Often, North Carolina workers’ compensation cases discussed on the blogosphere and elsewhere revolve around relatively “dry” issues, such as the minute, discrete meanings of definitions or jurisdictions. A hot-button case out of Las Vegas, however, will almost definitely have you sitting up in your chair:

Here is the scoop, according to the Las Vegas Sun.

Last week, the Nevada Supreme Court ruled in the case of Gary Mogg, an employee for Fitzgeralds Casino Hotel assigned to monitor over three dozen television screens, acting in the capacity of “eye in the sky.” One day, in January 2008, Mogg made the seemingly innocuous decision to put his feet up on his desk. Lo and behold, he lost his balance and tipped over and severely hurt himself. Mogg claimed that the chair was defective and that he should be entitled to workers’ comp. The Casino, however, suggested that there was “implied prohibition” that prevented him from doing things like putting his feet up on his desk.

The courts have gone back and forth over whether this implied prohibition existed or not. Last week, the Nevada Supreme Court actually weighed in on the matter, ruling that “there was insufficient evidence for Gary Mogg…to qualify for industrial insurance payments.”

Reaction from the blogosphere was a bit sarcastic. One commenter, writing under the handle of BChap, wrote: “I am not of the opinion that this man should be compensated for this accident. However, if the resort is going to allow this individual to return to work, the employer should be sensitive to his medical needs and workplace safety. Maybe one of those apparatus’ that women utilize at the doctor’s office where the patient puts her feet up in the stirrups [should be installed for him.]”

If you or someone you care about has recently been hurt or made ill at work, you likely worry about having to endure this kind of sarcasm at your expense. To protect yourself and to ensure that you are treated justly not only by your employer and insurance companies but also by the system as a whole, connect immediately with a qualified North Carolina workers’ compensation law firm.

More Resources:

Nevada Supreme Court rules in “feet up on the desk” case

After a serious workplace injury or illness, you worked extremely hard to obtain North Carolina workers’ compensation benefits and stabilize your medical condition.

Unfortunately, your quest to heal has been anything but linear. Perhaps you initially suffered some kind of insult to your musculoskeletal system – severe carpal tunnel syndrome, for instance, brought on by working a desk job somewhere in the Research Triangle – but your diagnosis got complicated, after you noticed that the numbness and tingling sensations extended beyond the afflicted area. Alternatively, perhaps you suffered spinal damage during a car crash while on a work delivery, and the extent of the nerve damage has only recently manifested, leaving both you and your doctors relatively depressed about your prognosis.

Setbacks with your North Carolina workers’ compensation recovery are not exclusively medical.

You might experience psychological setbacks, such as depression, anxiety, frustration, and loss of self-confidence. You might simultaneously feel financial setbacks, as you are compelled to pay for complicated, extensive treatment and rehab – all while making do with a reduced income stream. What’s worse, the various workers’ comp injury/illness-related stresses in your life can play off of one another, provoking a kind of a downward spiral. For instance, in your more agitated, anxious state, you may hold your body tighter and experience higher cortisol levels, which can in turn exacerbate the musculoskeletal damage you suffered at work.

Repairing physical, psychological, and financial damage is no small task, even for the well prepared. While hurt and injured workers can make significant progress by working with a reputable North Carolina workers’ compensation law firm, you still could face some pretty profound hurdles to long-term wellness.

It’s tempting to try to “deal with” all these setbacks at once, but this approach can also be discouraging. Instead, make an attempt to incorporate small, positive changes in your life, behaviors, and perspective. Just getting your e-mail under control, for instance, can restore a modicum of control and help you manage your setbacks in a more thoughtful, less reactive way.

Also, remember that even though your injury or illness might have taken just a second or even a fraction of a second to develop, doesn’t mean that you can solve the situation in a lightning-quick fashion. Instead, keep your eye on the “long road of recovery,” accept your reality for what it is, and begin to make progress, step-by-step, to move beyond the setbacks you encountered and rebuild your life, career, health, and future.

More Web Resources:

Small Positive Changes Really Add Up

Setbacks are More Common than You Think

In a recent blog post, we discussed how many beneficiaries (or would-be beneficiaries) on North Carolina workers’ compensation struggle with setbacks in multiple arenas, including medical, financial, emotional, logistical, and social.

To manage these setbacks, you might find it helpful to adopt proven strategies and tactics to keep yourself better organized, more in control of your life, more relaxed, and more resilient.

This blog post cannot cover every positive behavior or beneficial scheduling strategy. However, it hopefully can encourage you to take the process of self improvement more seriously. Here are a few small but effective “good habits” to inculcate to relieve the stress of your North Carolina workers’ compensation journey.

• Get into the habit of keeping your e-mail inbox “at zero” – try out productivity guru David Allen’s GTD system for controlling e-mail (see link at the bottom of the page).

• Spend more time and energy thinking through your problems instead of acting impulsively to solve them. Do the mental work of clarifying an ideal outcome, assessing your “on the ground reality,” and brainstorming ideas to move from your present reality to your idealized future in an effective, sure-fire, cheap, and easy way. In other words, seek to break out of the habit of “acting before thinking.”

• Seek help and outside input. It’s often very difficult for victims of workplace injuries or accidents to ask for help, because victims already feel like their pride and autonomy have been compromised. Consciously break through that barrier and get help from friends, colleagues, family members, and outside resources, like a competent North Carolina workers’ compensation law firm.

• Test “catastrophic thinking.” When we get hurt or injured – when our welfare, health, social status, etc., are threatened by events or by other people – we have a tendency to imagine worst-case, catastrophic outcomes. This is a normal, human thinking, and it’s not necessarily deleterious. In fact, it can be helpful to be vigilant, depending on the situation. However, we always want to test the reality of our thoughts – especially thoughts that agitate us, keep us from sleeping, or scare us into spending hours on the Internet searching for a description and diagnosis of our symptoms.

• Thinking realistically is different from being a pollyanna. You don’t want to ignore dangerous symptoms, be they indicators of medical, financial, or psychological problems. On the other hand, we also want to detach our emotions and fears from our thoughts and seek to see them with a clear, objective lens.

• How do you cultivate this kind of clear-headed thinking? Some experts recommend engaging in daily meditative practice, such as mindful mediation, concentrated prayer, or some other exercise that enhances focus and helps you avoid getting sucked up into catastrophic thinking.

More Web Resources:

The Perils of Catastrophic Thinking

David Allen’s System for Controlling E-mail

In Part I of our series on how internet-based “info overload” can make the quest for North Carolina workers’ compensation more stressful, we defined an underlying problem that leads to frustration and anger. Specifically, we discussed how researching North Carolina workers’ compensation related topics online can make even the most organized, purpose-driven researcher slightly mad. And we also talked about how the solution to the problem often involves outsourcing your researching activities to a better-equipped partner, such as a North Carolina workers’ compensation law firm.

In this post, we are going to go bit deeper. We are going to ask the question: Why does all the researching make us nuts?

The answer is partly related to the “uncertainty factor.” In other words, when you research a lot online, you may actually learn quite a bit of useful information. Theoretically, this information should make your journey toward financial recovery and physical healing faster, safer, and more certain. But in practice, we often leave our research feeling more overwhelmed than ever.

The reason is not that we’ve learned too little – or even that our information is “bad” – instead we’ve learned too much!

You can see this phenomenon at work in medical students. When a young, would-be doctor is trained, he or she often learns about all sorts of different ways the human body can go wrong. Theoretically, this powerful medical knowledge should empower people. In practice, however, often the new knowledge makes med students anxious and despairing. Why? Because the med students come to fear they have all the different diseases they study. So they have gone from a state of blissful ignorance to a state of increased knowledge and increased anxiety.

This is probably going on with web searchers looking for answers about workers’ compensation. At first, you’re blissfully unaware of the potential problems – and also what you “should” be doing about them. By the time you finish researching, you realize just how “far behind” you are. This isn’t to say that ignorance will remain bliss forever. But it reinforces the earlier lesson that the key to digging out of this rabbit hole is to connect with reputable, experienced partners, who can answer your questions and help make the system work for you.

More Web Resources:

Med students think they have every disease

Increased knowledge leads to increased anxiety

An October 20 AP article reports that entrepreneurs, corporations, and other free enterprise groups are considerably satisfied with the 2011 North Carolina workers’ compensation reforms.

What about the rest of us?

Before we delve into the point/counterpoint, let’s quickly review the findings of a North Carolina Free Enterprise Foundation Survey. The group found that “66% of [NC] senate members consistently support [pro-business] viewpoints, compared to 42% two years ago. In the house, it grew from 49% to 61%.”

The legislature has had a busy 2011. In addition to changing the North Carolina workers’ compensation rules, lawmakers altered medical liability litigation processes and also changed the rules by which local governments can provide high-speed internet.

That the General Assembly has become more “business friendly” should not surprise anyone; Republicans took control of the body in the 2010 elections, and Republicans, in general, tend to side with free enterprise advocates.

Notwithstanding, obviously, many lawmakers seem pretty excited with the changes and pleased with themselves for passing them. But are these changes really creating fairness in the system, saving money, and fixing the long-term structural problems which have bedeviled the workers’ comp system and other similar institutions?

Part of the problem with assessing the changes is that the North Carolina workers’ compensation reforms did not occur in a vacuum. They occurred amidst a period of tumultuous change, both in the state and on the national stage. Thus, if, in the wake of the reforms, the state witnesses business growth, favorable changes to employee health, etcetera, one cannot conclude that the changes in the law caused or even contributed to the positive effects.

Of course, likewise, if what follows during the next several years is less than ideal, for businesses, employees, and insurance companies, and one should hesitate before pinning blame on the workers’ comp reforms.

The law is, in many ways, a subset of a larger, much more complicated dynamic system. From a strictly scientific perspective, it may be nearly impossible to effectively “suss out” how small reforms to various laws ultimately redound to affect things like the regional business climate or the relative health and well being of workers.

But that’s all a little heady, especially if you are a hurt or injured worker who needs guidance through the system. A North Carolina workers’ compensation law firm can help you understand your rights and responsibilities and advocate for yourself successfully.

More Web Resources:

North Carolina free enterprise foundation

NC general assembly is more business friendly?

The Washington Times has reported on a relatively minor workers’ comp case in Virginia that may ultimately have bearing – perhaps substantial bearing – on North Carolina workers’ compensation law.

Why would a struggle over a mere $4,000 workers’ comp award have national implications?

Simply put, because the case pertains to whether professionals injured in cell phone related automobile accidents should be reimbursed by workers’ comp. The debate is controversial, emotionally charged, and interesting. Before we examine the broader implications, let’s take a look at the specifics of this case.

Donna Turpin was a hospice nurse on call late one night in November 2009, when she received a call on her cell phone, which was tucked into her uniform. Distracted by the call, Ms. Turpin drove off the road and hit an embankment. She suffered some injuries and damage to her vehicle, but it was otherwise a minor incident.

Should Ms. Turpin be entitled to workers’ comp, since her employer knew to contact her via her cell phone if the employer-provided pager did not work? According to testimony, she had responded to 12 pages or calls earlier that same day. Ms. Turpin testified that she was “programmed” to tune into her beeper and cell phone to answer medical or hospice emergencies. Did it matter whether the message was work related or not? The judge decided that, in this case, it did not.


However, the judge’s ruling had some nuance: “the mere possibility that a call on a cell phone might originate from an employer does not make any injury that occurs while the employee attempts to respond to the call, or received call, one that arises out of employment.”

So what are the broader implications? The Washington Times report suggests that the unpublished opinion “could contribute to debates in cases involving doctors, reporters, food delivery drivers, and others whose work is tied to urgent cell phone calls.”

No doubt, in the following years, we will see a spate of circumstances similar to Ms. Turpin’s. In this case, the costs were low. Ms. Turpin only asked for $4,000 to treat her whiplash and pay for an ambulance and an emergency room visit. Fortunately, she returned to work that very weekend. But what might happen if and when a worker stops to answer a cell phone or pager and causes a catastrophic accident – perhaps one with fatalities – and seeks damages on the order of six or seven figures? We will likely see bigger headlines then, and the implications could stir up even more debate in the blogosphere.

The takeaway is that hurt workers need to examine and understand their legal rights. A North Carolina workers’ compensation law firm can help you make sense of what happened to you and determine how and whether to pursue a case against an insurer or other entity.

More Web Resources:

Workers’ Comp Case Upheld in Cell Phone Related Crash

Nurse Injured While Glancing at Cell Phone Due Workers’ Comp

North Carolina workers’ compensation beneficiaries often fight battles on multiple fronts.

You fight with insurance companies to make sure they make good on benefits and pay you on time. You fight with employers – or even your employer’s parent company – to get fair and just treatment. You fight with your doctors and medical staff to ensure that you get adequate care, answers to your questions, and the right medication and rehabilitation. You may even fight with random strangers on the street, who sadly and inaccurately believe that North Carolina workers’ compensation is only for people who want to “leech off the system.” You also fight with your own body, to try to heal it as quickly as possible.

At the end of all that fighting, you are likely exhausted. The last thing you want to do is fight with friends and allies – particularly your spouse or partner.

Unfortunately, when you are hurt or injured, your entire family may become stressed. First of all, you may temporarily lose an income stream. Second, you may need significant medical care. Third, you may need logistical support. Fourth, your partner or spouse may lose out on a critical ally to help with child care. Fifth, any big change – good, bad, positive, or neutral – temporarily increases stress. Think about the last time you moved offices, started a new job, etc.

All those stresses would challenge even the most perfect relationship. And most of us do not have perfect relationships. So the stresses will likely push on the fault lines in your relationship that have already been giving you trouble.

So how do you break the cycle? How do you find peace, protect your spouse’s needs and also protect your own needs in your relationship?

There is no quick, snappy answer here. But taking small but certain steps toward resolving some of your uncertainty, frustration, and stress will relieve the burdens on your family and could possibly benefit your relationship. As the old saying goes, “a rising tide lifts all ships.”

So how do you “raise the tide” and make your life less stressful, fretful, and uncertain?

Here are five solutions:

1. Connect with a reputable North Carolina workers’ compensation law firm to get answers to burning questions about your situation.

2. Practice 15 minutes of mindfulness meditation (focusing on “just the breath”) every day.

3. Write down “best-case scenario” outcomes for your workers’ comp case and read them aloud at least twice a day.

4. Regularly re-read the serenity prayer.

5. Improve your diet to reduce stress and medical problems by limiting your consumption of sugar – particularly liquid sugar.

More web resources:

The serenity prayer

A rising tide lifts all ships

As regular readers of this blog know, the quest for a successful resolution to a North Carolina workers’ compensation issue can take months, require significant mental and logistical energy, and lead to profound challenges as well as surprising opportunities. To make the best progress, you should keep a clean, coherent, private, and ideally “backed up” record of your experience in the North Carolina workers’ compensation system.

To that end, here are several “rules of thumb” to maintain order in your records, safeguard critical information, protect evidence, and take action to spend less time fretting over your workers’ comp case and more time rebuilding your body, life, and vocational skills.

1. Collect anything that might be relevant to your North Carolina workers’ compensation case.

This “anything” could include medical assessments, transcripts of conversations you’ve had with insurance companies, a journal of thoughts and feelings about your injuries, receipts for medical care, and records of your conversations with friends, associates, and colleagues. Basically, if there is even a slim chance this information might be useful or relevant, write it down.

2. Collect everything in one place.

Create a folder to store all requisite documents, transcripts, etc. Don’t let materials get scattered all over the place in various piles around your office, desk, etc.

3. Make backups and secure potentially sensitive materials.

Use electronic data backup solutions, third-party data security management technologies, etc. Consider keeping certain documents, data, recordings, computer files, etc., stashed in a safe or lock box. Make copies of important information that might get lost.

4. Keep a running list of all your “active” workers’ compensation projects, along with the “next actions” associated with each project.

Productivity guru David Allen considers a “project” anything that needs to get done that takes more than one step to do. According to Allen’s methodology, ideally, you want to have a running list of all your projects – with an ideal outcome associated with each one of them. You also want to create a separate list of specific, concrete options associated with your projects. So, if one of your projects is “retain the services of a North Carolina workers’ compensation law firm,” the next action associated with that item might be “R&D firms online and talk to friends and colleagues for their recommendations.”

More web resources:

David Allen’s “Getting Things Done” System

Tools, Tricks and Traps of Organizing

Doctors have their Hippocratic Oath: “First, do no harm.” North Carolina workers’ compensation beneficiaries should also have an oath along those lines: “First, don’t make your medical situation worse.”

This advice should probably go without saying. Obviously, no one wants to get sick. And once we are sick, we generally want to do everything we can to get better – and quickly.

But there is a big gulf between believing that good care should be applied and living a healthy lifestyle, even if you’re injured or sick.

In a twisted version of the idea “the rich get richer and the poor get poorer,” often, the “sick get sicker.” In other words, once you already have an illness or injury, you become vulnerable to all sorts of medical and physical problems that you were previously invulnerable to.

For instance, say you broke your leg in an industrial plant, after your foot caught in an unmarked rut. Now, not only must you deal with the broken leg and all the complications the injury has created, but you also must protect yourself from favoring the other leg too much and causing wear and tear on the other leg. Your immune system could also be compromised by an injury/illness, making you susceptible to things like the flu or infections. And so on.

Once you get sicker and sicker, the situation becomes a vicious cycle. Hurt and sick workers often develop a mindset that “I am never going to get better,” which perpetuates/exacerbates the cycle. At some point, you need to break the cycle and start building toward “healthier and healthier.”

Obviously, one key to do that is great medical care – a proper, complete diagnosis; effective, compassionate, thorough medical treatment; the right medicines; the right diet; the right kind of exercises, and rehab plan, etc. You also may need to reprogram how you think about your health and make conscious choices to stop engaging in practices that you know are destructive but which you could “get away with” back when you were healthy. Practices like smoking cigarettes or cigarillos, “pushing yourself hard” as a weekend warrior in a volleyball or touch football league, or binging on root beer floats.

When you treat your body and mind with compassion – and with good care – you might be surprised at how quickly you are able to spring back from your injury/illness and take on the world again.

Connect with a North Carolina workers’ compensation law firm.

More web resources:

Breaking Free from Your Cigarette Addiction.

Breaking Free from Your Sugar Addiction.

In Part 1 of our series on how “too much too soon” can devastate North Carolina workers’ compensation beneficiaries, we defined this often misunderstood problem. When hurt and sick workers feel an obligation to “get back out there” and return to work early to make ends meet, they can suffer reinjury, other accidents, and psychological setbacks.

