North Carolina workers’ compensation fraud is a profound and seemingly indelible problem that saps much needed resources, degrades trust in the system, and leads to hardship and chaos for dependants. Why, then, do so many people continue to perpetrate this crime?

For example, let’s look just over the border to West Virginia, where last week, owners of an Apple Dumplin in Oak Glen, West VA, Keith McBride and Lois Ventura, got hit with three charges of workers’ comp fraud. Investigators with the workers’ compensation fraud prosecution unit tracked the couple since July. Here’s the scoop. The 51-year-old Ventura was hurt last August at her former job at Big Cheese Pizza. She collected workers’ comp benefits as a result of that claim. All good. But then, in violation of the benefits arrangement, she started running an Apple Dumplin with her boyfriend, Mr. McBride, and continued to “receive cash and medical benefits through the workers’ compensation program.”

When questioned about his girlfriend’s allegedly fraudulent activities, McBride “reportedly misrepresented the facts of the case by stating that he was the sole owner of the business and had no knowledge of the workers’ compensation benefits Ventura was receiving.” Not a good move. Now both Ventura and her boyfriend face counts. On November 3, at their arraignment, they both pled not guilty. A court date has been set for January 10.

Obviously, based simply on news reports, you should avoid leaping to judgment. Unless you probe the back story, evidence, and other relevant details, it’s probably wise to withhold “convicting people in your mind,” if only to hone your ability to see life objectively.

For the sake of a discussion, let’s assume the charges are correct. What lessons can we extract?

First of all, the story suggests that a significant number of North Carolina workers’ compensation fraud cases probably result from unplanned errors and inappropriate innovations. In other words, while some people plan workers’ comp fraud far in advance, many people simply “stumble into it” because fraud is easier and faster than operating ethically.

Often, people who are simply trying to “scrape by” come to believe that somehow they have been wronged by the system and that they “deserve” to break the rules.

The story also suggests that many workers’ comp beneficiaries do not receive enough training to understand the limits of what they can and cannot do. People might know that violating workers’ comp rules is somehow “wrong” in the abstract, but they may not know the specific punishments that are likely to meet them if they commit a crime.

For excellent guidance, no matter what your situation, connect immediately with a qualified and compassionate North Carolina workers’ compensation law firm.

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Apple Dumplin couple hit with workers’ comp fraud charges.

Whether you’re a prospective North Carolina workers’ compensation beneficiary, or the relative or friend of someone who was recently hurt or injured at work (e.g. hurt while doing construction outside of Raleigh or sickened by repetitive stress syndrome contracted while working at a bank in the Research Triangle), you want help with getting fair compensation, holding wrongdoers accountable, and making sure insurers play fair.

Tackling all of these issues is of paramount importance. However, you may also want to analyze the broader context and think about why workplace accidents and injuries happen every year in North Carolina and beyond.

Are workers simply careless and negligent? Are employers careless or negligent? Is the system structured in a way that creates opportunities for injury/illness?

Perhaps. Perhaps. And perhaps.

However, there may be a “hidden cause” lurking underneath many workers’ comp cases. It’s a cause that doesn’t place blame employees or employers or even the system. The problem is a fundamentally human one. It’s the problem of creeping complacency.

Let’s analyze this.

When a new employee finds a job, he or she tends to enter the arena cautiously. New employees are more likely to listen to a supervisor’s instructions, handle complex machinery with care, and avoid overly ambitious or dangerous working conditions, such as working while fatigued, working without supervision, ignoring the company’s safety policies, etc. Likewise, employers tent to “dote on” new employees, putting them through rigorous reviews, following them through intra-company educational processes, and firing workers who violate company norms.

Dial forward several years (or, in some cases, several months), and that caution vanishes, or at least diminishes. Lassitude develops. Workers are allowed – or even encouraged – to push their limits, to “bend or break the rules” to get more done in less time and for less money. For instance, a construction worker, who in his first three months of working on a job would never use a sophisticated and dangerous piece of equipment without help, might, by month eight on the job, use that piece of equipment by himself, late at night, and without paying attention.

Which worker is going to be safer: The attentive rookie or the over-confident veteran?

Of course, “the complacency problem” is not the only fundamental cause of workplace injuries or illnesses, but it is one that is not discussed enough.

For specific help with a benefits question, connect with a time-tested and trusted North Carolina workers’ compensation law firm.

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The cost of complacency

How we become careless

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.

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Small Positive Changes Really Add Up

Setbacks are More Common than You Think

As this North Carolina workers’ compensation blog has opined numerous times, when individuals or institutions perpetrate workers’ comp fraud – or any other kind of fraud – “downstream” effects on workers, employers, insurers, and governmental institutions can be profoundly damaging. Indeed, the North Carolina workers’ compensation system works, when it does, because various parties trust one another to act fairly and in good faith.

That’s why it’s so disturbing to read stories like a recent account from Tulsa, Oklahoma, where a local attorney pled guilty last week to embezzling more than $1 million from his clients and conspiring to commit workers’ comp fraud.

According to the Oklahoma Attorney General’s Office, 61-year old Fred Schraeder will receive a “five-year deferred sentence and will pay more than $36,000 in restitution, $500 in fines and a $100 victim’s compensation assessment… Schraeder must surrender his law license and isn’t eligible to reapply while on probation.”

Schraeder did not act alone. He apparently had an accomplice, William Anton, who was sentenced in August to pay over $700,000 in restitution and serve “four consecutive sentences totaling 35-years, with 25-years suspended.”

The Attorney General’s Office claims that Schraeder and Anton embezzled money from clients between 2004 and 2009. They stole from their “personal injury benefits, insurance settlements and workers’ compensation benefits.” Over 49 victims were identified by the Attorney General’s office.

This disturbing story highlights how important it is for sick and injured people to work with trustworthy North Carolina workers’ compensation law firms. Just because an attorney or a law firm boasts a pretty website and ostensibly credible qualifications does not mean that the team will be a “best fit” for you. Before you select your law firm, ask many questions, really research your prospective firms, and make sure you choose a firm that has a reputation for ethical behavior as well as for getting good results in complex cases similar to yours.

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Oklahoma attorney embezzles over $1 million dollars from clients

Charges filed against Schraeder and Anton

In the struggle to obtain North Carolina workers’ compensation, hurt and injured workers often think only one or two steps ahead.

So let’s think four or five steps ahead today.

What will happen once you recover from your injury or illness and return to work? What might the environment be like at work? What challenges might you face in terms of re-acclimating? What should you do if and when co-workers or superiors want to discuss your time off or even challenge whether or not you needed or deserved workers’ comp benefits in the first place?

These questions are all quite complicated to answer. But it is worth discussing strategies for how to avoid “weirdness” after you return to the office. Here are some suggestions:

• Prepare a spiel in advance to answer basic questions about why you went on workers’ comp, what it was like, and how you recovered and got back to work. This might sound silly, but you may want to actually practice this spiel at home with a spouse or a friend. This way, you will have a quick, snappy answer that will ward off unwanted questions and staunch nosey gossip.

• Don’t expect to “normalize” everything on day one. Expect that there will be an adjustment period. Even if you did not go on an extensive North Carolina workers’ compensation leave, and you never had to fight with your employer over your treatment, it’s totally normal to feel disoriented and a bit out of sorts during your first days and weeks back on the job. So provide yourself a break.

• Understand what you can and cannot say about your workers’ compensation agreement. This is critical. Depending on the terms of the settlement, you may not want to disclose certain aspects of your care or talk about the terms with co-workers or superiors. Consult with your North Carolina workers’ compensation law firm before returning to your job to make sure you understand the do’s and don’ts.

• If it’s too weird for you to stay at your job, even after you’ve spent some time and energy and resources trying to re-acclimate, consider switching companies or even changing careers. Understand your skill set, needs, and utility, and recognize that you are never “stuck” at your job. You can always harness new ways of thinking, outside resources, and vocational training to “begin again” or make lateral career moves.

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Returning to work after a long absence

How to tell if your co-workers are jealous

Current law allows only human workers to collect benefits through the North Carolina workers’ compensation system. And perhaps that is fair and just. After all, although our nation’s cats, dogs, hamsters and fish take a fair amount of abuse – especially from curious toddlers – most of these furry friends (or scaly friends or feathered friends or what have you) do not get hurt while actively engaged productive labor.

However, there are exceptions. For instance:

• Firehouse dogs.

What happens to an adorable spotted Dalmatian who tags along with his fire crew and then one day gets caught in a ladder during a rescue operation and loses the ability to wag that adorable little tail forever more?

• Bomb and drug sniffing dogs.

These highly trained pooches spend their time identifying booby traps, drug mules, nefarious packages, and the like. They can easily find themselves in work-related situations that lead to injury. For instance, one can only speculate on the fate of a bomb sniffing dog who identifies a ticking piece of luggage “too late” to do anything about the “ticking.”

• Show tigers.

Most Americans are familiar with the horrific big cat attack that ended the long renowned Vegas act of Siegfried and Roy. While most news analyses of the Siegfried and Roy disaster focused on the agony the trainer endured, one can imagine that the big cat also suffered in the incident. If so, should the cat be entitled to compensation for the injuries and trauma he suffered on the job?

Of course, this post is meant to be facetious. It is not meant to belittle the cause of North Carolina Workers’ Compensation. And animals hurt “in the line of duty” often do have terrific care options at their disposal, including money for bills and the like.

On the flip side, hurt workers are often treated in “less than humane” ways by employers, insurance companies, and the workers’ comp bureaucracy.

Workers’ comp, philosophically at least, is about much more than dry issues like monetary compensation and regulations. It’s about fundamental human rights.

