that you want to shrug off your shoulders – we talked about how you need to get into action and seek continuous improvement towards a positive end state.

Whether you want to get your finances in order, straighten out your employment situation, deal with your health issues, or simply understand your potential legal rights and responsibilities with respect to North Carolina workers’ compensation, taking action is critical.

That said, there is another myth about how cases typically progress. A more subtle one!

While most people know that they need to “take action” to get things to happen in their lives, they don’t understand this second point too well. And that point is that progress does not happen linearly! It’s not like, day by day, your body will heal and heal and your financial circumstances will get better and better. On some days, you might see progress. But on other other days, you might feel like you are going in reverse.

Imagine you’re walking towards the Appalachians from Charlotte. You won’t just slope gently up and up and up until you get to the top of a mountain somewhere in West Virginia. Sometimes you will be going up, sometimes you will be going down. But as long as you keep heading in approximately the right direction, you will eventually reach the mountains. You will eventually get to the top. That is, if you continue to reset your perspective, reevaluate your progress, check your map, etcetera.

What does this all mean, specifically, for your workers’ comp case?

It means that, if you find yourself suddenly concerned about your medical situation or your legal battle, the answer is not necessarily to panic. The answer might be to panic! But not necessarily so. Because progress towards a worthy goal always has its ups and downs.

Of course, you also need to know whether you’re marching towards the proverbial mountains or heading towards a cliff. And you can’t really do that if your perspective is overly limited. That’s why it’s so helpful for beneficiaries or would-be beneficiaries to work with an experienced law firm, like the team at the law offices of Michael A. DeMayo. Since we have gone through the process of getting clients the resources they need many, many times, we know the common hurdles that they face and how to bypass those obstacles or make them irrelevant.

 
 

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