In the second part, we are going to talk about what North Carolina workers’ compensation beneficiaries and their family members can do to “outthink” this tendency to want to overwork.

Here are three ideas:

• Set concrete, doable goals for your medical and vocational recovery and work toward them.

As the tired (but still true!) old adage goes: “The journey of a thousand miles begins with a single step.” As long as the hurt or sick worker feels like he or she is making progress toward a better future, he or she might avoid straining or taking on too much too soon. But success must be clearly defined. Make success as quantifiable as possible, so that working toward it can be more like playing a video game than like running a marathon toward an ever-elusive and receding finish line. For instance, maybe one goal could be to regain the ability to walk without crutches two months faster than your doctor says you will be able to.

• Get help.

You are proud and strong worker, and the thought of having to turn to other people – such as a wife or spouse, family members, or public assistance – may seem less than palatable. But now is not the time for foolish pride. Seek out and utilize other sources of help to take care of the physical tasks that you can’t manage right now.

• Get good legal assistance to reduce uncertainty.

The more “loose ends” in your life, the more you will feel stressed and desperate to “take action” to consolidate and organize the chaos that’s found its way into your life since the injury or accident. Talk to a North Carolina workers’ compensation law firm to understand how you can leverage the law and other resources to solve the nagging crises that have been keeping you up at night and stressing your pocket book.

More Web Resources:

The journey of a thousand miles begins with a single step

Importance of quantifying your goals

As a North Carolina workers’ compensation beneficiary (or someone who wants to become a beneficiary), you’re likely in a lot of pain right now.

Not only are you suffering from – hopefully recovering from – a serious workplace injury or illness, but you also face imminent financial challenges. Since so much bad news has come your way recently, you might be focused on what you lack in your life as opposed to what you can gain from this experience. This blog post will attempt to begin the process of turning around your perspective on the whole situation – to see that your whole North Carolina workers’ compensation situation not just as a stop gap for pain, but as an opportunity for change.

For instance, your injury or illness might mean that you cannot go back to the work you used to do and love. Now, you might be able to recover with the right therapy, medical help, and other resources, and return to your old job. But you might alternatively think about novel ways to utilize your knowledge, skills, and passions to change your career path within your industry or change industries altogether.

For instance, if you were hurt in a welding accident, you might not be able to go back to doing what you did before. But you might start your own welding company – or work in the front office of someone else’s welding company – earning more money, working fewer hours, and utilizing your experience in the field to help up-and-comers.

Sounds pretty good, doesn’t it?

Alternatively, you can go on a journey of self exploration, rediscover old skills, tools, and passions you used to have, and exploit those to earn money. In other words, what might have been a disability in one industry — such as your loss of your ability to bend your knees — might be completely irrelevant in another industry or in another part of your current industry.

Of course, identifying these opportunities is often easier in theory than it is in practice, especially if you are in a down mood or if you have never gone through career retraining.

But hopefully, just by recognizing that these options may be possible for you – as the saying goes, every cloud has a silver lining – you might feel more hopeful.

There is no need to go through this struggle on your own. A North Carolina workers’ compensation law firm can help you deal with the practical issues, nuts and bolts logistics, and legal questions to keep you focused on healing, regenerating your career, rebuilding your finances, and restoring hope and confidence.

More Web Resources:

Universe is Abundant?

Reboot Your Career

Perhaps you’ve received North Carolina workers’ compensation benefits after a long, hard fight. Or you may be just beginning the process, researching your options, interviewing attorneys at various North Carolina workers’ compensation law firms to figure out who can help you deal with a bad faith insurance company or a boss who refuses to understand your predicament. In any case, you face a long-term challenge with your recovery – one that many people fail to recognize even exists. The challenge is this: When you subsist on a fixed income, you must “make room” in your budget for surprising, variable costs.

Fixed cost is something that you pay every month at a regular interval. For instance, your rent, your insurance premium, the parking permit for your condominium complex, etc. Variable costs change over the time. You can’t predict them exactly. For instance, your grocery bill varies from month to month, as well the amount you spend on gifts or on fun accessories, like electronics or gadgets for dad.

We are all told – we all know – that we need to budget for variable expenses carefully – to make sure that we have enough money to deal with these strange costs.

But if you apply the thinking of Nassim Taleb, author of the Black Swan, you will quickly recognize that small allotments for variable expenses may not be sufficient.

To put that in plain language: If you are on workers’ comp, and you and your spouse are only bringing in a certain amount of money a month, and you’ve “conservatively” budgeted to spend Y amount of money (where Y is less than X), then you may not be as safe as the math says you will be.

Taleb’s big insight is that shocking, unexpected events – so called “Black Swan” events – can radically throw off your financial plans.

In other words, even if you’ve budgeted carefully to save Z amount of dollars every month (where Z=X-Y), and you’ve been careful and accounted for all the variable costs we discussed above, this kind of linear, rational thinking may not save you from big “Black Swan” events. For instance, say you or your spouse develops a catastrophic medical condition or gets into an accident. Or say you have a change of heart one day and realize that your apartment is too small, and that you must, must, must move to a bigger place or your family is going to go completely insane. You take on these extra expenses that completely wreck your budget.

There is no quick and easy answer to defend against “Black Swan” events from messing up your budget. But even just knowing that they exist is a huge help in your planning. This will give you insight into the almost irreducible complexity and uncertainty of planning in the real world.

To make progress, you need different ways of thinking about planning effectively, and you want to connect with the resources that can help you solve your problems as they occur – because they will occur whether you expect them to or not. For instance, a reputable North Carolina workers’ compensation law firm can help you navigate surprising and perhaps even shocking obstacles that might get thrown in your path – such as a bad faith insurance company or an employer/boss who, out of the blue, denies that your workplace accident/injury ever took place.

More Web Resources:

Budgeting right

Black Swan

You may be in a hard fight right now to win North Carolina workers’ compensation benefits to pay for medical and surgical bills, therapies and medications, and your family’s day-do-day expenses. The fight could be consuming a significant portion of your life, particularly if your employer has refused to cooperate or if your insurance company is giving you a hard time.

But your battle goes well beyond the struggle for North Carolina workers’ compensation benefits. It grades into struggle to rebuild your life after an accident or injury. And that means taking responsibility for your current reality, setting up a strategic course for a better direction for you and your family, and finding helpful resources.

Turning to adept resources, like an experienced North Carolina workers’ compensation law firm, is a good start. There is so much about workers’ comp law that you likely don’t know. Would be beneficiaries often make critical strategic mistakes that reduce their chances for collecting fair and just payments.

However, the battle is internal as well as external. Your struggle is not simply to collect the maximum amount of money. It’s to rebuild your life – ideally, rebuild it better than it was before the accident or illness. To that end, you will need to face down a key boogeyman: complacency. Human beings are creatures of habit. When we get into a groove – or regular routine – that routine becomes comfortable because our brains’ neuro pathways are strengthened by following that routine. In other words, you don’t have to spend time thinking about how to brush your teeth everyday because that pattern or behavior is now been hardwired into your neuropsychiatry. Likewise, when you are on benefits, the experience may seem novel and surprisingly exciting at first, but over time, as more and more benefits checks comes, you will grow somewhat accustomed to receiving your checks and – if you are not careful – you will become dependent on them.

Of course you should fight for all the money that you are owed. However, it’s never healthy to become too dependent on outside forces, particularly when the rules that govern those forces are outside of your control. As we have seen with the recent reforms to the NC workers’ comp laws, even “tried and true” realities about the system can be dismantled and reformed in the blink of any eye, and it’s out of control of any one beneficiary or even the best NC workers’ comp lawyer.

The challenge then is to protect yourself from this kind of complacency. One powerful strategic weapon to battle complacency is creating plan for your life. Spend some time reflecting on your life’s purpose and your vision for a better future. Keeping your focus there – instead of on conserving what you have now or what you might lose – will motivate you and give you the power to find resources and tools that can help you.

More Web Resources:

Resilence

Self-reliance

The political fracas that accompanied the recent debate (and subsequent passage) of North Carolina workers’ compensation reform drowned out a few curious and intriguing developments. Thanks to the reform – just penned into law by Governor Perdue – and a piece of legislation called the Patient Protection and Affordable Care Act (PPACA), states like NC (and the nation as a whole) are reassessing their medical billing systems.

North Carolina, for one, adopted new eBilling rules. The state joins Illinois, California, Minnesota, and Texas as part of a select, small group of states that has accepted the new “e-reality” of medical e-billing and moved away from traditional paper bureaucracy.

So what does this all mean? Will eBilling, in and of itself, radically alter the North Carolina workers’ compensation system?

According to many experts, eBilling is inevitable. The internet is altering every facet of our lives. And more and more people feel more and more comfortable paying bills online and even banking at institutions like ING Direct.

But will eBilling eliminate redundant and needless bureaucracy and thus streamline and smooth out hiccups in the system? One would like to think so. If you Google around, you can find countless examples of how eBilling solutions have improved trade, souped up customer service, and even made whole industries workflow processes work better.

On the other hand, eBilling does carry risk. Security, technology, and recordkeeping issues abound. One can easily concoct dozens of “nightmare” scenarios, in which workers’ comp beneficiaries get sucked into a vortex of bureaucracy – or even defrauded out of money or a social security number – due to an eBilling error, technological glitch, or hacking scandal.

Nevertheless, the time has passed for what-iffing. The new eBilling paradigm is upon us.

To make sense of your rights, opportunities, and “best practices,” avoid doing all of the legwork yourself, and turn to a trusted and experienced North Carolina workers’ compensation law firm to help you develop a strategy for the way forward.

More Web Resources:

Patient Protection and Affordable Care Act (PPACA)

medical e-billing

On June 25, North Carolina Governor Beverly Perdue signed an historic North Carolina workers’ compensation reform into law…and simultaneously vetoed a Republican proposed cap on medical malpractice awards.

Governor Perdue, a Democrat, called the North Carolina workers’ compensation reforms fair and balanced – she argued that the changes both protected businesses and preserved the rights of injured and sick workers. But she was far less effusive about the proposed cap on punitive damages to be awarded in medical malpractice cases. Republicans wanted the limit to be capped at $500,000. Governor Perdue responded in a written statement: “I commend the legislature for addressing this important issue [medical malpractice reform] but, in its current form, the bill is unbalanced… I urge our legislators to modify the bill when the General Assembly returns in July to protect those who are catastrophically injured.”

The North Carolina Senate passed the “medmal cap” bill by an enormous margin, but the House only passed it by a narrow, non-veto-proof margin of 62 to 44. Advocates of the cap were livid. They did not mince the words. A Republican from Rockingham, Phil Berger, the NC Senate’s leader, said Perdue’s actions dealt “a severe blow to the state’s medical community and every citizen struggling to cope with skyrocketing cost of health care.”

Over 30 states currently have some cap on medical liability damages. It’s pretty clear from interest group statements that this battle over a potential cap is far from over.

On the other hand, the changes in the workers’ comp laws have created a not insignificant amount of confusion and agita among claimants and their families. If you or someone you care about has questions about how the reforms might affect you – or needs help with a benefits question – talk to a qualified North Carolina workers’ compensation law firm about your rights and possible remedies.

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.

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Carl Fuller

Florida Department of Financial Services

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.

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Pinnacol Assurance

Martin Lobatos fraud

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.

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North Carolina Workers’ Compensation Reform Bill –

Employers Coalition of North Carolina

Ohio Governor John Kasich is seeking to lower that state’s workers’ comp rates – if the Governor succeeds, what will that mean for Ohio, and what will it mean in general for the programs of other states, like North Carolina workers’ compensation?

First, the basics, courtesy an April 29 story from the AP: “Ohio’s Governor wants to lower premiums employers pay for workers’ compensation by 4% for a total cut of about $65 million a year.”

Governor Kasich submitted his proposal last Thursday to the Ohio Bureau of Workers Compensation – his goal is to encourage businesses to work in Ohio and “make the state more competitive.” If the BWC adopts his plan this month, employers would not see changes in their premiums until February 2012. Steve Beuhrer, the CEO of the BWC’s Board of Directors had the following comments regarding the proposal (courtesy www.business-journal.com) “our goal is to increase premium stability and lower costs for all Ohio employers… rates are a critical part of job growth decisions made by Ohio employers, but will also continue to focus on other aspects, such as containing medical costs and helping injured workers return to leading healthy productive lives sooner.”

Beuhrer’s comments here are germane to discussions about how to renovate and streamline the North Carolina workers’ compensation system. It’s NOT just about slashing rates and limiting benefits. Our solutions must also focus on “continuing medical costs” – and perhaps even more importantly “helping injured workers return to leading healthy productive life sooner.” After all, this is the raison d’etre of workers’ comp – it’s to help return us to productivity ASAP.

Unfortunately, the political discussion about workers’ comp reform often revolves around costs: whether to spend or not; on what; and for how long. This inevitably leads to political calculations.

But what if the most relevant parts of the equation are those two factors that Beuhrer named – containing costs and helping people recover?

Perhaps we are giving short shrift to these questions. Maybe we’re not thinking “out of the box” enough. For instance, cost control measures tend to focus on measurable, direct contributing factors. We aim to reduce the severity and number of workplace injuries, for instance. But we don’t take time to look at long-term exacerbating factors. For instance, are workers getting enough rest? Are workers too distracted by things like the internet and social media to concentrate effectively on their tasks? These indirect factors – such as how much sleep we get, how distracted we are, how much sugar we eat, et cetera – must be addressed if we want to lower injury rates and reduce hospital bills.

Backing away from the philosophical discussion… you may have more practical concerns about how to collect benefits and how to deal with insurance companies and employers. A North Carolina workers’ compensation law firm can answer your questions and put you on a good track.

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Ohio Governor John Kasich

Steve Beuhrer, the CEO of the BWC’s Board of Directors

On Thursday, May 12, a House committee worked feverishly on North Carolina workers’ compensation legislation designed to relax employer responsibility for workers’ comp claims.

The AP has reported that the current sticking points “include whether employers, their attorneys and their insurers should have greater access to the medical records and doctors of an injured worker. Another issue is whether to cap temporary payments for a totally disabled worker at nearly 10 years.”

Powerful figures in the North Carolina workers’ compensation system are currently “at the table” per the AP, including insurance companies, legal representatives, NC workers’ comp lawyers and the Chamber of Commerce. Workers filled the hearing room in a bid to influence the proceedings. As of 6:41pm on May 12th, no compromise had been yet worked out, but observers remained hopeful that something could be accomplished.

It’s easy during moments like these – when everything seems to be on the line – to get defensive and to start about thinking in catastrophic terms. If you are a hurt or injured worker, for instance, you might worry that reforms will result in unexpected and decidedly unwelcome changes in your recuperation plan and your family’s financial strategy. And, depending on your situation and the outcome of the debate, you very well might have to adjust your expectations.

But it’s a good idea to remember the difference between what productivity guru Steven Covey once designated your “circle of control” and your “circle of influence.” Unless you are currently in the assembly room right now, chances are the bill is way out of your hands. Your best strategy for success, therefore, is to react appropriately to whatever laws get passed (or don’t get passed).

Part of dealing with the fallout effectively is getting good help. A North Carolina workers’ compensation law firm can help you understand how the new laws might influence your benefits and take the smartest, most efficient steps towards minimizing any negative fallout.

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House committee works feverishly on NC workers’ comp

Catastrophic thinking

In this two part blog post on the possible reform of the North Carolina workers’ compensation system, we’re going to boil down legislation proposed recently by business groups.

According to an Associated Press article from April 22nd, business groups are practically giddy about the potential to alter North Carolina workers’ compensation laws to reduce employer costs and set limits and constraints.

The AP quotes Bruce Clark, the President of a business group called Capital Associated Industries: “a multi-million dollar event with no legal means to ever end or settle the open-ended, lifelong claim… this is not what good and fair workers’ compensations do around the country and it should not happen here.”

The newly Republican controlled state General Assembly aims to prioritize workers’ comp reform, and the proposed bill will do the following:

• Limit temporary total disability payments to approximately 9.5 years (currently, these payments can last a lifetime)
• Extend benefits for families of workers who die on the job from 400 weeks to 500 weeks.
• Burial benefits will also be ratcheted up by an additional $10,000.
• A provision will be inserted that “would allow employers, their attorneys and their insurers access to the medical records and physician of an injured worker seeking compensation.”
• Workers will be restricted in how they choose the physicians who treat them.

Advocates of hurt workers admit that some people do try to “game” the system by staying on workers’ comp too long or even faking symptoms. But they also point out that insurance companies and employers work relentlessly to challenge claims. The AP article quoted an advocate: “every insurance company works overtime to limit payouts, sometimes by putting injured workers on a carousel of different doctors until one provides an employer friendly diagnosis.”

The AP article then discusses the sad case of a 42-year old Randolph County man, Levy Grantham, a tree trimmer who seriously hurt his back, arm and shoulder on the job. Grantham’s “employer’s insurer… sent [him] to five doctors after the initial diagnosis in a pattern of persistent refusal to provide timely treatment.”

So the debate rages on, and both business advocates and advocates of hurt workers are more than well aware of the stakes. In a subsequent blog post, we will discuss possible outcomes to this fractious debate and analyze the deeper implications.

If someone you care about needs immediate help with a claim or a benefits issue, connect with a North Carolina workers’ compensation law firm to go over your resources.

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NC panel hears effort to change workers’ comp law

NC panel hears effort to change workers’ comp law

Several days ago, this blog reported on proposed changes to the North Carolina workers’ compensation laws. Politicians, business advocacy groups, and workers rights groups have contentiously debated the merits of the reform proposals. Some of the changes would redound to “good effect” for workers (e.g. the ratcheting up of death benefits); while some of the changes would take away rights that injured workers currently have (e.g. allowing employers and insurers access to workers’ medical records, limiting the time workers can collect temporary total disability, et cetera).

Anyone who even casually reads the news about North Carolina workers’ compensation will be struck by the passions exuded in this debate.

Indeed, many advocates of the reforms see them as nothing short of foundational – in other words, if the state doesn’t pass them, NC will go to heck in a hand basket.

Conversely, opponents of the law worry that, if it gets passed, hurt workers are going to be essentially abandoned by the state.