For help with a specific legal question, connect with a North Carolina workers’ compensation law firm.

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What happens to a firedog injured on the job?

The Siegfried and Roy Disaster

Maybe you’ve been on North Carolina Workers’ Compensation for months or years as you work feverishly to heal your life, your finances, your body, and your stamina. Or maybe you are only exploring workers’ comp options. At some point, most likely, you will have to face the “end of the line” as far as your benefits are concerned.

Whether you consider this “fair” or not – whether you have legal means to fight the end of your benefits or not – you need to make adjustments to your lifestyle, budgeting, and possibly career path to accommodate the transition. Make no mistake: the transition can be quite difficult. You’ve gotten used to a certain way of living, a certain way of thinking about your income, and certain habits and expectations. Even if you’ve known that the “dry up” was coming for months or years, you can only prepare so much in the abstract.

When the reality hits – when you stop getting checks — you must make due with far less money. You may panic and potentially even make bad or dangerous decisions that can imperil your body, your recovery, or worse. Indeed, financial panic often drives uninformed, desperate people to commit crimes like North Carolina Workers’ Compensation fraud – crimes that can be prosecuted as felonies and lead to substantial prison time as well as the catastrophic destruction of your professional life.

The process of weaning yourself off benefits does not have to be agonizing, however. The more planning you can do, the better. And don’t simply focus on “planning your finances.” Focus on the psychological preparation. Understand that you will need some time to adjust to your new reality and to accommodate for the stresses of the transition. Maybe set aside some “special treats” for yourself during the transition. For instance, plan an inexpensive vacation (e.g. camping trips in the woods or meditation retreat) or spend some time with your family or close friends – a so-called “staycation.” Or give yourself permission to indulge in a treat, like a fun meal out, or fancy new gadgets from Apple or your other favorite tech product purveyor. (Obviously, don’t spend beyond your means when you get these “treats”.)

All that said, the doom and gloom you are feeling maybe a bit premature. Investigate your resources by connecting with a compassionate, skilled and thorough North Carolina workers’ compensation law firm.

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After Your Benefits “Dry Up”

Transitioning to Life with a Reduced Income Stream

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.

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The serenity prayer

A rising tide lifts all ships

Brace yourself. You are about to discover a powerful tool to tackle challenges with your North Carolina workers’ compensation issues… and many other issues you confront in your life, relationships, finances, you name it.

Drum roll please … the solution is: You need to write down your problems and what you want to do about them, and then review what you have written repeatedly, every day, every night, and keep this up for months.

That’s it.

That might sound overly simplistic. Possibly you’ve tried keeping journals, writing down affirmations, etc., in the past, and you weren’t particularly impressed by the experience. But research in diverse fields shows that repeated visualization and affirmations can powerfully change the way people think. When you read self-help books, productivity guides, and scientific research on productivity, you repeatedly encounter this advice: Your thoughts affect the dynamics of your life and your potential for success or failure.

Thus, if you make a purposeful, committed, repeated effort to alter how you think, the issues that you have with North Carolina workers’ compensation benefits or other problems may resolve themselves.

There is no magic involved. Rather, when you prime your subconscious and unconscious with repeated affirmations about a certain goal that you want to achieve or mental state you want to feel, your subconscious/unconscious takes the hint.

This may sound like hokum. But if you’ve never tried doing visualization, consider giving it a shot. Think of the most frustrating, annoying, scary problem you have right now regarding your workers’ compensation. Write it down on a piece of paper – be as specific as possible. For instance, maybe you’re stressed out about how your employer has treated you. You are angry and annoyed. You expected more after all of your years of service.

Now, write down how you would like this circumstance to be resolved in an ideal world. Maybe you might write something like: “I have made peace with my employer, settled on compassionate, fair terms, and moved on with my life in a way that’s untainted and unscarred by what happened to me.”

Next thing to do is to look at that “ideal outcome statement” every morning and every night and to do that for several weeks or several months. Obviously, doing this won’t necessarily change anything. But it might change how you approach resources, challenges, and opportunities.

Of course, having said all that, there is no replacement for a powerful, skilled, and strategic North Carolina workers’ compensation law firm to help you get the results you need.

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The Importance of Writing Things Down

Outcome Visualization

Policy wonks and ethicists in the North Carolina workers’ compensation community have been riveted by a case unfolding in nearby Waynesboro, Pennsylvania. Allegedly, a local police officer there stole over $22,000 workers’ comp checks over an eight-month period (from September 7, 2009 to May 3, 2010). The officer, Derrick Lange, hurt himself in an August 2009 foot pursuit and had to see a hand specialist for ongoing pain in his hand and wrist. After a specialist advised him to stay off of work after surgery, Lange began collecting workers’ comp payouts. But Lange later made an agreement that allowed him to collect his regular salary as long as he turned over the worker comp checks that he had collected.

Apparently, the 31-year-old officer ignored the terms of arrangement and actually deposited the checks into his bank account. Eventually, the insurance company that represents the Waynesboro Municipality caught on and alerted local authorities, who arrested Lange on Tuesday, September 7th and held him on a $15,000 bail. A September 21st preliminary hearing has been scheduled. Lange faces charges of theft by failure to deposit the funds that he received.

As this case illustrates nicely, abuses of the North Carolina workers’ compensation system can take many forms and can be years in the making. Individuals who defraud the system or cheat insurance companies or lie about their injuries can not only suffer grievous legal consequences – including having money stripped away from them and having to serve jail time (in some cases) – but they also endanger the efficacy of the entire system. For instance, an act of fraud has a “ricochet effect” throughout the system: insurers tend to trust claimants less and so they subject them to more bureaucracy and more invasive follow up. When money gets siphoned out of the system, employers and insurers try to make up those costs by doing things like cutting benefits, jacking up rates, and scrimping on service to save.

All this is to say that, if you or someone you care about wants to pursue a claim, make sure that you “dot all the Is and cross all the Ts” and that you stay away from anything even vaguely resembling illicit or unethical action. All that said, just because you play fair doesn’t mean that your employer or a responsible insurance company will play fair with you. To that end, if you are having trouble with any aspect of your claim, connect with a competent and battle proven North Carolina workers’ compensation law firm to develop a strategy to get the compensation due to you efficiently and quickly.

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The saga of Derrick Lange

Waynesboro police officer Derek Lange arrested for theft after allegedly stealing more than $22,000 in worker’s compensation checks

Contrary to the stereotypes that some people have about hurt and sick people on North Carolina workers’ compensation – that these people are lazy, indolent, and disinterested in returning to work – most beneficiaries usually fantasize about how and when they can return to complete and productive lives. Very few people want to sit around at home, click around the internet, and work without a plan for getting back to some kind of productive, satisfying work.

Indeed, work is a deep human need.

To that end, many injured workers actually stress themselves too fast and do too much too soon. In a two-part series, we are going to look at why workers do this, what problems result from this “too aggressive” approach to rehab, and talk about solutions that you and your family can deploy to prevent the “too much too soon” problem and still maximize the efficiency of your efforts toward rebuilding your life after a workplace accident.

First, let’s talk a little bit more about what exactly this problem is:

Warning Signs

Are you at risk for “too much too soon”? Whether you are a newly minted North Carolina workers’ compensation beneficiary, or you got hurt or sick on the job years ago, you might be at risk of pushing your mind and/or body too hard if:

• You and your family face urgent financial problems;
• You have a “Type A” personality;
• You love your work and can’t wait to return to it;
• There has been an urgent need for physical labor around the house – e.g. your family desperately wants to repair a room damaged by a branch fallen down during a hurricane;
• You have a history of pushing yourself too hard in other areas of your life, such as at work and in relationships.

Consequences

Pushing yourself too hard can result in aggravation of your injury or illness or reinjury. It can lengthen the time that you are out on leave. It can create new injuries or illnesses. It can result in other accidents. For instance, if you are too weak to paint your house, but you decide to paint it anyways, you probably stand a greater likelihood of getting hurt while doing so – falling off the ladder, suffering heat stroke, etc.

Solutions

In the next blog post, we will talk more about practical, creative, out-of-the-box solutions for the “too much too soon” problem. But for now if you have questions or concerns about your benefits and about how to maximize the law and protect yourself from malevolent insurance companies and bosses who won’t play fair, connect with an astute, experienced North Carolina workers’ compensation law firm.

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Too Much, Too Soon

Why we push ourselves

The fight to qualify for, collect, and utilize North Carolina workers’ compensation benefits to pay for your post accident/injury expenses can be dreary, annoying, drawn out, and full of ups and downs.

This holds true even if you have a high-caliber North Carolina workers’ compensation law firm on your side, fighting to protect your rights. But what if, after your case seems resolved, you still don’t have enough money – even after the workers’ comp is incorporated into your budget – to pay for the bare necessities? What options do you have?

Obviously, you might want to talk to your law firm about getting more benefits, extending your existing benefits, or searching for other social service programs to fill the gaps. But you also should consider other strategies and tactics to either lower your expenses or pump in new income in a way that doesn’t violate the terms of your North Carolina workers’ compensation arrangement.

You can find gazillions of articles online about how to penny pinch, coupon clip, and otherwise tighten the belt on your home budget. So we won’t ramble on about that.

But you might be surprised by the different ways you can reboot your productivity by tapping into latent talents, skills, and passions. For instance, say you spent 22 years working a difficult welding job outside of Raleigh. One day, a piece of equipment malfunctioned and gave you severe burns, lacerations, and few broken bones. In short, now you can’t – or you won’t – go back to your old welding job. So now what?

Well, let’s think. Maybe you’ve always had a passion for NASCAR. You’ve been a huge NASCAR fan, you know all the great drivers’ names and stats, you obsess over events, take your family hundreds of miles to see the big races, etcetera. If so, you might explore how to turn that passion – and your deep knowledge of the sport – into a money-making venture that could yield a second or third income stream for your family.

Of course, if you do enter into a business venture, be sure that it’s allowed by your workers’ comp arrangement. Otherwise, you can get into trouble for workers’ comp fraud – and that can lead to a revocation of benefits and other punishments, like jail time.

But assuming you do this correctly, you might be surprised at how many of your secret passions, hobbies, and skills you can leverage to rebuild not just your sense of excitement and joy about the world, but also your financial possibilities. We will talk more about the nuts and bolts of how to do this in our next workers’ comp post…

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Tighten Your Budget

Rediscover Your Passions

On August 26, 48-year-old Nicki Lee Buxmann of Sacramento was sentenced to jail for federal workers’ comp fraud. Our North Carolina workers’ compensation analysts react…

According to an article in the Sacramento Bee, Buxmann allegedly suffered injuries while working the United States Postal Service and obtained workers’ comp benefits from the Department of Labor.

While she collected those benefits, Buxmann owned and operated the TNT Takeover/MMA Boxing gym in Roseville, California. This was in violation of her sworn statements that she was not working and earning no income. When news of Buxmann’s alleged workers’ comp violations reached federal overseers, the inspector general of the USPS launched an investigation. According to the Sacramento Bee, “An undercover agent caught Buxmann teaching defensive tactics techniques, replacing light bulbs, cleaning windows, and sweeping exercise mats.” U.S. District Judge Garland E. Burrell, Jr., sentenced her to five months in prison, 36 months of supervised release, and restitution of nearly $105,000.

When someone like Buxmann defrauds the North Carolina workers’ compensation system, everyone in the system loses. Workers’ comp works only when all the players involved – including government entities, insurers, employers, and employees – trust that the system is fair and equitable. Plus, when $105,000 “disappears” from workers’ comp coffers, that money must be compensated for. Typically, the money lost through fraud is replenished by increased taxes, higher insurance premiums, and so on.

Of course, individuals who are hurt often want to get back to work quickly. The question is: Will taking another form of income replacement violate the terms of your workers’ comp? There is no way to answer that in the abstract. That’s why it’s so important to get good legal advice. A North Carolina workers’ compensation law firm will help you understand all you can (and cannot) do to supplement your income, get back to work quickly, and generally augment your career, your injury/illness notwithstanding.

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Nicki Lee Buxmann fraud

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.

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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.

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Resilence

Self-reliance

A workplace accident – such as an inhalation injury at a chemical/industrial plant or a chronic debilitating myofascial injury from typing too much at your white collar job – has compelled you to seek North Carolina workers’ compensation to pay for damages, lost past and future wages, rehabilitation, and myriad other bills. On this blog, we talk a lot about the logistics – the physical, external forces that influence your ability to collect North Carolina workers’ compensation benefits and maximize utility of those benefits. But we also need to cover the possible psychological traumas that can hurt injured workers. And one of those is fixating on the accident or incident that led to your injury/illness.

You’ve likely relived the painful memory dozens if not hundreds of times, and the memory has an enormously powerful emotional charge associated with it. Perhaps you fell off a ladder while painting a condominium, for instance. Now, at night, you dream about climbing a ladder, or maybe something metaphorically similar, like a mountain, and then losing your grip and falling. Maybe you were in a car accident while delivering goods for your employer, and the tape that accident regularly replace in your mind every time you get behind the wheel.

First of all, acknowledging that trauma exist is a huge part of the battle. You can’t fight what you can’t see or acknowledge. Second of all, recognize that time often heals psychological wounds like this – but not always, and that’s an important caveat. Third, a battery of therapies might be useful for dealing with it, including psychotherapy, hypnotherapy, meditation, cognitive behavioral therapy, and so forth. Educate yourself and connect with a therapist you can trust to help you rebuild your psychological immune system.

Lastly, psychological trauma can be worsened, or even directly caused by, instability and uncertainty in your life. To that end, take mind your p’s and q’s by connecting with an experienced North Carolina workers’ compensation law firm.

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Reliving the accident

myofasical trauma

The dog days of August are upon us, and, according to an analysis of Travelers Insurance Claims Data, North Carolina workers’ compensation claims at small businesses are peaking.

According to a blog post at InsuranceNewsNet.com, travelers found that, from June through September, “workers’ comp claims peak – approximately one-third of all injuries involve workers under 30 years old.” Common claims include “lower back strains and other back-related injuries and injuries from slips, trips and falls.”

This is the 100-year anniversary of the very first workers’ comp insurance policy ever written, according to Travelers, and maybe now is an appropriate time to reflect on how far the entitlement system has come, as well as on the challenges that the North Carolina workers’ compensation community faces.

One way forward is to zero-in on trends like the ones highlighted in the Travelers report. For instance, if we know that small businesses face a spike in claims during the hot summer months, then maybe we can figure out precisely what is going on during those summer months that makes workers vulnerable.

Are the workers getting too hot and thus endangering themselves due to heat stroke, delirium, or dehydration? If so, that might suggest that a policy for helping workers cool off could make a big difference. Or maybe it’s the type of jobs being done during the summer months. Construction, engineering, remodeling, and so forth might spike during the summer months. Thus, the problem may simply be related to the type of work being done as opposed to heat-specific problems causing degradation of worker performance.

This may seem like an insignificant point.

But we need this kind of analytical thinking to make progress with workers’ compensation reform. What are the root causes of waste in the system? What are the root causes of worker injuries and illnesses? The answers may not be obvious. We may not be able to glean them easily from reports, statistical analyses, or even from meta analyses of claims data.

Good science in any field is notoriously hard to conduct. And well-intentioned policies based on bad science can redound to horrific effect. For instance, if we look at the Travelers data and make the assumption that heat was the problem [instead of the proliferation of dangerous jobs (e.g. construction jobs)], then our policy solutions would not address the problem. We might tell workers to take more breaks, drink more fluids, and stay in air-conditioning more. But we would not address the primary cause (too many dangerous jobs being done), and thus wouldn’t make a dent in the numbers.

Philosophizing aside, if you or someone you care about has a specific, serious question regarding your benefits, a fight with an insurance company, or a battle with an employer, a North Carolina workers’ compensation law firm can help you figure what to do, how to do it, and when to do it.

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“approximately one-third of all injuries involve workers under 30 years old.”

Correlation vs. Causation

On August 8, the Illinois workers’ compensation system metabolized a minor reform. The changes to IL law come on the heels of the North Carolina workers’ compensation system’s major transformation, which this blog reported about at length earlier in the summer.

According to an InsuranceJournal.com article, the new IL law was sparked by a single horrific news story.

If you remember a few months ago, we talked about the case of former Illinois State Trooper Matt Mitchell, who sped at more than 100 miles per hour – while talking on a cell phone, no less! – soared through a median strip, hit another car, and killed two teenage girls. Mitchell was charged with reckless homicide, but he got off with just 30 months of probation thanks to a deal with prosecutors.

That alone galled some Illinois residents. But Mitchell then claimed workers’ comp for his injuries. The arbitrator who later denied Mitchell’s claim concluded that he “took substantial and unjustifiable risk resulting in a gross deviation in the standard of care of his duty as an Illinois State Trooper.” The arbitrator also highlighted the fact that Mitchell was driving at a high speed and might have been writing emails on his car computer as well as taking personal phone calls right before the accident happened.

So the reformation to Illinois workers’ comp law is narrow and is essentially just meant to stop cases like Mitchell’s from ever again even being considered. Here is how InsuranceJournal.com summarized the measure: “[the measure] would prevent any state employer hurt at work from being eligible for workers’ compensation if the injury happened during a forcible felony, an aggravated DUI, or reckless homicide, and if any of those crimes killed or injured another person.”

Governor Pat Quinn emphasized that the law would ensure that “workers’ compensation benefits go only to those who deserve them.”

The changes to Illinois system are essentially closing a loophole, whereas the changes to the North Carolina workers’ compensation system are more systemic and designed to control costs and help businesses (and, to a lesser extent, injured workers) get a fair deal.

Securing benefits is complicated enough. If you are hurt or sick, you don’t have time to track all of the North Carolina legislature’s activities. Fortunately, you don’t have to pay attention to the minutia. By turning to a trusted, compassionate, aggressive North Carolina workers’ compensation law firm, you can make smarter decisions, protect your rights, and ensure that you get the benefits you and your family need.

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former Illinois State Trooper Matt Mitchell – quest for comp

No Workers’ Comp Benefits For People Convicted Of Crime

On Monday, a woman named Michelle McKee was sentenced to 2 years in prison for defrauding the Colorado workers’ comp system out of $25,000. North Carolina workers’ compensation experts and analysts are closely following the story, as it may have relevance to in-state cases. According to a local news report, McKee had been working as a housekeeper at a hotel, when she hurt her ankle. Although she claimed the injury was work related, an insurance investigation found that McKee had been bragging to friends about cheating the workers’ comp system. She also allegedly admitted to hurting herself not while at work but while out partying (she twisted her ankle after stepping off a curb). The state’s senior assistant Attorney General convinced the court that Ms. McKee had made false statements to collect money – a felony charge. In addition to her 2-year jail sentence, Ms. McKee now faces $25,000 in forced restitution to her old employer, Pinnacol Assurance.