Obviously, both of these positions are extreme. In reality, the reforms may not do much of anything – that is, they may not solve our states’ fiscal crisis or even workers’ comp crisis – nor might they particularly derange the care and treatment that workers receive. This isn’t to say that the passing of reforms won’t change the playing field – in some ways, significantly. But it is to say that we should “let the air out of the balloon” and stop awfulizing and catastrophizing about it [or overly celebrating it].

As this blog tirelessly advocates… we must examine root causes of our problems if we want to contain costs, help workers, and get to “win win” outcomes.

Here is a rough (an obviously not totally consistent) analogy. Imagine a family fighting over money. A 16-year old daughter uses her credit card to buy clothes, purses, et cetera, while the family struggles to stay in the black. The father and daughter might get into serious screaming matches over the daughter’s purchases at the mall. Might there be ways that the daughter could cut down on her spending? Would that help with the family situation? Probably and probably. But does the debate about the daughter’s spending really address the root causes of the family’s crisis? Almost certainly not.

The analogy here is that our focus on controlling workers’ comp costs may be legitimate; but it’s definitely not the only thing we need to be focusing on. Instead, we need to look at the broader picture – the structural, fundamental problems with our state’s (and perhaps even our country’s) medical problems and institutions. These problems may not be easily tractable. For instance, the baby boomer generation is getting older – this is going to create a demographically “top heavy” situation, in which the sheer number of older Americans requiring medical help will go up, and the number of active workers engaged in productive work will decline.

This top heaviness is no one’s “fault” — but it’s a real structural problem.

Continuing our analogy – it’s as if the family home got flooded, and the basement got rotted out and mold developed in the house. It’s a structural problem that drains the family’s finances. It’s no one’s fault — it just is what it is. Efforts should go to sorting out that problem instead of simply addressing the more emotional (“political”) problems. Let’s spend less time trying to control “spending at the mall” (although that is important) and more time “fixing the foundation of the house.”

Need help with a claim? A North Carolina workers’ compensation law firm can help you get the benefits and fair treatment you need and deserve.

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NC panel hears effort to change workers’ comp law

New Bill Could Change Workers’ Compensation Laws in NC

The whole point of North Carolina workers’ compensation and other similar entitlement systems is to provide resources for hurt/injured workers, so that they can reboot their lives, treat medical conditions and reenter the work force.

For most people, these entitlements are stop gap measures.

Unfortunately, hurt and injured workers may come to depend on their benefits not only for essentials such as grocery and rent money but also for psychological reasons. And this dependence can be hugely problematic – not only for the employers, insurance companies, and taxpayers who foot the bill, but also for the hurt and injured workers themselves.

So, how can we deal better with these psychological hang ups?

First of all, it’s easy to grow dependent on any source of income – whether you’re earning six figures as an investment banker or you’re scraping by on the (unfortunately) low salary of a public school teacher. You start to think of your incoming sources of money as “your own” and you adjust your life style accordingly. This happens to everybody, irrespective of “will power,” class, or history. Trying to think about life without this income stream is frustrating and scary.

But a deeper and perhaps more problematic issue is that, when you are hurt and sick, you may start to think of yourself as “a hurt/sick person.” In other words, you may actually revise your internal self concept to think that you will never get to go back to work. This kind of thinking can, unfortunately, take on a reality of its own. If you think this way, there’s a very real possibility that you will accidentally manifest this reality.

Don’t get mixed up here, however: The idea that negative (or positive, for that matter) thinking can influence your real world destiny in no way suggests that the pain you feel is “all in your head” or anything like that. Indeed, one of the terrible (and ultimately illogical) criticisms leveled against people on workers comp is that they “want” to be “on the dole.” If you actually talk to people who use these benefits programs, it’s clear that nothing could be farther from the truth. People want to be motivated, independent. They want to work. They really do. There has nothing to do with will power or psychological constitution. Indeed, it takes tremendous courage and strength to recover from an illness and try to rebound and get your old life back.

The takeaway is simple: fixing the way you think can potentially have profound, positive effects.

But you likely need good help as you progress with your recovery. A North Carolina workers’ compensation law firm, for instance, can help you fight back against insurance companies, employers, and others who needlessly and unfairly block you from getting the benefits you need to get back on your feet.

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You Are What You Focus On

Calling Yourself “Sick” Makes You Sick? – Power of Language

Although this blog typically covers news germane to North Carolina workers’ compensation issues, those who report on benefits and entitlement issues have been riveted by an ongoing debate out of Washington state regarding how to reform WA’s workers comp system.

Here’s the latest news in the WA workers’ comp saga.

According to an April 20th AP article, eight moderate House Democrats have unveiled a proposal to change the Washington system. In 2010, Washington Governor Chris Gregoire — along with leaders from the state’s House and Senate — prioritized workers comp reform after evidence surfaced suggesting that the system was in danger of insolvency.

One of the “harder core” plans for reforming the system would have required major concessions from workers. Hurt and injured workers would have to take “lump sum” settlements in lieu of ongoing payouts. While business groups backed this measure, injured workers voiced concerns that the arrangement would leave many in a lurch; and workers who could not afford legal representation would be at risk for decreased protection.

The new “moderate” plan proposed would provide workers some protections. Essentially, it would thread the needle. Workers would get enhanced safeguards, and a study would be conducted in three years to assess how the plan is performing, both in terms of saving money and in terms of protecting workers rights. On the other hand, while settlements from medical claims would be eliminated, “the option for lump sum settlements would remain.”

One interesting factoid from the AP article: “About 85% of compensation costs come from only 8% of all claims.” It’s very likely that a similar breakdown occurs in the North Carolina workers’ compensation system.

The so-called Pareto Principle (also known as the “80-20 Rule”) suggests that, in a variety of natural systems, 80% of inputs yield 20% of the results and vice versa (20% of inputs yield 80% of the results). So, when you get a statistic that says something like “8% of workers’ comp beneficiaries drive 85% of all costs,”– yes, at first, it sounds alarming. But it really shouldn’t be. Distributions of wealth, water, commodities, and basically everything else in the world organically wind up lopsided. This is why a small fraction of the people in the United States – and indeed in every country of the world – owns the majority of the wealth. It’s not a sinister plan – it’s just the way that distributions tend to form.

Getting away from the abstract, if someone you care about needs help from a North Carolina workers’ compensation law firm, don’t wait to get that assistance.

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WA workers’ comp proposal

WA Governor Chris Gregoire

Last year, the family of injured Montgomery Police Officer, David Brown, filed a lawsuit against the city of Montgomery to collect workers’ comp to pay for medical bills Officer Brown received during a tragic September 11th accident. Industry watchers — including many widely respective figures in North Carolina workers’ compensation — couldn’t help but reflect on the sequence of truly tragic accidents to befall the officer. Although this blog covered the accident and lawsuit, we’ll recap the details:

• On September 11, 2010, Brown got hired by a funeral home to work a funeral procession.
• A motorist slammed into his motorcycle during the procession, causing critical injuries.
• The ambulance that took Cooper Brown to the hospital overturned on I-65, hurting Brown even more.
• Brown suffered a double amputation, major burns, and brain injuries.
• He underwent dozens of surgeries to save his life and to correct some of the damage. He now owes $3,000 in co-payments and $1.5 million in medical/surgical bills.
• To top it off, the city of Montgomery initially denied his worker comp claim because Brown got hurt during “off duty” work for private company (the funeral home).
• Brown’s family sought workers’ comp anyway, since Brown had been in uniform as a police officer and had been using Montgomery Police Department equipment.
• Circuit Judge Tracy McCoey ruled in favor of Brown’s family last Tuesday – saying that Brown should get the workers’ comp.
• But… Mayor Todd Strange is prepared to fight the decision.
• More legal wrangling and national headlines will be sure to follow, as this story has touched a nerve not just here in the North Carolina workers’ compensation community but also elsewhere throughout the Southeast.

If you or a family number got hurt or sick at work, the last thing in the world you want to do is wrestle with your employer or deal with tedious bureaucracy or an uncaring insurance company.

Unfortunately, if you don’t fight for your rights actively, you can lose benefits that you should be entitled to. A North Carolina workers’ compensation law firm can give you the guidance, professional support, and wherewithal to get the benefits you and your family require.

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David Brown’s saga

Brown’s September 11th accident

The blogosphere has been on fire since February with worried articles about how and whether the North Carolina General Assembly will fundamentally alter the North Carolina workers’ compensation system. The Republican controlled General Assembly – boosted by business groups – boasts an ambitious agenda to redraw the medical malpractice and North Carolina workers’ compensation systems to limit costs.

Opponents have complained that the proposed legislation could negatively impact hurt workers. For instance, when the changes go into effect:

• workers’ comp will cease after 500 weeks
• individuals who fail to follow their treatment may receive more limited compensation
• workers may lose flexibility in choosing their physicians
• hurt workers may lose certain privacy rights

All told, the North Carolina Industrial Commission (NCIC) processes more than 60,000 claims every year, so the General Assembly’s actions could profoundly change the landscape for hurt workers. Reformers, such as Republican McAlister, have argued that the system is tantamount to a retirement program: “In too many instances, it’s become more of a retirement program instead of taking care of a person until he is ready to go back to work.”

One of the key questions policy makers should look at here is: will the proposed General Assembly changes actually save the state costs and help small business owners? In other words, let’s set aside for a second how precisely these changes would impact hurt workers and ask a more fundamental question: what is the primary purpose of this legislation, and will it accomplish that purpose?

If the state seeks to save money, might there be other ways to make the system more efficient that don’t involve restricting benefits? For instance, could we collectively improve system administration through digital record keeping? Could we enact more data based programs to boost workplace safety and thus reduce burden on the system proactively? Could we help our workers avoid chronic illnesses and obesity by, for instance, regulating soda and sugar consumption on the job? These are all “out of the box” ideas that may or may not be useful, but it’s critical to at least search for “win-win” solutions that will help the state, small businesses and hurt and sick workers alike.

If you need help with a North Carolina workers’ compensation issue, connect with an experienced and highly reputed law firm to protect your rights.

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North Carolina General Assembly

proposed General Assembly changes to workers’ comp

Whether you’ve been on North Carolina workers’ compensation for two weeks or eight years, with your doctor’s blessing, you’re now ready to start looking for part-time work again. This blog post will give you ideas about how to make this transition as painless and productive as possible.

1. Don’t violate the terms of your North Carolina workers’ compensation arrangement

If you take certain work while on workers’ comp, you may violate the terms of your benefits. Not only could you lose your benefits as a result, but you could also get in trouble for North Carolina workers’ compensation fraud. Penalties for fraud can include fines as well as jail time, so play it safe.

2. Don’t go “all in”: Test your limits, and work incrementally towards a full return

For instance, say you twisted your knee badly on a construction site. Your orthopedist and physical therapist helped you recover full function of the damaged joint. Now you’re tempted for financial reasons to get back on site and start drilling holes (or whatever) again. Careful! A too-early return to work could undermine the sensitive reconstruction efforts.

Your basic process should be: “Start small. Test. Ramp up a bit. Test. Ramp up a bit more. Test again.” And so forth. Yes, it can be frustrating to have to hold back when you “know” you could handle more. But the goal here is not a one-time push or exertion – it’s the ability to engage productively in the work that you love for as long as you want to do that work. If you shortcut the recovery process, you may make it difficult, if not impossible, to recover fully.

3. Pay attention to medical issues that snag your attention

Often, in our desperation to return to gainful employment after an injury or illness, we ignore or subconsciously repress feelings of pain, uncertainty, and anguish. Especially if your family is depending on you to produce — and your coworkers and employer are counting on you to “step it up” in the wake of your recent time off — you may be tempted to go faster, harder, or more vigorously than your body is ready for. Don’t ignore your body!

One way to identify your subconscious feelings about your work is to keep a journal. Write down your experiences after every work shift. Note any chronic or acute pain or even general odd feelings you have about your job. Often, these written descriptions of your day-to-day work will give you clues to help avoid re-injury and even speed up your recovery. For instance, you might notice that a specific kind of bending exacerbates your pain. If so, talk to your boss about not having to do that bending work anymore.

4. Get advice you can trust

Is your employer giving you a hard time about your benefits? Are you caught up in insurance red tape? Are you confused about something you read on the North Carolina Industrial Commission (NCIC) website? If so, a qualified North Carolina workers’ compensation law firm can give you insight and guidance about how best to proceed.

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North Carolina Industrial Commission (NCIC) website

going back to work “too soon”

An intriguing new study published in the January issue of the magazine Spine has critical implications for North Carolina Workers’ Compensation patients. The study, out of Massachusetts’ General Hospital, looked at nearly 1,000 patients with lower back pain and leg pain stemming from herniated discs and sciatica. Some patients underwent surgery to treat back problems. Other patients received non-surgical interventions such as drugs, physical therapy, and exercise plans. The leader of the study, Dr. Steven Atlas, discovered that, while surgery initially yielded better results for patients; after two years, the differences between the surgery patients and non-surgery patients dwindled away – at least for Workers’ Comp patients.

In other words, injured patients who got surgery for sciatica faired equally as well as injured patients who did non-surgical treatment, two years down the road. The implications for treatment of North Carolina Workers’ Compensation patients seem pretty profound. They suggest that surgery may not be the best course for action for some sciatica patients.

Here is one potential explanation of these results: BOTH surgery and non-surgical interventions may not deal effectively enough with fundamental back health problems. Consider: nodules of fibrous tissue (called trigger points) will form at stressed sites in the muscle tissue. These trigger points have been implicated in causing all sorts of soft tissue injuries and repetitive stress problems, from Carpel Tunnel Syndrome to lower back pain. Neither of the two interventions studied effectively located and resolved the trigger points that might have been causing/exacerbating the sciatica. Thus, it makes sense that the treatments would yield similar (less than stellar) results two years out.

It would be interesting to see how the patients studied would have compared with a third cohort of patients who received trigger point therapy and other soft tissue treatments for their backs.

The big point here is that North Carolina Workers’ Compensation patients must keenly research their treatment options. What is in vogue today, medically, may be disproven tomorrow. Thus, it’s important to speak with your physician at length before making any decisions. Informed patients can work more effectively with their doctors and, theoretically, develop more proactive recovery plans.

For assistance with any North Carolina Workers’ Compensation legal questions, get in touch with a qualified and top caliber attorney today for a free, no obligation, and confidential consultation.

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Dr. Steven Atlas Back Study

Trigger Points and Back Issues

Few hardworking individuals prefer to stay on North Carolina workers’ compensation benefits indefinitely. Unfortunately, with the state’s job market still somewhat in limbo – and with your own medical future potentially in doubt, you and your family may be losing hope that you will ever be able to transition back to the workforce in a real and meaningful way. This blog post will hopefully inspire you to realize that return to work is indeed possible – and you may be able to get back on track faster than you ever realized. Here are some things to think about:

1. Are you really getting the “best care” for your condition?

Employees’ who suffer an occupational disease, like chemically-induced emphysema or repetitive work-induced damage to soft tissue, do not always get high quality care from their doctors. Busy physicians may overlook important causes; a more holistic approach to wellness may be needed. For instance, say a person gets a serious typing injury while working at a bank in the Research Triangle. His doctor gives him cortisone shots. These don’t work, so he’s told to undergo surgery. The surgery may offer temporary relief. But the underlying insults to the soft tissues and ligaments and muscles may not be repaired – thus, someone on North Carolina workers’ compensation benefits may remain out of good working condition… until he re-learns how to use his or her body correctly and eliminates fibrous nodules called “trigger points” in the upper back, chest, and thoracic regions.

2. Focus on your goals and eliminate your road blocks

Professionals in athletics and business coaching often emphasize goal-oriented thinking. Rehab specialists also encourage thinking in terms of goals – and using visualization. But many recovering workers are never encouraged to think in vivid positive terms about the future. They are merely told to “get back to normal.” It may be more helpful to aim for a very positive, optimistic outlook to galvanize healing. It’s a lot more exciting, for sure, to think about going back to work and earning twice as much as you had been earning than it is to daydream about maybe, possibly getting your old job back and working half the hours.

3. Focus on improving your strength

When you are on disability, you may be tempted to spend a lot of time resting and recuperating. This is good. But don’t let this sedentary attitude harden. Improving your muscular strength can have many long-term benefits. Talk to your doctor and rehab specialist about doing isometric strength training exercises (ideally, in a slow, controlled fashion) to speed up your recovery time.

4. Avail yourself of good legal resources

A North Carolina workers’ compensation law firm can provide a free evaluation of your current situation and help you think strategically about how to collect benefits, how to budget for the near and mid-term future, and how to get additional resources to improve your recovery.

More Web Resources:

Strength Training Help

RSI resources

In Part I on our series on hot button North Carolina workers’ compensation issues for 2011, we discussed how escalating health care costs, information overload online, and confusion over “independent contractor” status have redefined the national and local NC workers’ comp systems. In today’s post, we will examine other burning issues that insurers, analysts, employees, and employers will be debating this calendar year.

1. Confusion over Medicare Set-Aside Arrangements

The so-called Medicare Secondary Payer laws – MSP laws – can be overwhelming, even to people who have familiarity with the laws in theory and practice. A hurt worker can lose key Medicare benefits if he or she fails to deal with his or her MSP issues effectively during a settlement. Indeed, a scary number of experts remain confused about things like the best practices for dealing with Workers’ Compensation Medicare Set-Aside Arrangements (WCMSA).

2. Is workers’ comp litigation helping or hurting?

Detractors of workers’ comp litigation point to the fact that institutions like the Equal Employment Opportunity Commission (EEOC) have ramped up their legal activity thanks to expansions of laws like the Genetic Information Nondiscrimination Act, the ADA, and the Ledbetter Fair Pay Act. With so many legal disputes in the works, some analysts fear a break down in employer-employee trust.

Obviously, litigation for litigation’s sake can clearly damage the economy and degrade trust. But critics of the EEOC should recognize that that group and others like it may merely be responding to longstanding unfair industry practices. It should be possible to work out “win-win” arrangements to simultaneously reduce litigation and improve conditions for both employees and employers. For instance, the strategic use of “social nudges” to prevent people from engaging in bad behavior and encouraging more generous employer-employee relationships could really help.

3. The frequency of workers’ comp claims may be reversing

Starting in the early 90s, the number of claims filed per company payroll began to decline. This reduced caseload helped to counterbalance the increase of medical and rehab costs. But the frequency of claims may be picking up again… adding yet another stressor to the North Carolina workers’ compensation system and other state systems.