As this blog has often discussed, North Carolina workers’ compensation fraud matters create tensions throughout the system and ultimately harm all major players involved: insurance companies, employers, legislators, and genuinely injured employees. It’s this latter category that is most vulnerable – subsequent to fraud cases like this one, legitimately hurt workers will likely have a harder time in Colorado collecting benefits without hassle. When insurance companies and employers grow suspicious of claimants, they tend to require higher burdens of proof and conduct longer investigations as to the veracity of claims.

If you’ve been the victim of undue harassment, frustration, or non-compliance by your employer or your employer’s insurance company, it may behoove you to seek out the counsel of a North Carolina workers’ compensation attorney to figure out how to resolve your situation adequately, get the benefits you want, and get these issues off your mind so you can focus on recovering and fixing your financial circumstances.

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Michelle McKee

Colorado workers’ comp system

Many North Carolina workers’ compensation beneficiaries (or people who want workers’ comp money) labor under a variety of painful and generally destructive delusions. Let’s dig into some of those, rip them apart, and talk about how to approach your struggles more productively.

Delusion #1. Believing that your North Carolina workers’ compensation benefits will “fix” everything.

Obviously, maximizing your compensation gives you more leverage and resources. And if you’re in pain, unable to work, and saddled with serious bills and costs to take care of your family, you want to open up your options. But the resources you have are actually in some ways less important than the resourcefulness you demonstrate.

Learning better problem-solving costs nothing but can redound to a hugely positive effect. In other words, regardless of whether you collect a lot of money or less than you thought, you can leverage that money to better effect if you think more clearly about what you want to achieve with that money. (If that makes sense.)

Delusion #2. The best you can hope for is to “make it back” to where you were before you got hurt or injured.

This delusion is an absolute killer because it de-motivates victims and makes them feel disempowered and unresourceful. In fact, many famous business leaders emerged from bankruptcy to become tycoons. So, too, can many hurt and “down and out” workers emerge to become better, healthier, wealthier, and happier than they were before they got injured. It’s all a matter of frame of reference. If yours is tilted towards the negative, change it, ASAP.

Delusion #3. You injury/illness will permanently make you “less happy.”

If you’ve recently been hurt or made sick at work, you may feel like your life has changed dramatically, for the worse. And it might have, objectively speaking. But in terms of your happiness, don’t jump to conclusions. As researcher Daniel Gilbert notes in his book, Stumbling on Happiness, our levels of happiness do not necessarily correspond with objective circumstances. You can be on top of the world – a multibillionaire – and miserable. Likewise, you can be about to be decapitated at a guillotine and feel wonderful about your life.

The faster you retain good help from a North Carolina workers’ compensation law firm, and the sooner you do so, the easier it will be to maximize your recovery and to feel better and secure in your path to healing.

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Stumbling on Happiness

Life gets better and better…

If you’re a worker who needs North Carolina workers’ compensation benefits to pay for a painful carpal tunnel surgery, injury rehab, or even extensive and expensive surgical bills, you’re probably only looking one or two steps down the road.

You’re probably thinking along the lines of…

• How can I maximize my benefits?
• How can I prevent my employer from treating me unfairly?
• How can I compel an insurance company to “play fair?”
• How can I better understand my obligations under North Carolina law? Etc

These are all crucial questions to ask – and obviously a qualified North Carolina workers’ compensation law firm can help you figure them out. But deeper issues might be at play. And deeper questions may need to be asked, if you really want to recover completely from your injury or illness, get back into the workforce, and put the painful incident or accident behind you for good.

Let’s say you suffered a terrible typing injury at work. Maybe you worked as a receptionist for some bank located in the Research Triangle in Raleigh, for example. You might casually assume that the cause of your stress was all of the typing you did. And you might be right – but perhaps only partially. It might be that there are some other factors – such as dietary influences (too much sugar, vitamin deficiency of some kind, etc), postural stressors or back alignment issues, etc.

And if you fail to address those fundamental problems, you will never recover full function. And even if you do recover some function and return to work, you will likely continue to stress and hurt yourself — even if you take steps towards reducing the amount of typing you do. In other words, if the primary stimulators of pain and illness remain entrenched, then your solutions won’t work well, or they won’t work for long.

So how do you tap into these bigger and deeper solutions? First off, expand your thinking. Get multiple opinions about your injury and accident – and look at the problem from many different angles. Talk to people who have had similar problems. And experiment – obviously under the direction of your doctor – with various processes and methods and tools to treat your issues and prevent them from coming back.

Educated patients – educated workers’ comp clients – tend to recover faster and easier, even when the odds are stacked against them.

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too much sugar?

educated patients do better

A Nevada Supreme Court ruling on July 15th has rippled across the nation and grabbed the attention of analysts and pundits in the North Carolina workers’ compensation community. The NV Supreme Court ruled that a North Las Vegas correctional officer is not entitled to collect workers’ comp benefits. It’s a relatively “run of the mill” story…at least on the surface.

First, the details.

Jacqueline Phillips hurt herself in 2005 – ostensibly because she lifted heavy boxes at her job. Her claim was denied.

In September 2007, Phillips again filed for workers’ comp, this time because she claimed that she hurt herself pulling an inmate from a squad car into a holding cell. A quote from the Las Vegas Sun article describes what happened to her: “On September 22, 2007, she said she was injured on the job while transferring the inmate. She initially told her doctor this was an aggravation of the injury suffered in 2005. She told a second physician her symptoms began on September 30, or eight days after the reported incident. The city denied her claim. She was then treated by a third doctor whom she told her symptoms began on September 22.”

The court ruled that the doctors who treated Phillips did not link the injury with the event that happened on September 22. In other words, despite Phillips’ word that she had been hurt, neither the doctors nor the courts believed her – or least believed her to the point that they allowed her to start collecting benefits.

So this case might not have been particularly noteworthy, and it’s not like the mainstream media is engaging in a feeding frenzy about it. It’s no Casey Anthony. But it does hold important lessons for potential North Carolina workers’ compensation claimants. Specifically, it suggests that your word alone may not be enough.

In other words, YOU may believe that you got hurt on the job. But it takes more than subjective opinion to win a benefits case. Unfortunately, many claimants make errors of judgment, give inaccurate statements, and wait too long to get help from legal professionals. As a result of flailing and delaying, they may further injure their chances of being able to win a claim.

An experienced North Carolina workers’ compensation law firm can help you identify: A, whether or not you have a case against an insurer, employer, or other institution and B, help you figure out a “best path,” strategically speaking, to get the compensation in the shortest, easiest way.

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Nevada Supreme Court ruling on Phillips

Casey Anthony case

Congress’ investigative arm, the Government Accountability Office (GAO), wants to clamp down on North Carolina workers’ compensation fraud (and workers’ comp fraud throughout the country). According to the official GAO website, the government is seeking information about beneficiaries secretly working second jobs, overstating claims, or collecting money owed to a deceased worker.

In fiscal year 2009, the U.S. Office of Workers’ Compensation Programs paid more than a quarter of a million workers over $4.1 billion (disbursed through four programs) for workplace injuries and illnesses. Many of these workers resided in North Carolina. (To be more specific, only $2.73 billion was spent on federal workers or their survivors, per the GAO’s report.)

It’s nice to see the government trying to clamp down on North Carolina workers’ compensation fraud, since systemic abuse doesn’t just hurt “faceless” corporate entities and government agencies with big pockets. Fraud “pays forward” throughout the system and creates mistrust, frustration, gridlock, friction, and bureaucracy.

When insurers and employers become more suspicious of beneficiaries’ intentions and actions, they throw up more roadblocks to prevent getting scammed. Inevitably, legitimate claims get held up in the dragnet. What’s the most appropriate response to this kind of abuse? Should scam artists, schemers, and those who aid and abet workers’ comp fraud be punished harshly?

Perhaps a better solution would be to disincentivize fraud through some non-punitive way. A broad and deep analysis of typical workers’ comp fraud crimes, for instance, might reveal certain patterns of behavior and typical perpetrator motivations. Policy analysts could then work towards solving would-be perpetrators’ problems in advance to prevent them from turning to the dark side and seeking to exploit vulnerabilities in the system.

If you or someone you care about needs help with a benefits issue, a reliable, honest, and aggressive North Carolina workers’ compensation law firm can help you move forward.

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Government Accountability Office (GAO)

Fraud “pays forward” throughout the system

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

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

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

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

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

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

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

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

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

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

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NC house sets up final vote on workers’ comp bill

Representative Paul Leubke

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

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

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

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

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

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

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Curt Hagman

Section 3600

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

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

The responses to his editorial reveal a complex debate.

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

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

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

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

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

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North Carolina Senate passes workers compensation reform bill

Pine Hall Brick Company

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

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

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

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

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

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

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

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North Carolina House Bill 709

Dismantling the Rights of Workers

Whether you’ve recently been injured, and you need to collect North Carolina workers’ compensation benefits – or you’re a healthy individual who’s concerned with the North Carolina’s fiscal state, you want to stamp out workers’ comp fraud. When someone – or some company or institution – steals money from the North Carolina workers’ compensation system, you suffer, and the state in general suffers.

Often, the indirect effects are the most insidious.

Breaking news out of Ohio illustrates the seriousness of this crime. According to woio.com – an action news team based out of Ohio – On April 29th, a man named Luiz Paneto pled guilty to a fourth degree felony for defrauding the Ohio workers’ comp system. Paneto was ordered to pay over $24,000 in restitution and nearly $20,000 in investigative costs.

In 2001, Paneto got hurt at work while performing a general contracting service. Shortly thereafter, he began to collect living maintenance and temporary total disability benefits. In 2007, he was granted permanent total disability.