4. The obesity and diabetes epidemics

Good data suggest that the increased prevalence of obesity and diabetes (sometimes known as “diabesity”) may be driving up health and medical care costs throughout North Carolina and other states. This epidemic not only creates additional cost control problems but also indirectly impacts the job market itself.

5. Bad advice at the beginning of your research can bias you and make you continue to make poor decisions

Social science findings show that the quality of the resources you initially tap into can have a dramatic influence on your long-term prospects for economic and medical recovery.

To that end, it may be helpful for you or your injured coworker to connect with a North Carolina workers’ compensation law firm that has the resources, track record, and wherewithal to deliver excellent service.

More Web Resources:

Medicare Secondary Payer

Ledbetter Fair Pay Act

From the corridors of the Research Triangle to rural parts of Western NC, North Carolina workers’ compensation specialists have been reviewing crucial trends in the industry and trying to identify the major issues that will shape the system in 2011. In a two-part blog post, we will be exploring pertinent studies and ideas weighing on the minds of physicians, employers, insurers, injured workers, and government policymakers.

1. OSHA bringing down the hammer

OSHA, the Occupational Safety and Health Administration, has stepped up its enforcement activity, according to the National Safety Council. The agency expects to collect $1 million this fiscal year for each of its 10 biggest penalties. A National Safety Council report indicates that, while the organization’s “Top 10” list of major workplace violations will remain the same, “the agency’s message of strong enforcement is clear.”

2. Medical costs continue to escalate: When and how will it all stop?

The National Council on Compensation Insurance (NCCI) has found that workers’ comp claims are skyrocketing – they now represent nearly 60% of all claims. A study in the January 2010 Journal of Occupational & Environmental Medicine reported that “injury types or diagnoses that don’t have clearly defined treatment pathways could easily lead to higher costs.”

Notably, fewer than 4% of all doctors are responsible for nearly three-quarters of workers’ comp costs. Perhaps by targeting those physicians and trying to help them treat patients more cost effectively, the North Carolina’s workers’ compensation system and other state systems could save some money without reducing care quality.

3. Hurt workers finding it harder than ever to get work

The “Great Recession” that stretched from 2008 to 2010 — and the relatively anemic recovery that’s followed — has meant that workers throughout the Atlantic region have found it difficult to earn effectively. That means hurt workers are finding it harder to get new work. This lag in reemployment stretches out temporary total disability benefit periods. This creates a drag on the system and a disincentive for hurt workers to find reemployment.

4. Murky definition of “independent contractors”

When should someone be considered an employee under workers’ comp law, and when should he or she be considered an independent contractor or freelancer? The answer may not be as clear cut as most employers and employees realize. The US Department of Labor, among other institutions, is cracking down. The DOL compelled employers to pay 5,200+ employees $6.5 million in back wages in 2010 – that’s more than double the 2009 numbers.

5. Information overload and confusion among workers’ comp beneficiaries… going WAY up

Despite the proliferation of websites, blogs, and other informational sources about workers’ comp (or maybe because of them), injured claimants are finding themselves more and more overwhelmed and confused by the sheer glut of often contradictory resources.

If you are struggling with a workers’ comp issue – or a friend or a family member is – get a free consultation from a qualified North Carolina workers’ compensation law firm.

More Web Resources:

About the Research Triangle

National Council on Compensation Insurance (NCCI)

Injured or sick workers who are forced to rely on North Carolina workers’ compensation benefits to pay for medical care, surgical bills, and replacement wages often spend a tremendous amount of energy battling their employers and insurance companies to get fair payment and appropriate treatment. Simultaneously, they must reconfigure their family budgets, repurpose their careers, and manage various medical costs, drugs, and procedures.

If you or someone you care about has been swamped by this kind of chaos, you likely empathize with how difficult it can be to “right one’s ship.” Moreover, aiming merely for a return to the status quo before you got hurt/sick is kind of dispiriting. You would much rather aim for something better than what you had before you got sick or injured. But is striving for greatness really possible when you must confront a gauntlet of face pesky insurance rules and medication side effects?

This essay attempts to rekindle your hope that a better life is possible – not just a return to “normal” but actually an elevation to a better state of mind, work, life, and financial possibilities.

First things first, it’s important to accept precisely where you are now in your life, financially, physically, and psychologically. “Accepting” doesn’t necessarily mean agreeing that this should be your ultimate reality – it simply means acknowledging what’s true now. One good method to clear your head is to use the productivity system developed by best-selling author David Allen. In his book Getting Things Done (GTD), Allen recommends that individuals make a total and comprehensive inventory of “open loops” — anything in your life that’s bothering you or that has a grasp on your attention in any way. Once you have everything out of your head and onto a written form – a Microsoft Word document will do – then it becomes infinitely easier to process this information and organize what to do with it next.

Another powerful method to help you deal with your North Carolina workers’ compensation issues – or any other problems in your life – is to spend some time envisioning “best case” scenarios. Imagine yourself in the future from a place of great success. What does your life look like? How do you feel? Where do you work? What’s happened to your injuries? How have you dealt with your insurer and/or employer? How have you managed the anger, confusion, and overwhelm about the accident? Once you have a vision of your success, it becomes a lot easier for you to figure out how to get there.

This may sound like a lot of homework – and it certainly is — but it’s also empowering work. When you’ve been knocked off your game by an injury or a workplace accident or illness, it becomes all too easy to mope around in self pity, confusion, and helplessness. You can go numb to your actual life and ignore potential useful advice. These kinds of written exercises – getting stuff out of your head onto an objective format for easy review and envisioning ultimate success without prejudging your vision – can make an enormous difference not just in terms of your actual on the ground success but also in terms of your psychological state.

On a more practical note, if you are struggling to deal with an insurer or an employer or a confusing series of forms, don’t struggle alone. Get help from a responsive and compassionate North Carolina workers’ compensation law firm right now.

More Web Resouces:

Getting Things Done

Power of Intention

Last Wednesday, the North Carolina Personnel Commission ruled that it could not reinstate former Cherry Hospital employee O’Tonious Raynor to his job, marking a setback for a man who went through a long and drawn out process to collect North Carolina workers’ compensation benefits for eye injuries he sustained in a fight with a patient.

Raynor got into a fight with a schizophrenic patient in early March 2010. 55 year-old Bernard Freeman had been smoking when he wasn’t supposed to. Raynor interfered, and Freeman snapped and punched Raynor in the face, seriously hurting his eye. Raynor then pinned the patient down against some furniture and stood on his broken hand. Although the initial fight happened in a common area under surveillance, Raynor then wrestled Freeman out of view of the cameras into a nearby bedroom. Raynor later confessed: “I didn’t intend to hurt the patient. I felt like I was in danger, and I did the best I could under the circumstances…he told me “when I get up, I am going to kill you.””

The North Carolina Department of Justice examined the case against Raynor. No charges were filed. A judge agreed that Raynor used excessive force, but he also argued that the hospital could have simply disciplined him instead of firing him outright.

As this case illustrates, North Carolina workers’ compensation situations can get quite complicated and even ethically tricky. If a worker causes his own injury through carelessness (even partially), he may find it difficult to collect money for medical bills, surgeries, back pay, and lost wages. For instance, say you and some co-workers goofed around at a construction site. You then slipped on some tar, twisted your knee, and tore a ligament. Your employer might argue that your goofing around caused (or exacerbated) the injury and thus you should not be entitled to benefits or should be entitled only to limited benefits.

To clarify your rights and responsibilities, it’s important to get excellent legal guidance. Any on-the-record admissions you make – even seemingly minor admissions – can hamper your chance to get the money you need to support your family and recover. If an insurance company or employer has unfairly denied benefits to you, you can take legal steps to compel them to make good. A North Carolina workers’ compensation law firm can provide a free and effective (and confidential) consultation about your injuries and advise you about the best next steps to take.

More Web Resources:

O’Tonious Raynor’s story

Cherry Hospital

Last year, 38 year-old James Hunt, a former Principal for Fairmont Middle School in Southeastern NC, got shot in the face with a shot gun while driving to school. Fortunately, Hunt survived (albeit with ongoing pain and chronic injuries), but his North Carolina workers’ compensation battle had just begun…

The Robeson County School System initially refused to pay his benefits — which included $60,000 a year and medical expenses — in spite of the fact that Hunt had been driving to school when he got shot and that the shooter almost certainly committed the attack in response to Hunt’s attempts to rid his school of gang violence. An official from the North Carolina Industrial Commission, Philip Baddour III, said that the shooting attack almost certainly “arose out of [Hunt’s] employment because the shooting was more likely than not related to his anti-gang activities as school Principal.” Furthermore, Baddour said that Hunt had been talking on a cell phone issued by the district about Middle School business. Hunt remains disconcerted by the attempt on his life, and the mystery shooting prompted Hunt’s supporters to create the website www.whoshotprincipalhunt.com to ferret out the truth.

Per the terms of his North Carolina workers’ compensation agreement, Hunt will get his wages compensated as well as his medical/surgical bills. In a statement, Hunt said that: “it’s just unfortunate we had to take this route to get the help I need… I really felt like my school system, my employer, let me down on this. They left me hanging.”

If you or someone you care about has similarly faced frustrating issues collecting benefits or dealing with an insurance company, get good help from a qualified and compassionate North Carolina workers’ compensation law firm. You likely have many rights and resources available that can help you resolve your troubles with minimal stress and maximal efficacy.

More Web Resources:

www.whoshotprincipalhunt.com

Ex-principal wins workers comp; Sues school system over 2009 shooting

Many high profile North Carolina workers’ compensation cases have major interstate elements. A recent case filed by the Texas Insurance Department’s Division of Workers’ Compensation demonstrates how interconnected states like North Carolina, Texas, and Pennsylvania can be when it comes to workers’ comp claims and insurance disputes.

A Philadelphia-based company called ACE American Insurance Company was fined $221,000 for failing to pay key medical costs and failing to comply with the Texas Workers’ Comp Commissioner’s rulings. According to local sources, ACE had to pay a $74,000 fine pursuant to the company’s failure to respond to preauthorization requests and failure to pay for certain key treatments, services, and emergency care. In a second case, the insurance company paid out $147,000 pursuant to its failure to pay indemnity and medical benefits and failure to comply with the Texas Commissioner’s orders. ACE also did not pay medical bills according to Texas’ medical fee guidelines.

While this kind of case is not exactly novel – insurance companies have been known to try every tactic and strategy in the book to get out of paying North Carolina workers’ compensation claims – the story does illustrate the truly interstate ramifications of workers’ comp disputes.

Here you have a Philadelphia-based company dealing with allegations drawn up by the Texas Workers’ Comp Commissioner. Although states do make independent decisions regarding their workers’ comp programs, this case illustrates the essential interconnectedness of the US workers’ comp systems. National and even transnational players, like insurance companies, funds, and big businesses, often get deeply embroiled in state-specific litigation.

Fortunately, most workers’ comp claimants don’t have to worry about these highly technical ramifications. If you have been recently injured at work – or if you know someone who has come down with an occupational disease, such as bronchitis or repetitive stress injury, from work related activities – you want a simple, clear and precise strategy to get your benefits as quickly as possible and reboot both your health and your career.

Talk to an experienced North Carolina workers’ compensation law firm to develop and execute a sound plan of action to get the help you need.

More Web Resources:

Texas Insurance Department’s Division of Workers’ Compensation

Case against ACE American

Most North Carolina workers’ compensation policy analysts focus on “after the fact” remedies for workplace injuries and diseases. In other words, they focus on how to get injured workers paid for things like back surgery, time off of work, and finger amputations. They also look at how insurance companies can provide better service at more affordable rates and how employers can cut through red tape to give their employees the protection they need without compromising the business’s finances or other objectives.

But what’s missing in this discussion, overall, is frank and specific talk about preventing injuries and diseases. As the old adage goes, “an ounce of prevention is worth a pound of cure.” This cliché is common advice that’s unfortunately uncommonly practiced. Rather than focus so much on solving problems once they have already occurred, we in the North Carolina workers’ compensation system should collectively focus our energies more on attacking the root causes of workplace injures with the goal of ultimately making workplaces from the Research Triangle to the far west of the state safer for all employees.

To that end, we need to recognize dangers that often go unremarked upon – and try to figure out how to deal with these pernicious hazards.

1. Too much sugar in the workplace

Whether you work as an high powered banking executive in the Research Triangle, or you supervise a construction crew in a rural part of far western North Carolina, chances are you encounter sweets many times during your day. There might be a vending machine in your office lobby that sells extremely sugary drinks. Your secretary may keep a bowl of delicious candy on his desk. Or, if you work at a large office, you may be asked to partake in weekly or even biweekly birthday parties for your office mates, during which you’ll be fed cupcakes, ice cream, and other goodies.

The problem is that all of this sugar is extremely bad for people – bad for workers, bad for the cardiovascular system, and bad for our collective health. Furthermore, eating too much sugar can make you feel lethargic, less attentive, lightheaded, and more. Excessive sugar consumption can also lead to problems such as diabetes, heart disease, and perhaps even cancer. If North Carolina workers and employers could focus on reducing their collective sugar consumption, this would almost certainly lead to reductions in things like workplace accidents, sick days, and occupational diseases (sugar also compromises the immune system).

2. Too much informational input

Whether you are an office worker bombarded by dozens of emails everyday; or you are a construction foreman snowed under by frustrating paperwork, chances are that you get more information than you can comfortably process. Studies suggest that this overconsumption of information can be hazardous: it can lead to inattention at the workplace, general fatigue, and even depression and anxiety.

3. Not enough sunlight

Medical studies suggest that most people could benefit from getting regular sun exposure to boost levels of Vitamin D and stimulate the immune system. Unfortunately, many North Carolina workers don’t get enough sun exposure – they are trapped in office buildings all day – and this lack of natural sunlight could impair mood, cause fatigue, and lead to inattention that could further stimulate on-the-job injuries and other problems. Perhaps employers could institute a 20-30 minute break per day – kind of like a “recess” – during which workers would be encouraged to go outside and recharge.

4. Bad Ergonomics

Whether you sit in a chair for 8 hours a day, spend 8 hours doing repetitive tooling and machining work, or engage in some other repetitive or physically uncomfortable activity, you could be setting yourself up for long-term work-related injuries. Working at a computer, for instance, can create all sorts of problems from eye strain to thoracic outlet syndrome to lower back problems. Remedies could include taking regular breaks, getting better and more ergonomic office equipment, using programs like Feldenkrais or the Alexander Technique, engaging in strength training, and changing up your work tasks so that they are not as repetitive.

If you or someone close to you needs guidance with a workers’ comp issue, connect with a quality and experienced North Carolina workers’ compensation firm to go over your options and ensure that you get all benefits owed to you.

More Web Resources:

Sunlight and Vitamin D research

Good v. Bad Ergonomics

Analysts often get mired in the details of internal state policy, spending time reviewing in-state cases and poring over announcements from individuals like Insurance Commissioner Steve Poizner to understand factors shaping the North Carolina workers’ compensation system.

But sometimes it’s instructive to attend to the trials and tribulation of other state’s workers’ comp programs. To wit, a November 23 report out of Austin, Texas highlights a slew of nagging problems with that state’s Division of Workers’ Compensation (DWC). The report identified four serious problems that “significantly inhibit” the DWC’s ability to offer benefits and care for workers hurt on the job. The points get technical and dry, but they are worth quickly reviewing:

1. The Texas DWC allegedly does not process complaints about medical practitioners well, so system auditors cannot evaluate the consistency and appropriateness of any disciplinary actions.
2. The complaint process the DWC uses fails to comply with the Texas Labor Code.
3. The way healthcare providers get chosen creates major inefficiencies and results in the “overutilization” of healthcare.
4. DWC also has problems in engaging in sanctions and enforcing its decisions.

Texas professionals plan to meet on December 14 in Austin to discuss how to rehabilitate the Division of Workers’ Compensation. But the ongoing struggles in the Lonestar State should alert analysts and policymakers who focus on North Carolina workers’ compensation to the sheer size and scope of some of the crises we face.

One major theme that emerges here is the idea that failure to process information effectively can have serious systemic consequences. State bureaucracies are not exactly known for being efficient. But lack of a structured set of processes and systems gums-up the whole system. It forces people to engage in extra paperwork. It drains resources from already resource-strapped and time-strapped individuals.

New developments in information processing theory may be useful. For instance — and this may sound silly at first — but imagine if everyone in the system adopted the “K.I.S.S. principle” (keep it simple, stupid) when developing their systems and procedures. A return to simplicity could make regulations and restrictions clearer, allow employers and hurt workers to make better decisions and foster a more genial overall spirit.

Stepping back from these global and philosophical implications…

If you’ve recently been put out of work by an injury or occupational disease, or if your family has been struggling to collect benefits from an insurance carrier, you are probably less concerned with what’s going on in Texas and much more concerned with questions like: “How am I going to feed my family if my benefits run out?” and “What can I do to heal faster so I can get back to work?”

To tackle all your concerns, you may benefit greatly from a free consultation with a North Carolina workers’ compensation law firm.

More Web Resources

Division of Workers’ Compensation (DWC)

Texas’ workers comp agency’s oversight faulted: Auditor

The business of reforming North Carolina workers’ compensation – or any other state system – is a complicated and fraught one.

To wit, a monumental brouhaha is brewing in Seattle, Washington over a reform program championed by WA businesses. Theoretically, the reforms could save the Washington workers’ comp system upwards of $1.2 billion, including a one-time net savings of $730 million. Different entities within the Washington government have proposed wildly different estimates of the savings that the business backed plan would generate. Labor groups are vociferously protesting; they have put forward a different plan that may save the system approximately $450 million over the next several years.

According to the Seattle Times, WA governor Chris Gregoire is treading carefully, aiming to split the different between these two plans. The state’s Office of Financial Management believes that one quarter of all injury claims in WA (approximately 7,000 cases) will end up at settlement. The Chair of Washington state’s House Labor Committee, representative Mike Cells, doesn’t plan to give the bill a hearing, stalling its advance.

What bearing does this tug of war over Washington state’s potentially insolvent workers’ comp system have on the North Carolina workers’ compensation system?

Practically speaking, not a lot!

But although Washington is located literally thousands of miles away from North Carolina, it’s a mistake to underestimate the influence that out of state battles over benefits and entitlements can have on the timbre of debate here in NC. As we’ve explored in other posts, states around the union are desperate to get workers’ comp costs under control. (Witness the recent very public battles in both Illinois and California over similar issues.) As the national economy continues to stall and unemployment rates remain stubbornly high, political figures will look at entitlement programs like unemployment and workers’ comp to identify places to cut.

The problem is that indiscriminate, non-strategically optimized cutting may not necessarily save states. Slashing may also create longer term headaches — not just for hurt and injured workers, but also for the states’ fiscal health. Imagine, for instance, if the North Carolina General Assembly passed a draconian measure to chip away at workers’ comp. Say, for instance, the benefits period maxed out at 250 weeks. What might happen to all those hurt and sick workers? Where will they get money to support their families and to pay for rehab and medical bills? It’s not like these people will just disappear.

Obviously, there is no quick solution to these problems. And if you are personally struggling with an employer or insurance company, a consultation with a North Carolina workers’ compensation law firm can be crucial to making sure that you’re treated fairly and justly — and that you have the information you need to get your health back on track.

More Web Resources:

Can the Washington workers’ comp system be saved?

North Carolina General Assembly plan to reform NC workers’ comp

While most North Carolina workers’ compensation analysts probe the local news for instructive stories, sometimes blogs look to international sources to find the most compelling news. And a case out of Toronto – reported by the Vancouver Sun – has many in the North Carolina workers’ compensation community talking. An Alberta tribunal has ordered workers’ comp payments for a convenient store worker who suffered serious shoulder injuries from scooping hard ice cream. According to the Sun’s report, the woman had to serve up an enormous quantity of orders in a short period of time during a heat spell in April 2009. The Appeal Board noted that “the activity required considerable force with her right hand and arm in a twisting motion because the ice cream was frozen hard…the total sale of ice cream cones [for a 2 day period] was $1,500.”

The woman had been treated for a shoulder injury prior to working at the ice cream store and had rectified that injury through the use of cortisone shots. But the ice cream scooping reinjured her shoulder so badly that she needed surgery on her rotator cuff to deal with the flare up. The Sun’s article quoted an orthopedic surgeon, Dr. Stephen Reed, who argued that ice cream scooping is indeed a dangerous activity. Dr. Reed said “they are forced to do this basically at arm’s length, reaching into a large cabinet…it’s basically poor ergonomics, and they are doing it repetitively.”

Repetitive strain injuries due to manual labor, such as ice cream scooping, typing, or repetitive lifting, can cause lasting damage to muscles, fascia, ligaments, and other soft tissue. More frustratingly, the full extent of the damage may take weeks or months to reveal itself. By the time an injured employee notices what’s been happening, it may be too late to reverse the problems easily.

If you or someone you love or work with has been sidelined with a repetitive stress injury or other workplace injury, either chronic or acute, you can benefit tremendously from consulting with a qualified North Carolina workers’ compensation firm. By exploring your rights as a potential claimant, you can collect compensation for things like your lost wages and medical bills. Moreover, you can simplify the process, focus your limited resources on healing from your injuries and getting back to work (or finding new work), and holding reluctant employers or insurance companies fully accountable.

More Web Resources:

Scooping hard ice cream can be hazardous to your health

RSI resources

Whether you’ve been on and off North Carolina workers’ compensation for a bad back or other occupational injury for years; or you are concerned about chronic nagging aches and pains, you want solid and tested advice about how to take better care of your back.

When most people think about back injuries, they envision things like falling off a crane at a construction site, slipping and falling on a patch of dry ice in the office parking lot, screwing up one’s lower back while trying to pick up a heavy box, or getting whiplash in an auto accident.

While all these situations can result in back injuries, chronic abuse of muscles and poor posture can also cause/exacerbate back problems. For instance, if you work a desk job, and you don’t employ proper ergonomic techniques and tools, over time, your posture can degrade, making you more vulnerable to muscular weakness, atrophy, and damage to soft tissue. This can actually weaken your structure to the point that a back injury may be almost inevitable.

Furthermore, your diet can influence your potential to get hurt (or to recover from) a back injury. If you consume lot of heavily processed foods and sugars, you can weaken your immune system and degrade your body’s natural resilience to things like stress.

Obviously, this blog cannot provide medical advice, but if you or someone else that you love has been dealing with a North Carolina workers’ compensation claim for your back, you might want to explore modalities with your physical therapist and physician to strengthen your body and eliminate the factors in your life and workplace that may be causing or exacerbating back problems. For instance, cutting out refined sugars and starches can help the body’s immune system. Engaging in regular strength training overseen by a therapist can be useful for many people, even for workers in “non-active jobs,” such as data entry or marketing. De-stressing can also be a crucial resource, as can taking regular breaks from repetitive activity.

Other more “exotic” forms of back strain relief include the Alexander Technique, Sarno body awareness, and Feldenkrais movement. For certain individuals who have been severely or chronically injured, traditional therapies, like surgery, may be needed. Other modalities that some have found useful to treat back pain include massage, acupressure, acupuncture, and training in meditation/mindfulness.

On a more general note… many injured workers develop a mentality of helplessness. Since they’ve been hurt, and they have suffered financially, they feel a loss of control over their lives. Fortunately, this loss of control is often imaginary. Even if you have sustained serious problems, you can take advantage of good modalities to speed up healing and prevent re-injury.

All that said, from a practical “nuts and bolts” point of view, you still likely have many questions about how to collect benefits owed to you, how to navigate the workers’ comp system, how to deal with bad faith insurers, and how to manage less than cooperative employers. For help now, turn to a capable and experienced North Carolina workers’ compensation law firm.

More Web Resources

WebMD article on causes of back pain

Listserve for people with repetitive stress and pain problems

The State of North Carolina and the North Carolina Rate Bureau (NCRB) reached an agreement over North Carolina workers’ compensation rates for next spring. The 2010 filings – which will go into effect on the 1st of April, 2011 – should save businesses approximately $7 million over what they might have had to pay, had the North Carolina Rate Bureau completely gotten its way. Wayne Goodwin, the State’s Insurance Commissioner, agreed that the “slight increase” in North Carolina workers’ compensation employers costs (0.6% for voluntary market loss costs and just a little more than 4% for assigned risk markets) was justified.

The Rate Bureau had hoped for slightly higher increases – 1.2% for the voluntary market costs and 5.5% for the assigned risk markets. The industry argued that it needed a hike in rates because of rising medical costs across the state. But opponents of large increases argued that the number of workers’ comp claims in NC has declined; therefore, rates shouldn’t be bumped too much. The Rate Bureau’s director speculated that the number of claims may have declined because:

A) High risk manufacturing jobs preferentially disappeared during the recent recession.
B) Employers have made strides in making their workplaces safer.

The Rate Bureau believes that employers across North Carolina will pay approximately $1.16 billion in 2011 in premiums alone. While a spokesperson for the NCRB claimed to be “a little bit disappointed” with the final decision, the Bureau didn’t seem too frustrated by the final outcome.

These macroscopic changes to the system may be interesting to policy analysts. But what if you are a worker who has recently been diagnosed with a chronic disease or who just got into a serious accident on the job? Will these rate changes affect you? And if so, how?

The trickle-down effect of major policy changes can be very difficult to detect and to quantify. Rather than getting distracted by macroscopic state rate politics, focus instead on what you need to do maximize your claim and speed up your recovery. If you’ve been having trouble with an employer or an insurance company – for instance, an employer unreasonably denying your benefit request or an insurance company acting in “bad faith” and refusing to pay money owed – consult with a North Carolina workers’ compensation law firm to figure out your best next steps.

More Web Resources

North Carolina Rate Bureau (NCRB)

More about the rate hike

A heartbreaking case out of Montgomery, Alabama has much of the nation, including many top North Carolina workers’ compensation policy analysts, debating the effects and legality of a suit filed by the family of Corporal David Brown, a police officer who got hurt while off duty.

Corporal Brown had been escorting a funeral procession on September 11th, when he got injured. The ambulance that took him away flipped over while carrying to the hospital, injuring Brown further. As of this writing, Brown remains seriously injured. The Corporal had been working for a private funeral home and had been technically off duty (September 11th this year was fell a Saturday). But Brown’s family wants the city to declare that the Corporal was actually “on duty” so he can collect workers comp.

Montgomery Mayor Todd Strange has indicated that the city can’t grant the workers’ comp benefits because state law does not allow it. That said, Mayor Strange indicated that the city would do everything it could to help Brown and his family. Brown reportedly will get retirement benefits for life as well as medical disability retirement benefits and extra leave time. In the Montgomery Advertiser, Mayor Strange said, “we want to do everything conceivable under the law to help him.”

On October 27th, the Brown family filed suit against Montgomery, arguing that the corporal had been working “with permission, knowledge, and approval” of the city’s police department and had been working to help the citizenry of Montgomery while directing traffic for the funeral procession.


This case illustrates nicely how complicated certain North Carolina workers’ compensation cases can become – even when employers (or in this case the Mayor of the City of Montgomery) want to cooperate and provide maximal allowable assistance under the law. In other cases, employers and insurance companies may resist obligations to pay an injured worker and may even skirt the law to get out of paying monies owed.

If you or someone in your family has gotten hurt or ill at a job in the state, a North Carolina workers’ compensation law firm can provide a free and confidential consultation about how you can go about collecting benefits in a fair and timely way. A good team of attorneys can also help you battle back against a bad faith insurer and uncooperative employer.

More Web Resources

Corporal Brown lawsuit

Mayor Strange vs. Brown family

The North Carolina Industrial Commission is sponsoring the 15th Annual North Carolina Workers’ Compensation Educational Conference next week from October 13 through 15. The event – which will take place at the Raleigh Convention Center – aims to educate people involved in all different aspects of the state’s workers’ comp system about:

• Policies
• Forms
• Procedures
• Rules

The conference also aims to allow diverse participants to discuss key issues about the system. The NCIC website says that the following participants may gain useful info from this conference:

• Employers
• HR managers
• Attorneys
• Medical providers
• Mediators
• Rehab providers
• Paralegals
• Self-insurers
• Administrators
• Claims adjusters
• Safety managers

Both the Raleigh Marriott City Center and Sheraton Raleigh hotels offer discount conference rates just half a block away from the Raleigh Convention Center (where the conference will be held). According to the NCIC website, the following people will be speaking at the North Carolina Workers’ Compensation Educational Conference:

October 13:

• Pamela Young, the Chair of the NCIC
• Martha Dealy, the President of Kids’ Chance of North Carolina
• Denise Thomas, Consultant
• Kirk Leggott, the NCIC’s Chief Information Officer
• Adolfo Arsuaga, a speaker on Multicultural Issues
• Tracey Weaver, David Gantt, and Henry Byrum, who will talk about Professional Ethics

October 14 (Thursday) two breakout sessions will occur in the morning – one on Rehab Dilemmas and one on “The Workers’ Knee – A Medical Assessment”

In the afternoon, two other breakout sessions will occur: one on “Hot Topics in Claims Administration” and one on “I Know I Can Do It, I Just Don’t Remember How!” held by the NCIC Deputy Commissioners.

October 15 (Friday) you will get to hear more speakers, including:

• Pamela Young, the NCIC Chair
• Wanda Taylor, Keischa Lovelace, and John Schafer, who will talk about Industrial Commission Rule Changes
• Dr. T. Kern Carlton III will talk about Controversies in Chronic Pain
• Johnny Lee will talk about Workplace Violence
• Maggie Bennington and Bruce Hamilton will talk about Case Law Updates

If you or someone you care about has gotten injured or sick at work – and your employer, or relevant insurance company, or another party has not treated you fairly, it may behoove you to discuss what steps to take with a qualified North Carolina workers’ compensation law firm.

More Web Resources

more about the North Carolina Workers’ Compensation Educational Conference

North Carolina Industrial Commission

Whether you work at a potentially dangerous job, such as a construction site, welding factory, or farm; or you face dangers due to occupational diseases and/or repetitive stress injuries at a white collar job, you don’t want to have to go on North Carolina workers’ compensation, if you can help it. Ideally, you want to work pain-free and accident-free. So here are a few tips to help you stay safe at work:

1. Take Breaks, Particularly When You Engage in Repetitive Work

Whether you are doing data entry, computer programming, sewing, or hair styling, or any other kind of repetitive work, ergonomic professionals will urge you to take regular breaks to avoid injuries to your hands, arms, shoulders, and back. Repetitive stress injuries typically result from long-term abuse of muscles, bad posture, and “Type A” enthusiastic work habits. This may sound silly, but one thing you can do is – every 30 minutes or so, or whatever your employer will allow – take two to three minutes to lie down on the ground and let your spine and back relax before you start doing your repetitive activity.

2. Cut Back on Sugar and Processed Foods

More and more studies have linked excess sugar and high fructose corn syrup consumption with diseases like obesity and type 2 diabetes. Although these aren’t occupational diseases, when you get obese and pre-diabetic, you stand at a much greater risk of injury. And some evidence also suggests that excess sugar consumption can decrease your stamina, make you tired, and damage muscle and organ health – which will put you at greater risk of on-the-job injury.

3. Increase Your Strength

Strength training helps with muscular flexibility, improves bone density, leads to innumerable other health benefits, according to abundant medical literature. Many employees neglect effective strength training. But as we age, we will see a natural deterioration of our muscular strength (particularly in places like our lower backs) unless we actively work to improve strength in those areas.

4. Don’t Wait Until a Problem Gets “Too Big”

If you feel like you are getting hurt or you could potentially get hurt at work, tell your employer at once. Don’t keep your concerns to yourself. Your employer can and should want to help you solve the problem. For instance, say you type at an ergonomically dysfunctional workstation. Tell your boss, so he or she can help you solve your ergonomic problems and thus help you prevent injury. Speak up!

Do you need help with a North Carolina workers’ compensation benefits case? Don’t let bad faith insurers, uncooperative bosses, or confusion beat you down – get help from a qualified and well-credentialed NC workers’ comp law firm today.

More Web Resources

Sugar and Obesity and Diabetes

Learn to Take Breaks at Work

Gabe Reid, a former tight end for the Chicago Bears, got an award of $325,000 for a knee injury from the Illinois Workers’ Compensation Commission this week. North Carolina workers’ compensation experts have been closely following NFL related workers’ comp cases like Reid’s – this blog reported last month about California’s dilemma over how and whether to compensate injured athletes who played for teams outside of California but who got hurt in games played in the Golden State.

Reid played for the Bears from 2003 to 2006. The team released him in 2006 to be an unrestricted free agent. His settlement was the biggest settlement for a pro athlete in Illinois history; although another ex-Bear, Mike Brown, recently collected $140,000 for injuries he suffered to his foot and leg while he played for the Bears. More ex-Bears may be eligible to collect additional funds, according to state sports reporters.

How will Reid’s settlement impact similar North Carolina workers’ compensation cases, if at all? Will ex-Panthers be eligible for similarly large payouts? Truth be told, the states individually are in the process of working out how to compensate NFL athletes (and athletes in other sports). And it will likely be several years before policy analysts have enough data to draw any clear conclusions. However, with all the financial pressure on state workers’ compensation agencies to tighten their budgets – and the new POWER initiative launched by the Obama administration, which this blog reported on earlier in the week – it may be more difficult for claimants to win relevant arguments.

Irrespective of what happens to ex-NFLers like Reid and Brown, what can you personally do to improve the likelihood of collecting fair and flexible benefits for your injury or workplace illness?

If you suffered a chronic, debilitating injury at work such as a knee problem or typing injury – or if you got hurt in some kind of acute accident – such as a slip and fall or work-related car accident – you must simultaneously struggle under a number of burdens. First, you must deal with the medical recuperation, which can be exhausting and emotionally draining in and of itself. Then, you need to figure out how to rehabilitate yourself and get back to work in some fashion ASAP – and/or how to deal with your financial situation. And lastly, under certain circumstances, you might have to fight back against unwilling employers, recalcitrant insurance companies, and bureaucratic red tape to get benefits paid out in a timely fashion.

With all these stresses on your shoulders, it may behoove you to discuss your problems with a qualified North Carolina workers’ compensation attorney. A good lawyer can simplify your strategy, relieve you of logistical and emotional stresses, and help you collect appropriate payments without hassle or frustration.

More Web Resources:

Gabe Reid case

Mike Brown case

Initiative 1082 — way up in Washington State — has sparked a firestorm of debate and controversy among North Carolina workers’ compensation analysts. Ordinarily, a statewide initiative in a far off part of the country would not rile up insurers, business owners, injured workers, and state bureaucrats. But the vocal debate out of Washington has served as a touchtone for a number of issues hotly being discussed right here in NC.

Facts about the Initiative, and Implications for North Carolina Workers’ Compensation Politics

The Building Industry Association of Washington – regarded as a politically conservative group – sponsored I-1082 to crack the state monopoly on workers’ comp. To qualify for the ballot, the measure needed 241,000 signatures – allegedly, it got nearly 100,000 signatures above that mark. Clearly, many Washingtonians are fired up. Sponsors argue that the current system sticks business owners with high insurance premiums and allows injured workers to enjoy overly-plump benefits. Opponents of I-1082 say that introducing a for-profit component into the workers’ comp system could degrade benefits and lead to claims being delayed or denied.

Both opponents and proponents of the initiative claim that the implications of I-1082’s passage for the state could be profound. Currently, Washington is one of only four states that does not allow companies to privately compete with a state-run workers’ comp system.

The North Carolina workers’ compensation system allows private insurers to compete – so the WA debate can be relevant only indirectly. However, the growing frustration among business owners regarding workers’ comp costs – and the simultaneous growing health problems among workers, including chronic occupational diseases and medical conditions like obesity and diabetes – may well portend a sea-change in the next few years, economically speaking.

Can small businesses survive a clunky economy and potentially a double dip recession? Can hurt employees – many of whom may soon start to lose their unemployment benefits – survive if their benefits get curtailed or restricted?

If you or a coworker or a family member has been experiencing difficulties collecting your benefits, connect ASAP with an attorney to advise you. A free and confidential consultation with a North Carolina workers’ compensation lawyer can help protect your rights and ensure your family’s financial stability.

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Initiative 1082

Workers comp initiative steps closer to ballot

Appalachian State University will host a symposium on North Carolina workers’ compensation from August 1st to August 2nd in Winston-Salem, NC at the Embassy Suites Hotel. The symposium offers an opportunity for insurance professionals, lawmakers, employers, attorneys, regulators, and economists to get together to discuss critical issues about the state’s workers’ comp system.

For more information, go to http://insurance.appstate.edu// — you can also register online there. The price is $129 if you register by the 10th of July and $149 after that. The symposium is titled: “North Carolina’s Workers’ Compensation System: is the “compensation bargain” still working for both employers and employees in our state?”