In 2009, however, the Ohio Bureau of Workers Compensation’s Special Investigations Department received a tip off that Paneto had been doing home remodeling and labor – the same heavy work that he had being doing prior to his 2001 injury.

Per www.woio.com: “[the special investigations department] conducted surveillance and Paneto was seen walking, lifting heavy construction materials, driving his truck, and performing work as a home remodeler… in April 2010 [he] admitted to working in violation of his receipt of BWC benefits.”

Now look: $43,000 is not a tremendous amount of money, especially when you consider the millions of dollars that flow through the North Carolina workers’ compensation system every year.

But every case of fraud essentially pokes holes in people’s trust in the system. Stopping fraud is more than about simply preventing funds from being siphoned off. When fraud happens, suspicion ratchets up, and the system degrades.

If you or someone you care about has been dealing with a benefits issue – or an uncooperative insurer or employer – leverage the resources of a North Carolina workers’ compensation firm today to get results.

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Luiz Paneto fraud

Tensions mounted this week as the debate over potential North Carolina workers’ compensation reforms stoked passions on both sides.

An April 21st article in the Huffington Post quoted the President of North Carolina’s AFL-CIO, James Andrew, about the proposed reforms: “We believe there is a number of provisions being proposed that would hurt workers… [changes to make it more difficult for hurt workers to change physicians and the redefinition of what might constitute suitable employment] would require workers to take Wal-Mart type jobs in an effort to quickly return to work.”

The Post also quotes Ray Evans, the North Carolina Rate Bureau’s current Director, who did his best to cool the tensions between labor groups and business groups over the proposed North Carolina workers’ compensation reforms. Evans said “in this legislative environment, it’s difficult to separate the anecdotal evidence from what we consider more factual evidence… we hear all the time about people on disability out playing golf or basketball. We don’t know if that’s urban legend.”

As this blog reported last year, the Workers Compensation Research Institute (WCRI) found that our state’s workers’ comp costs were one of the highest in a group of 15 different states analyzed. Advocates of the Republican sponsored reforms point to this and other related indicators as signs that something must be done – now – to help to us regain fiscal control.

Meanwhile, as the debate rages in the state capital, hurt and injured workers – and their families – are anxiously awaiting the passage (or not) of the bill.

How will passage affect them, personally?

If you or someone you care about has been hurt, will you no longer be able to change doctors as easily, if you want to? Will you be forced to go back to work earlier than you thought? Will your workers’ comp benefits be cut off sooner than you had expected them to be?

These and other uncertainties may be plaguing you. Fortunately, you don’t have to go through this battle alone. A North Carolina workers’ compensation law firm can review your situation and help you understand how/if the changes to the law might impact you.

Part of what is so distressing about proposed reforms is that employers and employees alike are stuck in this state of transition. When you are in limbo, it is difficult to plan. Hopefully, this limbo won’t last too much longer, and we will get some resolution either way about the law, so hurt and injured workers and their families can take practical, proactive steps to protect their rights and their benefits.

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Workers Compensation Research Institute (WCRI)

President of North Carolina’s AFL-CIO, James Andrew

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

Experts who study North Carolina workers’ compensation issues are constantly trying to puzzle out why accidents, injuries, and illnesses happen at work and how these catastrophes can be prevented. The thinking is, if policy analysts can suss out the root causes, we can collectively reduce injury rates and sickness rates everywhere from the Research Triangle to the far West of NC.

So what ARE the major root causes of workplace related injuries and illnesses, and can they be effectively treated with smart policy?

Typically, we focus on improving safety of equipment and machinery; limiting number of hours worked (too many hours leads to fatigue and worker error); boosting worker education (poor training leads to safety catastrophes); and limiting repetitive work (repetitive labor leads to soft tissue injuries, like carpal tunnel syndrome).

But sometimes it helps to think out “outside the box” and look at other potential root causes of worker pain. According to a very provocative article in the April 19 issue of the New York Times magazine, the sugary snacks and beverages in your local office vending machine may be causing far more problems than you, your employers, and most North Carolina workers’ compensation experts realize. Taking his cue from pediatric obesity specialist Robert Lustig, science writer Gary Taubes argues that refined sugars – particularly sugars taken in liquid form (such as the Cokes and Pepsis in your local vending machine – as well as the fruit juices) may be making many, many people not only overweight but also sick.

What Lustig says is that, when you eat sugars – particularly when you drink them – your liver gets essentially biochemically “punched” and injured. Fatty deposits form in the liver, and this process may stimulate a condition known as insulin resistance, which appears to be the common denominator in many diseases of civilization, including obesity, diabetes and heart disease as well as many types of cancer.

If this supposition is correct, that means that one (albeit indirect) way to seriously reform our entitlement system is to get people to stop eating so many sugary snacks – particularly sugary beverages. Even a slight decrease in our sugar consumption might lead to a collective boost in our national health and lend some genuine relief to over stressed and under supplied healthcare providers.

On a more personal note, if you or a family member or someone at work is struggling with benefits issues, a North Carolina workers’ compensation law firm can provide the essential services you want and deserve.

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Is Sugar Toxic?

Lustig’s YouTube video

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

This North Carolina workers’ compensation blog recently covered an amazing political dog fight out of Washington state. Today, we’re going to touch on something happening closer by – in Kansas. KS Governor Sam Brownback just signed a bill rewriting the state’s workers’ comp laws – these new laws will go into effect on May 15th. At a ceremony for the bill on April 18th, Brownback and the backers of this revamp – which passed both the Kansas Senate and House without opposition – celebrated the reforms as an effective compromise between the interests of labor and businesses.

Employers won a few key battles. It will now be more difficult for employees to get comp if they hurt themselves at work while under the influence of alcohol or drugs. Also, injured employers will not get benefits if they got hurt or sick prior to employment. This is obviously fair. If you hurt your hands working an assembly line job and then switched over to become a high school guidance counselor, it would make zero sense to hold your new school to account for the hard-labor-related damage to your hands.

Workers did get some concessions, however. The families of workers who die on the job will now receive $300,000.00 (instead of $250,000.00), and comp for permanent injuries will also rise.

How and when will the North Carolina workers’ compensation system be revamped?

Will all the reforming going on in places like Kansas and Washington impact local politics, even peripherally? Hard to say. But it’s clear that getting comp costs under control is a big priority. With budgets tightening and the national debt swelling, you can be sure that business leaders and politicos will be focusing more and more on how to save and cut corners. This is good, at least in the abstract.

The key is to make sure that hurt and injured workers rights stay protected – and that the systematic problems that are causing or exacerbating our budgetary crisis get addressed through rational policy and good science.

Do you or someone you care about need help from a North Carolina workers’ compensation law firm? Even if you think you’ve got your benefits issues all under control, it may be useful to speak with experienced legal representatives.

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KS Governor Sam Brownback

Kansas workers’ comp bill

The Monday before last, a federal judge in the Southern District of New York issued a ruling that spurred intense discussion among North Carolina workers’ compensation experts and sports fans around the nation. Judge Paul Crotty issued an injunction requiring NFL owners and teams to stop “seeking to reduce the workers’ compensation benefits due to former NFL players as a result of injuries they suffered while playing the game.”

The NFL Players Association celebrated the legal victory – this battle between the NFLPA and the owners has been raging since 2005. Essentially, management wants to claim “dollar for dollar” offsets to workers’ comp awards paid out to men like Steve Arvy, David Alexander, Charles Smith, Michael Swift, and Dusty Renfro. The Players Association, on the other hand says that owners and teams should only be allowed “limited offsets.”

Although the NFLPA won a decisive arbitration ruling in 2007, the teams and owners essentially ignored this decision. Thus, the NFLPA leveled a lawsuit in 2008 to compel the owners to stop trying to wriggle out of their workers’ comp obligations. In 2009, the court ruled in favor of the NFLPA. But again the teams and owners proved recalcitrant. Let’s see what happens now that a federal judge has weighed in on the matter again on the side of the players.

When most people think of North Carolina workers’ compensation claimants, they picture injured, helpless, and perhaps weak and lazy people, struggling to collect from the state. Obviously, the NFL Players Association does not exactly team with “weak and lazy” individuals – it’s hard to imagine any individuals less weak and less lazy than NFL players.

But in this case, even the strongest and fittest of these players ran into serious problems trying to collect much needed (and legally obliged) compensation.

It’s hard enough to overcome negative stereotypes; it’s harder still to fight back against massive institutions, like insurance companies and corporations, while you are sick and struggling to make ends meet and recover from your injuries or illnesses.

Fortunately, there is a way to level the playing field. A North Carolina workers’ compensation law firm can equip you with the resources, tools, and knowledge you need not only to compel recalcitrant parties (such as the company you work for or the insurance company handling your claim) to treat you fairly and justly, but also to find a strategic way to return to health and reduce some of the agitation and anxiety you’re currently feeling.

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NFL Players Association celebrate their legal victory

Judge Paul Crotty’s injunction

Although Japan’s nuclear scientists and workers have managed to prevent a massive meltdown, many commentators – including high profile bloggers and pundits in the North Carolina workers’ compensation community and elsewhere – have practically torn out their hair worrying about the effects that radiation contamination might have on the people of beleaguered Japan.

Obviously, the three-tiered trauma that Japan recently endured – earthquake, tsunami, nuclear plant disaster – is intense and horrific, and the international community should be doing everything in its power to prevent further loss of life and help Japan out with the reconstruction.

All that said, are we worrying a bit too much about Japan’s nuclear plants? Recently, Fox decided to stop airing reruns of a famous Simpsons’ episode in which Homer and company face off against a nuclear disaster at the Springfield Nuclear Plant. The decision to pull the episode was blessed by former showrunner Al Jean – obviously, this was done out of desire to treat Japan with respect.