The conference aims to take a deeper and more levelheaded look at the so-called North Carolina workers’ compensation bargain – the idea that injured workers should be covered for medical care and missed wages in exchange for not filing negligence claims or debating questions of fault. Ideally, the system should move cases through faster because establishing fault is not the key issue. In practice, however, many North Carolina workers’ compensation claims end up tied up in court, potentially creating a drag on the system and even on the economy as a whole.

Some of the brightest minds and luminaries in the arena of North Carolina workers’ compensation will attend this conference. Special speakers include Nicole Coomer, an economist at the Workers’ Compensation Research Institute, Jay Norris, the President of the North Carolina Association of Self Insurers, Carol Telles, an analyst at the Workers’ Compensation Research Institute, and Pamela Young, the Chair of the North Carolina Industrial Commission.

If you or a loved one faces an intractable problem with your benefits or insurer; or if you need help understanding anything about the process, connect today with a knowledgeable and a results-proven North Carolina workers’ compensation attorney.

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Appalachian State University

“North Carolina’s Workers’ Compensation System: is the “compensation bargain” still working for both employers and employees in our state?”

Breaking news in a key North Carolina workers compensation case: The North Carolina Court of Appeals upheld an award in the case of Hatley v. Continental General Tire, stipulating that the claimant (Hatley) was entitled to temporary total disability benefits pursuant to an injury he suffered while repairing a tire.

Background

Hatley was a tire inspector who hurt his hand during a blowout accident at work. After he got treated, his physician put him on light duty restriction. Following this rest, he tried to go back to work but found that he could not perform his duties because of continued problems with his injured hand. His employer told him that he had to continue working or retire. The inspector chose to retire and take a new position as a teacher’s assistant, six months after the fact. His employer sought to get out of paying for disability claims; he alleged that not all of Hatley’s symptoms could be traced back to the at-work accident. (Pursuant to the North Carolina Workers’ Compensation Act, an injured worker must be able to show that a workplace injury caused a disability that resulted in impairment.)

The employer’s argument fell short, according to the Court of Appeals, because no doctor testified precisely how much of the injury resulted from work place trauma and how much resulted from other factors. Without good medical testimony to this point, the Court concluded that “any attempt to apportion plaintiff’s injury would have been speculative and improper.”

Although the plaintiff in this case managed to hold on to his temporary total disability benefits, many other workers with legitimate claims are not so lucky. They can find their benefits retroactively stripped from them. If you have questions or concerns about how to handle a difficult employer or a non-cooperative insurance company, it’s probably in your best interest to discuss your case in confidence with an experienced North Carolina workers’ compensation attorney.

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Hatley v. Continental General Tire

The North Carolina Court of Appeals

On June 15th, regulators announced that South Carolina workers’ compensation rates would fall to 9.8% — news that has sent ripples of interest and concern across the North Carolina workers’ compensation community. According to SC Insurance Director, Scott Richardson, 2009 marked the second year in a row in which regulators approved a decrease. He argued that “this trend [implies] an improved economic climate, and [we] hope to see this continue into next year.”

SC insurers will be able to use the new 9.8% rate in just 30 days. Richardson cited multiple reasons for the decline in rates, including enhanced employee safety programs, a reduction in the frequency of claims, and changes to the nature of claims themselves. In South Carolina, more than 40% of benefit costs can be directly attributed to payments for medical services. Most SC workers’ comp costs go to indemnity payments – that is, benefits to replace wages lost. As Richardson and others have noted, the extent to which the rate change will impact policy regarding medical costs in the state remains to be seen. Richardson noted that the state “will continue to monitor and assess the impact these reforms have on workers’ compensation rates…as it will take several years to realize the full impact.”

Meanwhile, north of the border, North Carolina workers’ compensation experts have been feverishly debating whether and how these rate changes might influence the playing field up here. So many unbalancing factors are at play – both at the state level (see our earlier blog entry about the ongoing devastation at the last year’s Slim Jim plant in the town of Garner, for instance) and at the national level (see our past blog entries on the local implications of the Gulf oil spill, for instance).

It’s important to recognize the limits of our collective power to influence the interactions of the dynamic elements that comprise the ecology of the North Carolina workers’ compensation system. Even among key players — who include but are not limited to insurance adjusters, attorneys, judges, economists, employers, employees, and their families — debate about how to set rates rages.

Getting away from generalities and down to brass tacks… if you or a loved one has a clear and present concern about North Carolina workers’ compensation benefits, insurance, or coverage, consider connecting today with a top caliber attorney to discuss your needs and responsibilities.

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South Carolina Workers’ Compensation Rates to Drop 9.8%

South Carolina Regulators Approve 9.8% Cut in Workers’ Comp Rates

Although her saga does not technically pertain directly to North Carolina workers’ compensation matters, Octomom Nadya Suleman quest for workers’ comp has riveted the attention of the nation. According to breaking reports, the Southern California mom of 8 has finally settled a long standing lawsuit for workers comp for just a little over $23,000.

Background

In 1999, Suleman sustained an injury at the Metropolitan State Hospital while working as a psychiatric technician (hurt her back). For this, she subsequently received around $170,000, which she used in part to fund the in vitro fertilization that led to her becoming the mother of octuplets last January. The California Division of Workers’ Compensation reported that her original settlement of $40,000 was diminished by nearly half because of attorney’s fees and advance payments.

Suleman has been roasted widely in the press for feeding her children with food stamps, selling pictures of herself clad in a bikini to the tabloids, and taking $5,000 from People for the Ethical Treatment of Animals in exchange for putting a sign in her window that reads “don’t let your dog or cat become an Octomom – Always spay or neuter.”

The workers’ comp drama may not be over for Ms. Suleman, given that some of her medical providers have a lien against her, claiming that she owes them around $800.

Are there lessons here for would be North Carolina workers’ compensation claimants? Likely not. Ms. Suleman’s case is fairly unique, and not just because she has octuplets and has behaved in fairly idiosyncratic manner. California has special laws in place that may not be applicable to North Carolina workers’ compensation cases.

For instance as this blog recently reported, an NFL player who hurts himself in a game in California can theoretically claim workers’ comp benefits from the state for the rest of his life – CA is unique in the nation regarding this kind of liberal policy.

If you or a family member faces difficulties collecting benefits, wrangling with insurance companies, or even processing paperwork to meet critical deadlines, it may behoove you to speak with a reputable and battle proven North Carolina workers’ compensation attorney. As the case of Octomom illustrates, workers’ comp – whether you succeed in getting appropriate payments or not – may not be a complete solution for your financial woes.

Speak with a financial planner to draw up a battle plan for you and your family to get on a more even financial keel.

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Octuplets mom Nadya Suleman settles her workers’ comp case

Octuplet mom settles disability claim for $23,000

Last Wednesday, the multinational bank Wells Fargo was ordered to pay out $30 million to four non-profit entities, pursuant to a jury’s verdict that the bank participated in fraud. North Carolina workers’ compensation policy analysts have been reviewing the case to see whether it may have interstate implications.

The four non-profit entities — the Minnesota Workers’ Compensation Reinsurance Association, the Robins, Kaplan, Miller and Ciresi Foundation for Children, the Minnesota Medical Foundation, and the Minneapolis Foundation — all alleged that Wells Fargo essentially tricked them into believing that they were investing in low risk options, when in actuality the bank had been funneling their money into risky investments which blew up during the recent credit collapse. The jury found that the bank violated the Minnesota Consumer Fraud Act (and other laws). Punitive damages have yet to be assessed against Wells Fargo.

Representatives for the bank expressed disappointment about the decision, although it could have been worse for Wells Fargo. The non-profits asked for $400 million — more than ten times what the jury returned.

The litigation over punitive damages (and the potential Wells Fargo appeal) could stretch on for years – a not uncommon phenomenon in North Carolina workers’ compensation cases in which millions of dollars hang in the balance.

Most individual workers’ comp cases involving occupational diseases, injuries at work, and conflicts with insurers do not take as long to resolve and do not get nearly as complicated as the Wells Fargo case. Nevertheless, if you or a loved one faces friction getting benefits, dealing with an insurer, or managing the deadlines associated with your claim, connect at once with a reputable and experienced North Carolina workers’ compensation attorney to review your strategic options and make sure that you’ve dotted all your I’s and crossed all your T’s.

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Wells Fargo vs the non-profits

Minnesota Workers’ Compensation Reinsurance Association

Many North Carolina workers’ compensation cases wind up being dry and technical, requiring attorneys to develop nuanced arguments based on subtle interpretations of the law. But a new case out of Montana has engendered lots of laughs and some raised eyebrows. Below are the deets.

On June 7, a judge found in favor of a 23-year old plaintiff, Brock Hopkins, who was mauled by a bear he had been feeding while high on marijuana. Brock had been volunteering at Great Bear Adventures in Montana. One day, he smoked a pipe of marijuana and came in to do his job when the bear attacked him, dislocating his knee cap, and leading to $70,000 in medical expenses.

The park’s owner, Russell Kilpatrick, argued that Hopkins’ marijuana use was the major cause of the attack – had he not been high, the bear would not have attacked. But although the judge found Hopkins behavior to be “ill advised to say the least and mind bogglingly stupid to say the most,” he also found that Kilpatrick’s testimony that he paid Hopkins “out of my heart” to be laughably disingenuous. Since Hopkins should have been considered an employee of the park, he deserved workers comp benefits.

We have to throw in this pretty amazing quote from Kilpatrick about the event: “Brock could not resist one last time of harassing the bear with his habit of blowing smoke in their faces for God only knows what reason in direct defiance of my telling him not to disturb them!!!”

Hopkins is clearly lucky to have survived the encounter and hopefully has learned his lesson. If you or another family member has been hurt at work (even if you don’t work at a Grizzly Park), your employer or the state could be liable for your medical bills, time off work and other costs. Filing out a North Carolina workers’ compensation claim is not easy. You can find more information about how to do so at the official North Carolina Industrial Commission website.

If you encounter any problems with your insurer, employer, or any other party, it may make sense to connect ASAP with a top caliber North Carolina workers’ compensation attorney to review your rights and make sure the legal system treats you fairly.

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Bear Attack Victim Eligible for Workers’ Comp Despite Marijuana Use

Pot not to blame for bear mauling, judge rules

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.

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Christina Gamble fraud saga

Strip club no cure for her bad back

North Carolina workers’ compensation stories often revolve around injuries associated with office jobs, such repetitive stress problems or occupational damage people suffer while working lines at factories. But today we will focus on one set of workers that receives scant coverage in the press – tobacco workers.

The Farm Labor Organizing Committee (FLOC) recently marched through downtown Winston-Salem to demand justice and fair treatment for the state’s tobacco workers, many of whom immigrated from Mexico to work for far below the minimum wage. These workers toil under extremely strenuous conditions – according to one source, nine people died working the North Carolina fields from heatstroke over the past two years. Many others get sick from nicotine poisoning they get from harvesting crops. Still others get sick from exposure to pollutants and chemicals or endure repetitive stress injuries.

Unfortunately, remedies for these laborers seem few and far between. With double-digit unemployment afflicting North Carolina and many of the state’s industries and businesses still reeling from the fallout of the Great Recession, it seems unlikely that major political action will be taken to resolve the plights of beleaguered farm and tobacco workers.

Nevertheless, options may exist. If you or a co-worker has been hurt on the job – whether you got hurt on a farm, at a factory, or in an office – you may be entitled to collect workers’ compensation benefits to pay for your medical care, time off of work, and other costs. Explore your options today by connecting with a competent and well-respected North Carolina workers’ compensation attorney near you.

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Farm Labor Organizing Committee (FLOC)

NC tobacco workers

Most North Carolina workers’ compensation matters that this blog covers are local or national. But today we turn our attention to a fascinating case out of Australia involving a pilot for the airline Qantas. This story’s applicability to North Carolina workers’ compensation concerns may be somewhat indirect, but it’s a gripping one, so we had to include it!

Background

A pilot named Bryan Arthur Griffin flew for Qantas in the late ‘70s and early ‘80s. During that time, he developed a mental illness related to obsessive compulsion and anxiety. Mr. Griffin felt a tremendous urge to crash the airplanes he was flying. He heard a voice inside of him telling him to turn off the engines, to cry and scream, to intentionally ignore crew instructions, and so forth. On one flight to Singapore, he developed an urge to crash the plane that was so strong that he had to physically immobilize his arm to avoid killing a whole plane full of people.

Throughout his ordeal, Mr. Griffin was repeatedly looked at by doctors and evaluated by Qantas. Amazingly, the doctors and the airline allowed him to continue to fly for over three years. Not only did allowing Mr. Griffin to fly potentially endanger passengers and crew, but doing so also caused health problems for Mr. Griffin, who became more anxious, depressed, and compulsive as his stint as a pilot wore on.

Eventually, an Australian Commissioner in charge of adjudicating workers’ compensation matters won a judgment for Mr. Griffin for $160,000 for all of his pain, anxiety, and compulsive problems. Qantas also had to pay for his legal and medical fees.

Have you or a family member ever been forced to work at a job that’s caused you anxiety, depression, or compulsion? Your on-the-job injuries and occupational diseases may be covered by North Carolina workers’ compensation.

Take the first step to filing a claim today by connecting with a reputable North Carolina workers’ compensation attorney for a confidential and free consultation. Understand your rights – and your employer’s responsibilities – so you don’t endanger yourself or others at work.

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Qantas

Bryan Arthur Griffin

Military personnel injured by exposure to carcinogenic elements at Camp Lejeune in North Carolina may soon be able to cash in on North Carolina workers’ compensation claims, thanks to a new bill under consideration in the Senate called the “Examination of Exposures to Environmental Hazards during Military Service Act of 2010,” also known as TRICARE. Since January 28th, the Senate Veterans Affairs Committee has held hearings about how to compensate injured military personnel for damages related to exposure to environmental hazards, such as benzene-based solvents like trichloroethylene.

The Senate bill is designed to respond to complaints at 130 military bases around the nation. These are all listed on something called The Environmental Protection Agency Superfund’s National Priority List. Thousands of military personnel may be impacted by the legislation.

At Camp Lejeune in North Carolina, officers and other personnel came into regular contact with trichloroethylene (TCE) during the course of cleaning airplane parts. This harsh solvent seeped into the ground and local water supply, and many personnel thus indirectly drank it, got it on their skin and inhaled the aromatic compound.

Assuming the proposed Senate bill becomes law, the Department of Defense will have 90 days to create a list “Of individuals exposed to environmental hazards at Camp Lejeune, during the period… in which the water at Camp Lejeune was contaminated with volatile organic compounds, including known and probable human carcinogens.”

To collect North Carolina workers’ compensation benefits from the DOD, potential beneficiaries will likely have to jump through many logistical hoops. If you or a family member suffered exposure to chemicals at Camp Lejeune, it may behoove you to speak with a qualified and highly credentialed North Carolina workers’ compensation attorney to protect your interests and to ensure that you get fair payment for injuries, medical costs, wages lost, and other damages.

More Web Resources:

Examination of Exposures to Environmental Hazards during Military Service Act of 2010

Camp Lejeune

You’ve successfully fought for and won a substantial North Carolina Workers’ Compensation claim. Now you are left with the difficult and long-term task of rebuilding your life, planning your career direction, and managing your injury/injuries. Here are some useful tips and solutions as you make this great journey back to financial and physical health.

1. Get support

No one recovers alone. Human beings are social creatures. We need the support of doctors, friends, family members, and other people who are going through similar situations. Reach out to people who can help you, including specialized North Carolina Workers’ Compensation attorneys, support groups, and the helpful operators at the North Carolina Industrial Commission. You are not the first person forced to endure a long and difficult rehabilitation from an on the job injury. And you need not “reinvent the wheel” when it comes to navigating recovery. Listen to what others have to say, and do due diligence and research now to save yourself trouble down the line.

2. Treat your injuries holistically.

You may simply have suffered a sprained finger on the job, or you may have endured something more severe, like a blood injury due to chemical exposure. Whatever the case, in addition to the acute damage the injury/illness has caused you, you have no doubt suffered secondary and even tertiary consequences from the initial insult. Often times, surgery and pain medications can alleviate some of initial symptoms. Work now with your physician to develop a long term system of pain management, exercise, diet, flexibility training, and ergonomic practices. Otherwise, you could easily reopen old wounds and exacerbate current problems. For instance, people who get typing injuries in one hand often revert to using the less favored hand to type — without changing anything fundamental about their work habits. As a result, the less favored hand also gets injured.

3. Budget realistically for the future – and don’t ignore your finances.

While filling out and waiting for a North Carolina Workers’ Compensation claim to go through, it’s easy to awfulize bad news and celebrate good news. Try to keep yourself on an even keel. The budgetary uncertainty won’t go away soon – even if your claim goes through fine. You have a difficult and unpredictable recovery and rehabilitation ahead of you. Budget conservatively, and develop workarounds to protect your nest egg and ensure a good quality of life — without creating undue expectations. If your spouse or partner can pick up some of the financial burden, may be that’s something to consider. If you can take on a temporary job that doesn’t stress your injuries or interfere with your rehabilitation, that also might be something to consider. Workarounds abound. The key is to, first of all, be honest about where your financial situation is right now. Only once you have collected all of your concerns, hopes, and fears about your financial future can you make an accurate and active strategic plan.

4. Consult with a reputable and experienced North Carolina Workers’ Compensation firm regarding any legal questions.

Often, North Carolina Workers’ Compensation claimants wait until the last minute – or wait until deadlines have passed – to get good legal help. Don’t make that mistake. Whether you are negotiating with insurance companies, dealing with an uncooperative employer, or simply confused by the maze of paperwork presented to you, you need not go down this path alone. A free consultation with a vetted and credentialed N.C Workers’ Comp Attorney can make a huge difference to your financial future and to the prospects for your rehabilitation.

More Web Resources:

Medical Rehabilitation Nurses Section of NCIC

Sorehand.org

Does the quality of the CAT Scan used on patients impact treatment outcome and cost? The answer may have significant relevance to North Carolina Workers’ Compensation cases. Consider this argument:

Many CAT Scan technologies in use in hospitals throughout North Carolina were developed in the 1990s and 1980s. When you compare these technologies to emerging CAT Scan equipment (such as the Siemens Somatom Definition Flash), real and potential significant differences emerge. A patient who gets a CAT Scan from an old piece of equipment may receive a fundamentally different diagnosis than a patient who gets analyzed using one of the newer machines!

For instance, on the newer machines, such as the Definition Flash, patients can be scanned in half a heartbeat and need not take beta blockers prior to the scan. These minor differences could be important; when you extrapolate the implications over the entire patient population of United States, we could be looking at potentially millions of dollars a year in patient/doctor savings.

Of course, whenever one does a cost benefit analysis of a new medical technology, we must remember the law of unintended consequence. Adding new machines to hospitals that provide more trustworthy analyses could lead physicians to trust their intuitions less and rely on machines more, for instance. This could lead to doctors ignoring smart intuitions – thus, putting some patients in dange. Furthermore, more accurate imaging technology could lead to more false positives and thus to more unnecessary treatments.

These kinds of concerns must be addressed whenever we debate improvements in North Carolina Workers’ Compensation policy. A policy solution may, at first blush, appear to have no downsides. But the execution of the solution can open a Pandoras Box of problems.

One famous, if peripheral, example of this kind of nasty surprise comes from ecology. In the middle of the 1900s, a Caribbean island was besieged a rat infestation. So the government literally parachuted cats onto the island to eat the rats. But the once the rats were eaten, this severely disrupted the island food chain and created an ecological catastrophe.

To mitigate against the dangers of unforeseen consequences associated with your North Carolina Workers’ Compensation claim, discuss your concerns with quality North Carolina Workers’ Compensation attorneys today.

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CAT Scan

Siemens Somatom Definition Flash

To collect North Carolina Workers’ Compensation benefits, you must first go through a rigorous and formal process. Even if you were legitimately hurt at work and you have a clear case for needing Workers’ Comp; if you don’t go through official channels, you could be denied compensation and long-term coverage. So, take your time now to understand your options. Go over any questions you might have with a credentialed North Carolina Workers’ Compensation attorney, and plot out a strategic course for your rehabilitation and remuneration.

To qualify, your injury must generally meet the following criteria:

1. You got hurt or sick during the course of your employment.
2. The injury or illness arose directly or indirectly from circumstances of your job.
3. The injury and illness created an impairment which led to medical costs and/or lost wages.

Of course, just because you got hurt on the job does not mean that you will automatically collect North Carolina Workers’ Compensation. Conversely, if you got hurt on the job and it was your fault, you are NOT necessarily denied coverage.

Confused? Let’s take a look at some examples to clarify these points.

Let’s say that you and a co-worker horsed around on some industrial equipment, and you fell off and broke your femur. In this case, you likely would NOT be able to collect North Carolina Workers’ Compensation benefits because your negligence led directly to the injury.

Similarly, let’s say that you suffered a stroke on the job. If you were predisposed to stroke (obese, diabetic, history of stroke, etc), and the condition occurred NOT because of your job, you may not be able to collect Workers’ Comp benefits. (You may have alternative avenues to collect support, however.)

Alternatively, let’s say you suffered a stroke during a particularly stressful time on the job. You might be able to argue that the stress of the situation caused or exacerbated the stroke; and thus you should be entitled to Workers’ Comp.

The point is, at the end of the day, subtle distinctions matter a great deal when it comes to North Carolina Workers’ Compensation benefits. To protect yourself against insurance company harassment, problematic negotiations with your employer, snafus with paperwork, and other potential but not so obvious hurdles. It likely behooves you to discuss your matter with a qualified and trained North Carolina Workers’ Compensation lawyer.

A professional attorney can draw upon a deep knowledge of the law and practical applications of the law to provide you with strategic guidance during this difficult time.

More Web Resources:

Workers’ Compensation Criteria

Denied Coverage? It can be maddening!

Most first time North Carolina Workers’ Compensation claimants find themselves ovewhelmed by the Byzantine claims process. To make things easier for you, we’ve put together this quick guide to explain the basic players who deal with North Carolina Workers’ Compensation claims and injury management.

1. Employee

This is you. A worker who gets injured while executing a job related duty can be eligible for North Carolina Workers’ Compensation.

2. Employer

Your boss or your company is technically be known as the “employer.” If you work for yourself, and you have Self Employment Workers’ Compensation Insurance, you may be both the employee and the employer. Many employers are required by law to carry North Carolina Workers’ Compensation policies. These policies pay out to injured claimants; thus, the money does not come directly from the employers/company’s pockets. Another technical name for the employer is the “Insured.”

3. Insurance Company

The insurance company issues policies to employers to cover them in the event that an employee (such as you or a co-worker) gets injured on the job and requires money to pay for medical services, rehabilitation, and time off of work. Different states have different laws regarding Workers’ Comp Insurance Coverage. If you have specific questions regarding how North Carolina Workers’ Compensation Insurance companies must behave, speak with a veteran attorney or call the North Carolina Industrial Commission (NCIC).

4. Insurance Broker/Agent

A Broker or Agent acts as a liaison between the Insurance Company and the Employer. A broker typically tries to sell services to employers. The Broker can also act as a consultant and risk benefit analyst for employers.

5. Claims Administrator

A third party administrator, also known as a TPA, manages claims, adjusting them per settlement arrangements. Some insurance companies outsource their work to these independent agencies. TPAs also must act in accordance with North Carolina laws.

6. Doctor/Rehabilitation Specialist

The Physician and/or Rehab Specialist play critical roles in the injury management process. Obviously, if you are hurt on the job, a medical doctor must examine you and attest to your state and degree of injury before you can collect North Carolina Workers’ Compensation benefits.

7. Attorney

A North Carolina Workers’ Compensation Attorney can help you resolve questions you have regarding eligibility, benefits, settlement arrangements, insurance negotiations, and so forth. Most good attorneys will provide free, confidential consultations to answer your questions and concerns. Take advantage of this opportunity to learn more about the lawyer’s services, fee structure, track record, and credentials.

More Web Resources:

Third Party Administrator (TPA)

More about parties involved in workers compensation claims

Elevated North Carolina Workers’ Compensation costs concern everyone in the “employment ecosystem” – small business owners, employees, government agencies, insurance companies, and physicians alike. To bring down costs across the board, however, requires a holistic approach to problem solving. In this article, we will speculate about remedies that could be applied throughout this “ecosystem” – at little to no cost to employers, insurers, or employees.

1. Put in place systematic solutions to common workplace ergonomic problems.
How many North Carolina workers’ compensation cases begin at the keyboard? Carpel tunnel syndrome, repetitive stress injuries, and other soft tissue injuries abound in North Carolina – many of them no doubt due to bad workstation ergonomics. An employer can mitigate against risk of repetitive stress injuries by investing in more economic keyboards, for instance, more tailored workstations, and a program of regular breaks and stressing. The cost of such a proactive “war” against repetitive stress injuries would be minimal, and the benefits would no doubt be long lasting. Workers who are not exhausted from keyboarding and other repetitive tasks can work longer hours (thus making up any theoretical costs of ergonomic modifications). Fewer injuries would mean lower North Carolina Workers’ Compensation insurance premiums.

2. Better Alert and Response System to Control North Carolina Workers’ Compensation Fraud.
As the old saying goes, a few bad apples can spoil the bunch. Everyone loses when people cheat the system. But how do you get people the stop cheating? This is the $64,000 question. Better monitoring of claims might be a theoretically good solution, but when you incentivize insurance companies to look for fraud, these companies inevitably will turn up “false positives.” I.e., they will harass people who are legitimately injured – trying to get them to admit that they are not actually hurt. This is obviously terrible, and it results in many tragedies, some of which we have reported on this blog.

A better solution might be to build in a more robust tracking system to make sure that claimants stay honest. In addition, insurance companies and employers must recognize and respect the claimants who are actually hurt and go the extra mile to help them.

3. Involve physicians in more holistic patient care.
The fractured approach to patient healthcare no doubt exacerbates many medical problems. If a patient sees four doctors, chances are that each physician will require separate paperwork, and that the doctors will not communicate with one another about the patient. This needs to change. Implement across the board holistic treatment for injured patients, and we will see much better health care. This is obviously an enormous task. But if we really want to bring down North Carolina Workers’ Compensation costs, we need to start treating patients as whole people — and not just as carriers of individual symptoms they present with.

4. Better, more thorough and more regular data analysis of North Carolina Workers’ Compensation cases.

Organizations like the North Carolina Industrial Commission (NCIC) and other government agencies do track serious injuries and deaths at NC workplaces. But the amount of data that’s mined and shared about these accidents is extremely small, maybe even negligible, compared with what could be mined. We need to gather much more information – much more detailed analyses of various injuries and incidents. We must be able to share that information not only with government agencies, insurance companies, and fellow employers, but also with employees.
Do this kind of analysis, and we will no doubt be amazed at the kind of improvisations and “band-aid” solutions that emerge.

If you or somebody you love has been hurt or needs help with North Carolina Workers’ Compensation issues, connect with a qualified veteran attorney near you for a confidential consultation.

A recent report released by the California Workers’ Compensation Institute has many experts and consultants who specialize in North Carolina workers’ compensation quite concerned. The CWCI found that just 3% of doctors who treat workers’ comp patients in the Golden State prescribe over 55% of the “Schedule II” medications, which include potentially addictive drugs like methadone, codeine, and fentanyl. The report, Prescribing Patterns of Schedule II Opioids in California Workers’ Compensation, found a variety of disturbing findings, including:

• The top one percent of hurt workers ingested 25 times more medication than did the average workers’ compensation patient.
• 279 physician prescribers drove two-thirds of all drug-related payments
• Over 50% of Schedule II drug claims involved minor back pain – certainly a troubling issue, but not an issue that necessarily requires strong medications.
• Schedule II drugs prescribed in CA skyrocketed from just 1.4% in 2005 to 7.2% by 2009.
• Payment for Schedule II drugs also increased by over 500%.

Dr. Arnold Milstein, the leader of Stanford University’s Clinical Excellence Research Center, explained why regulatory agencies may not be putting the brakes on what’s clearly an over-prescription problem: “The State Medical Licensing Board is horribly underfunded in terms of stopping these obviously crazy prescribing patterns by a small percentage of doctors.”

Another expert, Joe Paduda of Health Strategy Associates, explained why physicians might take unfair advantage of the system: “The workers’ comp industry is a very soft target for healthcare providers and other people who want to take advantage of regulatory or other loopholes.”

The California system, apparently, is set up in such a way that patients get encouraged to go the prescription med route instead of trying alternative, non-medication related modalities, such as physical therapy and strength training.

In any case, what might this CWCI report mean for the North Carolina workers’ compensation system?

States differ tremendously in their workers’ comp programs. And no North Carolina institution has done a similarly thorough study on Schedule II workers’ comp prescriptions. But it shouldn’t come as that much of a surprise that a minority of doctors causes the most abuse. The so-called “Pareto principle” – also known as the 80-20 Rule – is a well-established economic principle. It suggests that, in any given population, a minority of participants will drive the majority of results. For instance, if you own a small business, 20% of your clients will yield 80% of your work. 20% of your clients will also yield 80% of your problems. And so forth. So the fact that a small minority of doctors caused the majority of the Schedule II drug abuse shouldn’t be too much of a surprise. Indeed, data should find a similar pattern here in North Carolina.

If you or someone you care about needs help with a benefits issue or help with a recalcitrant employer or insurer, connect immediately with a North Carolina workers’ compensation law firm.

More Web Resources:

Prescribing Patterns of Schedule II Opioids in California Workers’ Compensation

California Workers’ Compensation Institute

Thanks to the efforts of the North Carolina Rate Bureau, North Carolina workers’ compensation insurance policy rates will plunge nearly 10% for 2010. Wayne Goodman, the state’s Insurance Commissioner, announced the rate slash this week, which government statisticians believe will help NC employers save around $120 million in 2010. An Insurance Department spokeswoman argued that the rate slash would drive down the cost of doing business in the state and thus spur growth. Insiders believe that the rate slash was made possible in part by a dramatic decline in the number of North Carolina workers’ compensation claims filed. This is the second year in a row that there has been a significant decrease in NC workers’ comp insurance rates. Last year, rates were slashed 4.4% over 2008 numbers.

The rate decrease won’t help every employer. Almost all North Carolina state employers won’t be impacted. And many private employers — for instance, those employers who have to pay insurance for high risk jobs — will likely not see the benefits of these insurance rate slashes.

The rate slash does nothing to change fundamental laws and rules governing North Carolina workers’ compensation. In general, businesses that employ three or more people must pay for insurance in case an employee suffers disability, requires medical care, or requires compensation for lost wages.

Whether the motion will spur renewed business commitments in the state is an entirely different debate. The recession has hit North Carolina relatively hard, notwithstanding the state’s diverse economy and relatively resilient tech sector in the Research Triangle. Perhaps these rate decreases will incentivize businesses to take on new projects, hire new employees, and attract contracts to the state. Still, some skeptics worry that the rate slash may have a dampening effect on growth and that it will destabilize the ‘playing field’ in certain industries, artificially favoring businesses which benefit from the rate cut and hurting businesses that don’t qualify.

More Web Resources:

North Carolina Rate Bureau

Workers’ comp rates falling in N.C., Charlotte Observer, Nov 5, 2009

If you have been injured at work — or hurt while on the way to or from a work function or while otherwise engaged in company business — you may be entitled to a wealth of North Carolina workers’ compensation benefits, including replacement for lost wages, vocational training and placement, help with medical bills, and compensation for pain and suffering. Unfortunately, if you mishandle your claim, you can miss out on these benefits.

So what are some of the common ways in which claimants ‘self-destruct’ their cases?

1. Ignoring the injury/accident.

Obviously, a claimant who falls off a ladder and breaks her leg is not likely to ignore her injury; however, not all job injuries are acute. Some are chronic. For instance, repetitive stress injuries — such as carpal tunnel syndrome, cubital tunnel syndrome, and thoracic outlet syndrome — can all significantly impair your quality of life, make job duties harder, and lead to thousands of dollars in medical bills and therapies. If you don’t report a claim in time, you may miss out on key workers’ comp benefits.

2. Failing to get appropriate treatment.

Not only can delaying your treatment lead to a worsening of your health problems or injuries, but neglecting to take proper care of yourself can provide insurance companies leverage to deny your claim. Delaying can also make it more difficult to demonstrate that the injury sustained was a direct result of your on the job accident.

3. Failing to realize that the insurance company will continue to investigate your situation even after your claim has been approved.

This shouldn’t be a problem as long as your claim is real (ongoing investigations are designed to probe for instances of North Carolina workers’ compensations fraud). But insurance companies generally do all they can to avoid paying long term claims. They may look for any loophole to deny your claim and/or reduce your coverage — even retroactively. Insurers have gone as far as to secretly videotape claimants to look for evidence to deny claims.

4. Trusting employers or insurance companies to ‘do right.’

As the old adage goes: trust, but verify. As we just discussed, insurers and employers may have sympathy for you. Some individuals may even go out of their way to help you figure out your rights and fill out paperwork. But make no mistake. These companies are in business to make money — and that means they have a strong motivation to deny claims and/or to limit them as much as possible. Thus, if you disclose too much information — or the wrong kind of information — to an insurance company investigating your claim, you could significantly impair your chances of collecting of a good settlement.

5. Settling for far too less.

Many claimants are desperate for any money to pay for medical bills, lost wages, and therapies. They thus will often quickly settle with insurance companies to get some active cash flow. However, usually an insurance company’s first offer is not the best offer. A reputable and time-proven North Carolina workers’ compensation attorney can likely help you get much more for your claim.

6. Waiting too long to consult/retain an attorney.

The longer you wait to speak with an experienced attorney about your injury/accident on the job, the greater the likelihood that you will make some error of omission that could damage your claim or cause it to be dismissed altogether. The laws governing workers’ comp benefits and payouts can be extremely complicated; thus, your case may require delicate finesse to get you the most compensation and in the fairest possible terms. Furthermore, a qualified and creditable workers’ compensation attorney can help you develop a plan of action that will reduce your anxiety and uncertainty.

More Web Resources

North Carolina Industrial Commission

North Carolina Office of Economic Opportunity

Repetitive stress injuries (RSIs) cause hundreds of thousands — if not millions — of American workers chronic problems and may account for a sizable percentage of a North Carolina workers’ compensation claims. But what are RSIs? And how can workers prevent and treat them most effectively?

Theories abound to explain how workers develop conditions like carpal tunnel syndrome, cubital tunnel syndrome, thoracic outlet syndrome, and tendonitis. Obviously, the etiology is complex and this blog is not prepared to offer medical advice in any way; however, a look at the dominant theories reveals much.

One school of thought considers and treats the different manifestations of repetitive stress induced trauma. For instance, a worker who complains of neck pain resulting from a typing injury may get treatment directly at the source of the pain — for instance, massage, cortisone injections, or doses of non-steroidal anti-inflammatory drugs to relieve the pain.

Another school of thought suggests that many RSI injuries result from systemic damage to the musculoskeletal system and that repairing the damage requires a broader approach. In other words, a pain in the neck that results from a typing injury may represent essentially the tip of the iceberg. The injury/insult may in fact be to the entire upper thoracic region, including perhaps the arms, chest, upper back, lower back, hands, and so forth. Moreover, the insult is not simply to muscle or nerve tissue but ultimately to the entire musculoskeletal apparatus, including connective tissues, such as tendons, ligaments, and fascia. Treatment thus focuses on a variety of modalities, including massage, trigger point therapy, stretching, resting, chiropractic, and improved posture and ergonomic practices.

Many occupations predispose to repetitive stress injuries. These include,

• Computer work
• Assembly line work
• Sewing
• Hairstyling
• Office/managerial work
• Any job that involves lifting or sorting (e.g. Postal Service work)
• Design work
• Craft work
• Any job that requires an employee to hold a position for many hours at a time — including waitressing (standing), truck driving (sitting), and athletic employment (running, twisting, etc).

Perhaps a majority of the working population in North Carolina and throughout the country may be subjected to repetitive work related traumas that can result in injury. Corrective measures can include workstation changes (to make a computer station more ergonomic, for instance); institutionalized massage therapy; better education about posture and relaxation techniques; reduced hours; enforced break times; and regular continuing education about the dangers and treatment methodologies for RSI.

If you have suffered traumatic injuries due to repetitious work, you may be entitled to significant North Carolina workers’ compensation benefits. It may behoove you to speak with a knowledgeable NC workers’ comp attorney ASAP to learn about your rights and options.