But is this a case of making a mountain out of a molehill? After all, the nuclear plants withstood colossal damage, and no meltdowns or severe radiation leaks (a la Chernobyl) are occurring or will occur, according to a variety of reliable sources – experts in nuclear physics.

Moreover, workers in other industries in Japan – railroad, automotive, industrial, et cetera — have no doubt suffered terribly during the clean up. We’re not saying that repairing a damaged nuclear plant is not dangerous. But workers laboring in these other industries – non-nuclear related – won’t likely elicit a rush of international sympathy when they come down with tuberculosis from stepping on rusty nails while cleaning up leveled landfills.

Truth be told, disaster recovery and repair is messy. It’s brutal, and it’s dangerous. And it’s our collective obligation to ensure that we neither “over blow” the dangers nor “under prepare” for them.

The bottom line is: injured and sick workers all need lots of help, good information, and sympathy and compassion. A focused North Carolina workers’ compensation law firm can help you understand not only how to collect all the benefits that you should be owed but also how to maximize your use of those benefits to recover and get back to work at your earliest convenience.

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Fox pulls Simpsons episode out of respect for Japan
Is danger to Japanese nuclear plant workers overblown?

Last year, this North Carolina workers’ compensation blog reported one of the most astounding stories in recent workers’ comp history. The case involved Brock Hopkins, a man mauled by grizzly bears at a park in Montana (Great Bear Adventures). Hopkins was stoned on marijuana, when he fed the bear that mauled him. The Montana Supreme Court last Tuesday ruled that Hopkins should be entitled to workers’ comp from the park, despite acting “mindbogglingly stupid” that fateful day when the perturbed grizzly (“Red”) severely injured the toker.

Initially, Hopkins’ bid for compensation was denied. Russ Kilpatrick, the owner of Grizzly Great Bear Adventures, claimed that Hopkins was not an employee of the park – even though he did pay Hopkins a stipend. Kilpatrick also told the young man in no uncertain terms that he should NOT feed the bears.

Nevertheless, the Montana Supreme Court overturned a lower court’s ruling in a unanimous decision – stating that grizzly bears are “equal opportunity maulers.” Thus, the fact that Hopkins was high on marijuana was not relevant. The court also found that Hopkins had been acting in the capacity of an employee of the park; ergo, he should get the compensation.

This case seems like a Scooby Doo adventure gone horribly wrong. But Hopkins’ claim to comp is not as absurd as some of his detractors have suggested.

North Carolina workers’ compensation is a “grand bargain” between employers and employees. The system evolved during the early 1900s to distinguished workers’ comp from lawsuit-related compensation. Injured workers gave up rights to sue in exchange for the right to be able to collect compensation without having to prove “fault.”

So, while Great Bear Adventures was not at fault in this case; since Hopkins was an “employee” of the park at the time of his mauling, he should get the compensation, despite his outrageously reckless behavior.

Most workers’ comp stories are not laughing matters. Many situations can be terrifically tragic, particularly for victims who suffer a double insult when an insurance company denies a rightful claim. Get help with your North Carolina workers’ compensation issues by connecting with a quality, experienced legal team to assert your rights and get the benefits you and your family need.

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Great Bear Adventures

Kilpatrick also told the young man in no uncertain terms that he should NOT feed the bears

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

A lot of what we discuss here on this blog pertains to constructive ideas for how to repair the North Carolina workers’ compensation system and help employers, employees, insurance companies, and the state understand one another’s positions and deal with problems like adults. But what if, instead of thinking constructively, we took the opposite tack for a minute – thought of ways to cause the North Carolina workers’ compensation system to spiral even MORE out of control?

Here are three ways to make everyone’s life harder and more frustrating…

1. Encourage employees to work harder and longer… and to spend WAY more time on the computer.

Could there be a better recipe for breaking the system than encouraging blue collar and white collars workers alike to spend more time online, more time on their cell phones and more time at the office? We’re clearly not “wired up” enough; so why not encourage our workers to spend more hours squinting at computer screens, staying late at the office, and generally working themselves to the bone? It will generate more revenue in the short term, right? And isn’t the short-term the only thing that counts?

2. Escalate ad hominem attacks and expand the “blame game.”

The last five or six years has seen the advent of an explosively close-minded political climate. Political figures and “average Joe’s” alike tend to find niche media that support their views. They only listen to the ideas and concerns of their in-group.

In other words… if you’re an insurance company, you’ll hang out with other people who like insurance companies. If you’re an employee, you’ll only listen to what other employees and labor groups say. If you’re a small business owner, you’ll only confab with small business owners.

Let’s make these distinctions clearer and shriller. Spread the blame around. Get louder and more political. Get more ad hominem. Even if this won’t directly skyrocket workers’ comp costs and cause the drag on the system, it will at least shred everyone’s temper and reduce the chance of compromise in the future.

3. Make things more complicated!

Let’s add more bureaucracy to the system. Longer wait times, more forms, more paperwork for employers, more paperwork for employees, more paperwork for insurance companies, and more paperwork for government bureaucrats.

Let’s make the rules and regulations governing NC workers’ comp more difficult to understand; and let’s change those rules at arbitrary intervals, so that no one has time or energy to catch up.

That ought to do it. That ought to seriously impede any progress we might be able to make towards making the system fair and more functional.

All snarkiness and kidding aside, if you’re caught up in the middle of a North Carolina workers’ compensation battle with a corporation, insurance company, or other entity, you may feel beleaguered and helpless. Fortunately, a variety of surprising resources may be available to help you get the benefits that you need and deserve. A high-quality North Carolina workers’ compensation law firm can deliver results and vastly simplify your benefits-related crisis.

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Time on the computer is costly

How to make things more complicated than they need to be

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

While many North Carolina workers’ compensation blogs focus specifically on breaking stories in state, this blog likes to take time occasionally to report on stories from around the nation (and sometimes from around the world) that concern NC workers, employers, insurance agents, and other key players in the system.

On March 21st, The Hartford Courant reported on the poignant story of Stephanie Laurin, who was engaged to a man killed at a Manchester, Connecticut beer distributing company last year by an enraged coworker. Eight people died in the shooting, which made national headlines.

William Ackerman, Laurin’s fiancé, had been receiving $500 per week in workers’ comp. Now, Laurin wants to collect that money. But the Hartford distributor and its insurer has denied Laurin’s claim because she was not technically a family member… even though she was engaged to Ackerman for four years. The key legal question here is: can Laurin be considered a “dependent” or not? According to The Hartford Courant, experts believe that Laurin’s case may wind up before the Connecticut Supreme Court.

If she wins (or loses), therefore, it won’t directly impact the North Carolina workers’ compensation system. But you can be assured that legal experts, lawyers, judges, and policy analysts will be watching the situation carefully. The fact is, the law is constantly redefining the scope, mission, and function of workers’ compensation. Who should be entitled to benefits, for how long, under what circumstances, and for what conditions? Who should pay for those benefits? What constitutes a fair and reasonable response to workplace tragedies?

These and other questions consume the minds of policy makers, judges, and legal experts – there is no “one size fits all” solution to them. Indeed, the answers change dynamically from year to year based on things like political fads, economic constraints, injury rates, and probably dozens of other factors that may be very difficult to measure.

One lesson here is that it’s dangerous to draw sweeping conclusions about the “fairness” or “unfairness” of this system based on one news story or even one piece of legislation. The system is complicated. Even if all key players involved had the best of intentions, occasionally “unfair” situations will arise. For instance, in this case, perhaps, morally speaking, Laurin should qualify as a dependent. But maybe the court will say no because saying “fine” would open the door to legal chaos. Is this fair or not? The answer is obviously up for debate. But the fairness or unfairness of the resolution of Laurin’s quandary should not necessarily reflect positively or negatively on the Connecticut workers’ comp system as a whole.

These complicated argument aside… many people out there have specific and direct questions about their benefits that they need answered now. For instance, maybe you’re dealing with an unfair insurance company or a boss who won’t listen to your concerns or a physician doesn’t believe that you are hurt.

If you need any help, look to a North Carolina workers’ compensation law firm with lots of experience and the wherewithal to deliver good results.

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Manchester, Connecticut beer distributing company shooting

Stephanie Laurin’s struggle

Experts in the field of North Carolina workers’ compensation spend a lot of time ruminating about how to identify and stamp out fraud. When parties bilk the system out of money, not only do the costs ultimately get passed on to insurers, employers and employees who need benefits, but the bonds of trust that hold the system together also weaken.

To that point, the Ohio Bureau for Workers’ Compensation has its hands full dealing with a case of workers’ comp fraud out of Butler County. A chiropractor pled guilty last week to fraud and agreed to pay $104,000 in restitution payments as well as $5,000 to cover the cost of the investigation. Dr. Gary Berner took the plea deal to stop an impending trial. His Back and Spine Center had been at the center of a probe. Dr. Berner and three other employees of the Back and Spine Center faced multiple charges, including workers comp fraud, forgery (32 counts), theft, and racketeering. The other three employees have already been convicted of workers’ comp fraud – Dr. Berner’s trial will start up on March 29th. Dr. Berner, along with his partner, Dr. Bruce Holaday, allegedly developed a scheme to bill for services even after being banned to provide said services to hurt workers.

Obviously, in cases like this, unless you read the investigation very carefully and examine all the arguments that both sides make, you can’t really come to a clear determination. For instance, did the chiropractor and his co-workers harm their patients, or did they simple bend the rules in a relatively benign way? Hard to tell from a simple news account.