More Web Resources

Sorehand

Deborah Quilter’s RSI book

On December 3rd, 2008, a construction worker named Hussein Montalovo died when a girder collapsed after temporary supports (“strongbacks”) broke while he was in a vulnerable position. Montalovo’s family has reportedly collected some North Carolina workers’ compensation benefits from the state’s Industrial Commission, but the family seeks more damages from potentially culpable parties, including two engineering firms, the bridge’s contractor, and even the State’s Department of Transportation.

Suing for negligence is very different from filing for North Carolina workers’ compensation. To prove negligence, you must meet a higher burden of proof. At the same time, if you win a negligence case against an employer, contractor, insurance company, or other entity, you can potentially collect more money to pay medical bills, afford therapies, and mitigate (to some extent) pain suffered.

To more forward with a North Carolina workers’ compensation or personal injury claim, it may help to work directly with an experienced attorney. Given the legal complexities – as well as the sheer number of entities that can be involved in disputes such as the case of Montalovo – it’s easy for claimants to experience confusion and make statements that could make it more difficult to prosecute a claim or law suit.

More Web Resources:

Family of construction worker killed in Oak Island bridge collapse suing DOT, StarNewsOnline.com, Oct 23, 2009

Family of construction worker killed in Oak Island bridge collapse suing DOT, Morning Star, Oct 24, 2009

Whether you got hurt at a processing plant or developed carpal tunnel syndrome while working as an executive for one of the big banks of the Research Triangle, you may need significant North Carolina workers’ compensation benefits to pay for medical care and support your budget while you recuperate. Unfortunately, a fair number of claims get denied every year because applicants don’t take the time to learn about best practices for filing. Here are some common mistakes that claimants make – along with suggestions for how to avoid these problems:

1. Waiting too long between the time of the injury/ incident and the time that you file a claim – Wait two or three months between getting hurt at work and reporting the accident, and not only might your employer be less sympathetic, but you also may lose some legal leverage. The longer you wait before investigating North Carolina workers’ comp, the harder it will be to collect evidence and statements to support your claim.

2. Saying the wrong things to your employer / and or insurance company representative –Candor is generally a sound ethical strategy. But you might be advised not to discuss your case at all with insurance company representatives, for instance, before speaking with an experience North Carolina workers’ compensation attorney. After all, your employer and your employer’s proxies may not have your financial interests in mind. And making even “innocent” statements can jeopardize your claim.

3. Changing your story – when you do give a statement to an employer or an insurance company representative, if you later revise the facts of the incident, your claim may come under significant suspicion, particularly if it’s a large claim or a claim for benefits that might last years or even decades.

4. Failure to keep a paper trail and to track witness statements – just because you ‘know’ you should be entitled to workers’ compensation benefits doesn’t mean that your employer, an insurance company, or even an objective judge will agree. Fortify your contentions by collecting statements from employees who saw you get hurt, by keeping track of any paperwork your doctor or employer provides, and so forth. Do this spade work, and your North Carolina workers’ compensation attorney should be able to dispatch your case more quickly, efficiently, and effectively.

Government statisticians and insurance companies spend millions of dollars each year to catalogue workers’ compensation injuries in North Carolina and elsewhere across the US.

Such injuries fall loosely into four major classes:

1) Traumatic or acute accidents

Examples of injuries that could lead to a North Carolina workers’ compensation claim might include:
• A construction worker gets hit by a falling beam while inspecting a site.
• A pizza delivery worker breaks her collarbone in an auto accident on the way to a customer’s house.
• A postal service worker slips and falls on icy steps and shatters his coccyx.
• A dog catcher gets a finger bitten off by an angry pug.

2) Repetitive stress injuries

Repetitive stress injuries (RSI) afflict millions of workers – particularly office employees and assembly line workers. Examples of this class of injury might include:

• A secretary gets carpal tunnel syndrome after typing dictation rapidly for her boss.
• A hairstylist hurts his hands after scissoring 12 hours a day for three years.
• A pianist adopts a lazy technique and as a result gets thoracic outlet syndrome (TOS).

3) Occupationally specific injuries

Certain occupations expose workers to very specific types of hazards. For instance:

• A painter gets sick after inhaling aromatic compounds, like benzene.
• A landscape artist gets electrocuted after attempting to move a live power line with faulty equipment.
• A farmer gets flu from one of his chickens.

4) Psychologically-induced injuries

Stresses at work – including verbal abuse, loud noises, and harassment – can cause physiological problems. For instance:

• An airline worker who works on the tarmac develops post traumatic stress syndrome from hearing jet engines launch all day.
• An assistant at a fashion company develops depression and stomach problems after getting yelled at repeatedly by her bosses.
• A medical resident suffers sleep deprivation and high cortisol levels.

For more information about North Carolina workers’ compensation categories and statistics, connect with a solid, reputable attorney who practices in the state.

Most North Carolina workers’ compensation stories begin with prosaic events, such as slip and falls or back injuries. But the case of HoneyBaked Ham Manager Richard Huether began literally at gunpoint.

Back in April, a burglar attempted to rob Huether’s HoneyBaked Ham store. In the ensuing confrontation, Huether ended up shot. Subsequently, the company (which is based in Georgia) reportedly went out of its way to provide North Carolina workers’ compensation, reimbursement for costs of COBRA payments, and extra pay to make up the difference between Huether’s benefits and his normal wages. However, Huether has now reportedly been terminated from his job — just after his workers’ comp benefits ran out.

In a public statement, the company maintained that Huether was let go in order to allow him to collect social security benefits. But the injured worker was not pleased by the decision. In particular, he publicly expressed concerned that he will lose his health insurance as a result of the termination. (Given Huether’s pre-existing injuries, new insurance could cost his family as much as $5,000 a month, according to sources close to the family.)

Although social security benefits may cover therapies, treatments, and other medical costs, the process of accessing social security moneys can drag on for a long time — even for years — and thus create financial stresses in the short term.

HoneyBaked Ham is a popular franchise in the south. But the company is no stranger to controversy. A vegan protest of a HoneyBaked Ham store once resulted in the mass arrest of activists and major media coverage.

HoneyBaked Ham Fires Employee Shot in Store Robbery, The Consumerist, Sept 26, 2009

Employee injured in robbery attempt loses job, WRAL.com, Sept 26, 2009

More Web Resources:

HoneyBaked Ham

How can you determine whether you, a family member, or a co worker may be eligible for North Carolina workers’ compensation benefits?

State law construes eligibility broadly. The law gives claimants significant leeway to make claims for benefits to cover lost wages and medical bills. As long as you suffered an injury on the job and as long as your sickness or injury was not caused by gross misconduct on your part, chances are you will qualify. (Of course, you must have sustained your injury/illness while working for your present employer to collect benefits from that company or from its insurers.)

If you got injured on the way to work or while travelling on a work function, will you qualify?

In most cases. As long as you were engaged in a work related activity, you should be eligible for North Carolina workers’ compensation benefits. Moreover, if your employer (through intentional misconduct or gross negligence) caused or aggravated your injury or illness, you may be entitled to extra benefits, such as double payments.

What kind of injury might constitute an actionable damage?

In general, the injury or illness must be significant. For instance, bruises, contusions, fractures, repetitive stress injuries, mental/emotional trauma, and back problems such as sciatica can all be grounds.

Will your eligibility last indefinitely?

No. You must file a claim within a designated time limit or your claim may be denied, or your benefits may be slashed or reduced. Moreover, just because you qualify for benefits now doesn’t mean that the employer or insurer will cooperate for the life of the claim. And, of course, each North Carolina workers’ compensation case is different and thus requires nuanced handling.

Given all these factors, it generally makes sense for claimants (or even potential claimants) to discuss their issues with a qualified North Carolina workers’ compensation attorney.

Web Resources:

North Carolina Industrial Commission

Who is covered under Workers’ Compensation

Since the early 1900s, North Carolina workers’ compensation benefits have provided injured workers with money for missed wages, medical bills and retraining. Unfortunately, abuses of the workers’ comp system have reached epidemic proportions, according to the National Insurance Crime Bureau, which surveyed the industry and found that this crime costs America around five billion dollars a year.

Workers who feign injury to collect benefits pass the costs of these payouts onto insurance companies, employers, and the federal government, resulting in higher premiums for everyone and stealing focus from legitimate workers’ comp claims. Insurance company advocacy groups and federal and state regulators claim that perpetrators of North Carolina workers’ compensation fraud do systemic harm, in other words.

No doubt many people do take advantage of the system by intentionally misreporting or mischaracterizing aspects of their conditions, and so forth. At the same time, however, the insurance companies cannot fairly claim to be pure victims of this fraud. Companies are generally free to hike up rates. And by investigating — and in some cases harassing — legitimate North Carolina workers’ compensation policy claimants, insurers often exacerbate the stresses on these individuals, thus indirectly causing more health problems for them and thus straining healthcare resources further and hurting the economy.

It’s also debatable whether at least some of the fraud that’s been going on constitutes a “gray market” as opposed to a “black market.” Consider: many injured workers don’t get a fair shake when it comes to their benefits. Some then rebel against a system that they perceive to be (and objectively may be) biased against them by committing fraud. Thus some attempts to siphon money from insurance companies could theoretically be justified. (That said, the law is the law.)

The deeper issue that needs to be addressed may be more global in nature. In other words, perhaps neither the perpetrators of fraud, nor the insurance companies are at the root of this epidemic. Maybe the problem is that American workers do not get adequate safety training. Alternately, maybe some massive as-of-yet-fully-acknowledged problem (such as poor workstation ergonomics) is injuring a vast number of workers and thus draining the resources of insurance companies (who in turn must bully policyholders to survive financially; and in turn policyholders must
perpetrate small scale fraud to be able to pay their bills.)

The Cost of Fraud, NYSIF

The Myth of Workers Compensation Fraud, PBS, May 29, 2000

More Web Resources:

National Insurance Crime Bureau

The laws and philosophies that inform the North Carolina workers’ compensation system evolved tremendously over the past century and a half. Innovations in industry, changes in the cultural zeitgeist, and demographic shifts have all played a significant role in moving and shaping the law. To understand the implications of current North Carolina workers’ compensation practices, it’s helpful to take in this historical perspective.

To get that perspective, though, we must dial way back. The concept of insuring workers against damages resulting from injuries and lost wages dates back literally thousands of years. In 3000 B.C, Chinese employers instituted one of the very first recorded systems of workers’ compensation. Around 1750 B.C, Babylonians spontaneously evolved similar kinds of protections for workers. Both the Roman and Greek empires developed elaborate systems as well — not only for workers’ compensation but also for life, health, and even disability insurance.

Flashing forward to more modern times, we can see the genesis of many of North Carolina’s workers’ compensation traditions in the 19th century, when so-called “heavy industry” began to flourish in the United States. Starting in the mid 1800s and continuing through the early 1900s, laborers had only a puny right to compensation (by modern standards). Many historians argue that it wasn’t until the first decade of the 20th century that a legitimate system of worker protection was put in place. This movement was driven by a handful of charismatic labor rights advocates, among whom was none other than President Teddy Roosevelt. At Roosevelt’s behest, in 1908, the U.S adopted the Federal Employers Liability Act, the first federal law designed to protect those who labored in the hazardous environments. The publication of Upton Sinclair’s 1906 best-seller, The Jungle, likely also did much to stir public sentiment about ongoing violations of workers’ right. In The Jungle, Sinclair described in vivid detail the plight of factory workers at meat packing plants. On not infrequent occasions, workers would fall into sausage making vats and becomes sausage themselves!

More Web Resources:

Workers’ Compensation, A Brief History by Lloyd Harger, Division of Workers’ Compensation for state of Florida

The History of Workers’ Compensation Laws, By Christopher Earle, eHow.com

Workers’ Compensation System, Author: Kelly L Allen, MD, Regional Medical Director, IMX-Medical Management Services, EMedicine

On August 26, the National Academy of Social Insurance (NASI) released a comprehensive report on 2007 data regarding overall domestic and state-by-state (including North Carolina) workers’ compensation benefits. Per the NASI, benefit payments across the nation in 2007 equaled $55.4 billion – a 2% increase over the amount paid out in 2006. Cash payments declined by about 10% in California, offsetting the increases in medical and indemnity benefits. All told, roughly half of the total amount paid out – $27.2 billion – went to cover costs of medical bills. That represented an increase of over 3% from 2006. (Health insurance analysts have been digging into the numbers to determine whether they represent a trend or whether the bump might simply be statistical noise.) The rest of the money – $28.3 billion – went to replace wages lost. This amount increased by just 0.08% from 2006. It would thus be statistically unsound to read any meaningful trends into such data.

NASI reported that employers across the US spent a total of about $85 million on insurance for workers’ compensation and other related expenses. (Those figures include employers who self-insure.) So how trustworthy are these data? Since NASI is both non-partisan and non-for-profit, one can safely assume that there’s no political agenda driving the numbers. Of course, calculating precisely how North Carolina workers’ compensation insurance and other types of social insurance ultimately impact the economy can be a complicated business. After all, given the number of non-linear factors involved, it’s tricky to tease out precisely how changes to different variables impact the economy as a whole.

For instance, if the relationship between North Carolina workers’ compensation insurance premiums and North Carolina’s GDP were simple linear, it might be easy to recommend policy solutions. But since these relationships are clearly complex and non-linear, there’s no way to predict precisely how to manipulate, for instance, social insurance premium rates to get desired effects. For more information about the 2007 NASI figures, check out the full report at www.nasi.org.

Business Insurance.com, Workers compensation benefits payments rise modestly: Report, August 26, 2009

PR Newswire, Drop in California’s Workers’ Compensation Spending Slows Growth in National Spending in 2007

More Web Resources

National Academy of Social Insurance

Per a news bulletin on the NC Industrial Commission’s website, the fourteenth annual North Carolina Workers’ Compensation Educational Conference will be held this year from October 7th through 9th at the Raleigh Convention Center on South Salisbury Street. According to the conference brochure, the purpose of the symposium is to “educate those who participate in the North Carolina workers’ compensation system regarding current rules, procedures, policies, and forms, and to provide an opportunity for dialogue among these participants.”

Various commissioners, attorneys, insurance representatives, and medical professionals will present, and individuals can attend specialized break out sessions during the conference. Registration fees range from $275.00 per person for registrants who pay before 08/15/09 to $350.00 per person after 09/15/09. The proceeds from the conference will be given to the International Workers’ Compensation Foundation, a non-for-profit group that assists with education and research. Certain individuals, such as attorneys, providers, and carriers may be able to collect continuing education credits for attending the conference. (Insurance adjusters may want to discuss any credit issues with the Department of Insurance, which can be reached at (919) 807 6800.)

The North Carolina Workers’ Compensation Education Conference generally boasts a diverse guest list, and discounted rates for groups are available. Attendees often include administrators, employers, HR professionals, attorneys, healthcare analysts and providers, and vocational therapists. This conference is a joint venture put together by the International Workers’ Compensation Foundation and the NC Industrial Commission.

More Web Resources

NC Industrial Commission

International Workers’ Compensation Foundation

Raleigh Convention Center

5. If you were hurt in a car accident on the way to or from work, can you make a workers’ compensation claim?

Answer: Depends on the circumstances. In some cases, it’s easy to make a case. (For instance, a pizza delivery person who gets into an auto accident on the way back from a delivery and suffers spinal cord damage can make a workers’ comp claim AND a claim against the driver who hit him.) Given situations like this, employers should keep their North Carolina workers’ compensation insurance premiums paid and up to date.

6. Can individuals or employers self-insure for workers’ compensation?

Answer: In many cases, yes. Self-employed workers and employers can often self-insure, provided they meet requirements stipulated by NC state law.

7. Can you claim NC workers’ compensation benefits even if your employer was not negligent?

Answer: Yes. Many potential claimants never file for workers’ comp because, in their minds, their employers didn’t “do anything wrong.” (For instance, if an employee crashed his car on the way to a work related event, the employer can hardly be blamed.) But a workers’ comp claim is not the same thing as a personal injury suit. If you’ve bee hurt at work, you can make a claim regardless of whether anyone was at fault. (That said, however, employees cannot generally sue their employers directly for benefits.)

8. How can you learn more about the North Carolina workers’ compensation process?

Answer: The North Carolina Industrial Commission website (www.ic.nc.gov) contains a wealth of information on the subject.

9. Do you need an attorney to collect workers’ comp benefits?

Answer: Not necessarily. However, in many cases, employees can get shortchanged. Insurance companies can use legal loopholes and other unsavory tactics to deny payouts to otherwise qualified claimants. In addition, sometimes employers don’t fully cooperate and even retaliate against workers who file claims. To protect yourself and ensure that you get the maximum remuneration for your pain, suffering, and medical bills, it may behoove you to connect with an experienced, aggressive North Carolina workers’ compensation attorney.

More Web Resources:

North Carolina Bar Association Pamphlet on Workers’ Compensation

NC Workers’ Compensation Law

North Carolina Industrial Commission

When most people think of accidents that merit North Carolina workers’ compensation coverage, they think of catastrophes, like the explosion at the North Carolina Slim Jim plant in June 2009. Acute injuries attract ample media coverage. But overuse injuries stemming from chronic ergonomic effects often don’t, even though they account for a significant slice of North Carolina workers’ compensation claims.

Overuse injuries, such as repetitive stress injuries (RSI), thoracic outlet syndrome (TOS), carpal tunnel syndrome (CTS), “blackberry” thumb, joint and soft tissue damage, and eye strain often take months or even years to develop. But once an employee suffers chronic damage, he or she may find it very difficult to regain functions, find good care, and get enough North Carolina workers’ compensation benefits to pay for medical costs.

Recovering workers often complain that physicians are too quick to prescribe cortisone injections, non-steroidal anti-inflammatory drugs (NSAIDs), and surgeries. At the same time, many doctors who specialize in treatment of these injuries seem not to pay attention enough to more holistic factors, such as trigger points, poor workstation ergonomics, bad posture, and lack of physical activity and work breaks. That’s why it’s so important for injured North Carolina workers to get the facts about soft tissue injuries and to explore their treatment options thoroughly before paying for expensive interventions or agreeing to surgeries that can have permanent negative consequences if they don’t go precisely as planned.

Third Body Found in Slim Jim Plant Explosion Rubble, FoxNews, June 10, 2009

On the Other “Hand”
Repetitive Overuse Injuries of the Hand & Wrist, Hughston Sports Medicine Foundation

More Web Resources
Ergonomic Tips

Thoracic Outlet Syndrome