All that said, there is a “broken windows” aspect to consider. The “broken windows” theory of crime management suggests that, when a city, store, or other place winds up in disarray (e.g., lots of broken windows, trash on the floor, etc,) it becomes easier for people to “misbehave” and commit criminal acts. Likewise, when chiropractors get away with committing forgery, fraud, and theft, other doctors – who might be “on the fence” about whether to commit fraud or not – may take the plunge and commit illegal actions. Thus, as a precaution, it may be useful to severely punish those who skirt the law.

This debate aside, what’s important to remember is that the workers’ comp system should help injured workers heal and support them and their families. If you are having difficulties navigating the North Carolina workers’ compensation system, you don’t have to keep plugging away on your own.

Connect with a reputable and skilled North Carolina workers’ compensation law firm to go over potential solutions today.

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“Broken Windows” theory

Dr. Gary Berner workers’ comp case

One of the most talked about North Carolina workers’ compensation stories has come to a resolution that’s been widely celebrated. As this blog reported several months ago, an ex Illinois state trooper, Matt Mitchell, had sought workers’ comp benefits in Illinois for injuries he sustained in a Thanksgiving 2007 crash that left two young women dead. Last Friday, an arbitrator rejected Mitchell’s quest for benefits — in no uncertain terms.

Mitchell’s driving had been egregious by any standard. He had been travelling at 126 miles per hour (!) when he zipped across the median strip on I-64 and killed the girls. As arbitrator Jennifer Teague wrote, the officer “simultaneously drove at speeds in excess of 120 miles per hour on a highway replete with holiday traffic, wrote e-mails on his car computer, and took a personal call lasting almost 4 minutes long… [what he did created] a substantial and unjustifiable risk resulting in a gross deviation in the standard care in his duties as an Illinois state trooper… his conduct was egregiously outside the scope of employment.”

When Mitchell first sought workers’ comp benefits for the accident, unsurprisingly, his act elicited a chorus of angry rebukes — even from parties normally sympathetic to workers’ comp plaintiffs.

The fact is, when claimants make outrageous claims for benefits, all parties in the system suffer. Imagine you’re a hurt worker in Illinois. You tell a friend that you need workers’ comp to pay your family’s bills. Ordinarily, your friend might be sympathetic. But then say in his mind he associates you with this trooper who killed two girls and then begged the state for benefits. He might not be so inclined to see your claim in a positive light!

This is just one of the many challenges that people seeking North Carolina workers’ compensation benefits face. If you need assistance with your matter, get in touch with a reputable North Carolina workers’ compensation law firm at your earliest convenience to avoid making mistakes and to protect your rights as potential claimant.

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Matt Mitchell verdict

http://nl.newsbank.com/nl-search/we/Archives?p_multi=NWRB&p_product=SHNP8&p_theme=shnp8&p_action=search&p_maxdocs=200&p_field_label-0=title&p_text_label-0=Trooper%20hurt%20in%20deadly%20crash%20denied%20workers%27%20comp&s_dispstring=headline%28Trooper%20hurt%20in%20deadly%20crash%20denied%20workers%27%20comp%29&xcal_numdocs=20&p_perpage=10&p_sort=YMD_date:D&xcal_useweights=noInfo on the Thanksgiving 2007 crash

Contrary to the stereotype of the average North Carolina workers’ compensation claimant as indolent and needy, most hurt and sick workers desperately want to get back to their jobs and produce and provide for their families. Unfortunately, when you go on benefits – even temporarily – you may find yourself subjected to negative messages not only from employers and co-workers but also from friends, family, and even yourself.

Finding internal resources to empathize with your pain can help you respond to critics and heal faster and better. Let’s look at some strategies to help you metabolize the toxic messages that you brew internally (or that you receive from outside sources) as you attempt to navigate the maze of North Carolina workers’ compensation and pull yourself back to health.

1. Use mindfulness meditation

For thousands of years, spiritual leaders from all religious traditions, including Buddhism, Hinduism, Christianity, Islam, Judaism, Taoism, etc, have used meditation and prayer to absorb and metabolize negative thoughts. Essentially, the goal is to clear your mind of thoughts, using an object or focus. In one kind of Buddhist meditation, for instance, you sit and focus on the breath for an extended period of time – allowing thoughts, judgments, and feelings to “pass you by” as you engage in the exercise. The goal is not to relax – rather it’s to become alert to the present moment. By doing this over time, you develop a heartier emotional immune system and can thus deal with anger and frustration easier.

2. Take positive action

When you are on a workers’ comp – whether you are laid up and can’t move or hobbled by a bad knee – it’s easy to feel worthless. To combat those feelings, get engaged with something positive that’s going to push you towards some other big goal in your life. For instance, if you always wanted to become a master amateur chef, now might be the time to rent a bunch of instructional cooking videos (or get them for free online) and sharpen your culinary skills.

3. Understand your feelings and needs behind anxiety and agitation

The world is inert. People say things and do things, but our emotional reactions to them form in our own brains. When we really listen to what’s going on inside our head – essentially slow down our internal monologue – we can learn a lot about why we feel the way we do about certain comments and reactions. By studying our thinking, using, for instance, tools like Non-Violent Communication – which we discussed in another blog post – you can hopefully develop better self empathy.

4. Get a legal help, if you need it

A battle-proven North Carolina workers’ compensation law firm can provide key legal resources.

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About Self-Empathy

Non-Violent Communication

Most injured and sick workers who need to file for North Carolina workers’ compensation benefits describe themselves with words like “put upon,” “mistreated,” and so forth. A common theme is victimization. Larger, uncaring, powerful forces – such as employers, insurance companies, and even groups like the North Carolina Industrial Commission – either “have it out” for them personally or simply lack the compassion to give good care.

These feelings are totally understandable. Hurt workers often lack the resources, language and training to express their feelings and needs in a way that drives best results. This blog post will hopefully give you some ideas about how to approach your frustration with your North Carolina workers’ compensation issues more resourcefully.

Identifying Feelings and Needs

A PhD named Marshall Rosenberg developed an alternative way of communicating feelings and needs that he termed Non-Violent Communication, or (NVC). Don’t let the name fool you. When Dr. Rosenberg uses “non-violence,” he is not suggesting that we all become pushovers and let unfair employers walk all over us. Rather, he uses the term in the way that Gandhi intended it – as a more constructive, “win-win” a way of looking at the world. He suggests we view “negative” communications from others as “tragic expressions of unmet needs.” Essentially, when an employer mistreats you or misapprehends your claim, what he (or she) is really saying beneath the blame and contempt is something along the lines of “My needs for X are not getting met.” You use the NVC translation technique to tune into the employer’s feelings and needs and thereby get what you want faster and easier.

The NVC process is complex and extremely counterintuitive. You can learn more at the official website for Nonviolent Communications. But essentially the process involves four steps.

1. First, you identify an action in the real world and try to describe this action in objective language.

For instance, if an employer has not responded to your claim in 30-days, you don’t say “hey, you idiot, why haven’t you responded to my paper work??” You simply note the reality: “I submitted this claim 30-days ago, and I haven’t yet heard the response.”

2. The next step is describing how you feel.

This is your emotional reaction – don’t ascribe your emotions to the other person. Own them. In other words, you don’t want to say “you make me angry.” Rather, you want to say: “when I saw (observation) I felt (emotion, such as angry, frustrated, etc).”

3. Third, you identify your “unmet needs” that come up for you.

For instance, in our example, your unmet need might be for reassurance that your claim will be processed fairly and on time.

4. Lastly, you make an explicit request of the person using positive language – something that the person can do in real time.

For instance, you might ask your employer “will you please dispatch the paperwork within the next 2 days?”

There is a lot more to the NVC model, but this form of counterintuitive (and clunky at first) communication offers lots of interesting and exciting possibilities for open and resourceful engagement with others.

If you or someone you care about needs assistance with difficult employer conduct, a caring North Carolina workers’ compensation law firm can help.

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Dr. Marshall Rosenberg

More on NVC

The experts who audit, debate, and refine the North Carolina workers’ compensation system spend a tremendous amount of time identifying the system’s inefficiencies. To maximize efficacy and minimize drag on the system as a whole, experts aim to identify:

• how insurance companies might be overcharging employers;
• how employers might be inadequately training their workers;
• how workers might not be engaging in proper safety, rehabilitation, self-care;
• etc

In this blog post, we will explore a novel approach to improving the North Carolina workers’ compensation system. This approach involves improving communication across all elements of the system, so that the feelings and needs of relevant parties get heard more clearly.

First principles: it’s clear that the participants in the system often feel like they are in opposition with one another. Employers strive to “protect” themselves from high premiums and workers who inflate their disability claims. Employees, on the other hand, “fight for every penny” and stay on guard to make sure that their employers and insurers treat them fairly. Insurance companies, meanwhile, watch their bottom lines. And the state strives to ensure order and fairness in the system.

So most people see these forces in opposition. But there may be another way of looking at our problems – a way suggested by Marshall Rosenberg, creator of the idea of “Nonviolent Communication.” According to Rosenberg, most individuals communicate in a violent language that he’s termed “jackal.” Most people – and most institutions – spend a great deal of time analyzing, judging, and labeling others. In Marshall’s alternative paradigm – what he calls “Giraffe” talk – the goal is not to see parties in opposition but rather to see them as each having feelings and needs. Once these feelings and needs get surfaced, it’s easy to find so-called “win-win” solutions. In other words, an employer and her employee may believe that they stand in opposition. But maybe that’s just because the employee doesn’t understand his employer’s feelings and needs. And vice versa. If both parties could only spend some time talking in the “giraffe” idiom, perhaps they could understand each other better and work together to develop more effective solutions.

In an event, employees who need help with their benefits claims often get confused about how to deal with recalcitrant or uncooperative insurers, employers, and other parties. A consultation with a proven North Carolina workers’ compensation law firm may help you significantly.

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Non-Violent Communication

Jackal vs. Giraffe

Many North Carolina workers’ compensation news stories involve subtle and arcane discussions about insurance rates, employment policy, and the state’s fiscal strategy. This blog wanted to take some time out to examine two more “down to earth” stories that should hopefully pique your interest and stir up discussion.

1. First on the docket: crazy workers’ comp fraud case.

On February 23rd, the Louisiana Workforce Commission reported an arrest for workers’ comp fraud. The owner of Streamline Framing Incorporated, Richard H. Woodle, allegedly engaged in “willful misrepresentations by an employer and unlawful practices” and was hit with felony charges. A local news outlet reported that the business owner made false reports to his workers’ comp insurer for three years to get out of paying his workers’ comp premiums. By lying to his insurer, “it is estimated that Woodle avoided paying hundreds of thousands of dollars in premiums.” The man could face a decade behind bars for felony workers’ comp fraud.

2. Story No. 2: KFC retaliation.

A KFC worker claims that his employers retaliated against him for filing for workers’ comp.

Most North Carolina workers’ compensation claims (and claims from other states) involve straightforward scenarios. An office worker gets carpel tunnel syndrome and then seeks benefits to pay for her hand surgery, for instance. Or a hurt dockworker struggles with an insurance company to get fair payment for his disability.

An Illinois worker at a KFC has filed suit in Madison County Circuit Court, alleging that his employers fired him for filing a claim. Michael Franklin managed a KFC on Johnson Road for more than 8 years. Last January, he reported an injury to his employer and made a claim pursuant to the Illinois Workers’ Compensation Act. 11 months later, his employer fired him. Franklin wants Morgan Foods to pay him $100,000 for compensatory and punitive damages.

If you or someone you love has been engaged in a fractious dispute with an employer or insurance company over your benefits or another workplace issue, it may behoove you to get a free consultation from a reputable North Carolina workers’ compensation law firm.

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Streamline Framing Incorporated workers’ comp fraud

KFC retaliation case

Last week, the Workers’ Compensation Research Institute (WCRI) released a study that found that North Carolina workers’ compensation costs were the highest per claim among 16 states. The WCRI report offers sobering news… but can it really be trusted?

Not according to the North Carolina Advocates for Justice (NCAJ). CEO Dick Taylor put out a scathing statement about the WCRI report, calling it “an unfortunate example of insurance companies and corporations seeking government subsidies by shifting their expenses to tax payers… WCRI is funded by insurances and big corporations and routinely issues reports that support “reforms” that would increase their contributors’ profits.”

The NCAJ rebuttal says that the WCRI charge about payment per claims being too high in NC just doesn’t hold water. North Carolina workers’ compensation “doesn’t cover many injuries sustained in normal work routine. North Carolina has fewer claims… and they are far more severe injuries. Naturally, our average payment per claim is higher.”

The NCAJ rebuttal also points out that the North Carolina workers’ compensation system tends to deliver good value per dollar spent… and at a relatively low cost to employers. NCAJ officials worry that corporate and insurance company interests may be tempted to leverage this WCRI study to slice into benefits for hurt workers. Indeed, business advocates are currently lobbying the North Carolina General Assembly to cut off workers’ comp benefits after 500 weeks. Such a proposal may not be popular – even with conservatives. According to an October poll conducted by Public Policy Polling (PPP), the idea of cutting off workers’ comp for hurt workers after 500 weeks is opposed by more than three quarters of liberals and 60% of conservatives.

The fracas over the WCRI report and the NCAJ counterclaims also illustrates a major problem when it comes to formulating public policy. Given enough “torturing” of any data, it can be pretty easy to support your point and/or refute your opponent’s point. For instance, the conclusions you draw may depend on how you look at trends. So it’s incredibly important that policymakers look to multiple perspectives before doing things like enacting major changes to legislation or cutting off benefits to large groups of people.

If someone you care about has been struggling with benefits, a North Carolina workers’ compensation law firm can be a tremendous ally in your battle to get fair payments and hold your employer and that employer’s insurer totally accountable.

More Web Resources

WCRI Report

NCAJ Rebuttal

Earlier this week, NC Governor Beverly Perdue spoke at length to 100 members of North Carolina’s AFL-CIO about North Carolina worker’s compensation and other critical issues. Gov. Perdue sounded a battle-ready tone as she defended her record of freezing spending, eliminating positions in the state government, stripping benefits programs, and making other Spartan accommodations to jumpstart the state’s economy and attract new businesses to town.

Governor Perdue and the AFL-CIO have been lobbying hard to prevent corporate and insurance interests from enacting legislation that would end North Carolina workers’ compensation benefits for injured workers after 500 weeks. The Governor said: “the AFL-CIO really understands what’s at stake…our future is at stake. Every decision that will take resources away from your child and my child’s public school is a bad decision.”

According to an AP report, North Carolina’s union membership is just 3% – around four times smaller than the national average.

Whether or not business interests enact changes to the North Carolina worker’s compensation system, the governor’s battle with the newly GOP-dominated state legislature seems poised to create political sparks. The Governor seems more than willing to put on her boxing gloves, if her spirited 20 minute speech to the union offers an indication of her fight-readiness.

Benefits issues make for good political theater, but hurt and sick workers care little for these battles over the system. They merely want to get maximum assistance for their injuries/disabilities and get on a path to getting back to work as quickly as possible.

If you or a family member needs help compelling an employer or insurer to provide benefits, consult immediately with a skilled North Carolina workers’ compensation law firm.

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NC Governor Beverly Perdue

Gov Perdue addresses AFL-CIO

While this blog attempts to discuss mainly “consumer friendly” information about North Carolina workers’ compensation, sometimes we turn our attention to technical – even abstruse and obscure – stories to “kick the tires” on important issues.

In that vein… a very interesting (in a subtle way) news story broke out of Jefferson City Missouri last week. The MO Attorney General, Chris Koster, finalized an arrangement with two companies that had violated MO’s workers’ comp laws. Both Specialty Risk Services, LLC (a Connecticut-based company) and Broadspire Services, Inc. (a Georgia company) were called to task for failing to file reports on behalf of companies that reported injured workers.

According to Missouri law, worker related accidents must be reported to the Missouri Division of Workers’ Compensation within 30 days. Both SRS and Broadspire on many different occasions failed to report injuries by this deadline. The settlement amount was relatively small. Certainly, you can find examples of North Carolina workers’ compensation settlements that don’t make the news that involve much more money. SRS had to pay out $75,000 to Missouri; Broadspire had to pay just $28,500. Also, per the arrangement negotiated by Koster, both companies agreed to having violated Missouri law and agreed to prevent recurrence of violations and stay in compliance for at least two years.

So it’s a small story. And it’s definitely (and, rightly) been buried in the popular press.

But the story hints at something much bigger.

Perhaps a not-insignificant slice of the inefficiencies in the North Carolina workers’ compensation system might be due to the negligence and carelessness of third-party intermediaries. Why is this interesting? Because workers’ comp experts focus nearly exclusively on insurance companies, business owners, employees, and relevant government agencies. They almost certainly don’t bring enough scrutiny to bear on intermediaries like SRS and Broadspire.

This isn’t to say these companies are necessarily bad. Rather, it’s to say that the network of players who impact the NC workers’ comp system may be both broader and deeper than the experts realize. And that means that opportunities for system waste are broader and deeper; and opportunities for powerful corrective actions that can redound to the entire system’s benefit are also possibly more abundant than we realize!

This very technical argument is probably beyond the scope of injured or ill workers who simply want help. If you need assistance to get an employer to pay out benefits, compel an insurance company to treat you fairly, or untangle the red tape that’s wrapped around your claim, get in touch with a responsible, reliable North Carolina workers’ compensation law firm.

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A-G Reaches Settlement Over Worker’s Comp Violations

Broadspire

This blog (and other media outlets, both in the mainstream and in the blogosphere) recently reported on a heart breaking North Carolina workers’ compensation case involving a middle school principal in Robeson County who was shot point blank in the face while driving to school.

Principal James Hunt miraculously survived the shooting. And he has managed to recover physically, despite having to undergo 9 facial reconstruction surgeries. But his battle to collect North Carolina workers’ compensation benefits from the Robeson School District and the North Carolina Department of Public Instruction is perhaps as frustrating as – or even more frustrating than – the ongoing search to find out who pulled the trigger that fateful morning.

As this blog reported several months ago, Hunt won his case. But now the school system has appealed the verdict. According to a WMBF News report, “in the meantime… [Hunt] is living on just 50% of his old salary and what his wife makes as a school secretary.” WMBF reports that: “Hunt… [believes] that since he was on his way to work and was conducting business on his cell phone at the time he was shot, he deserves payment for all the costs his health insurance isn’t picking up.”

It has been established that Hunt was on his cell phone — on school business — when the shooting occurred. And he was also on his way to work.

Hunt’s travails showcase the maddening and senseless complexities that frustrate many workers’ comp claimants.

Here’s another example: remember our blog’s report from several months ago about the woman who slipped and fell on a parking lot while walking to her office? Her employer fought her workers’ comp benefits, even though she fell just inches away from the door to her workplace! Had she crossed the threshold and then fell, she wouldn’t have had any problem.

What’s especially frustrating in cases like Principal Hunt’s is the revelation that institutions built to support employees can abandon them during the time of their greatest need. Principal Hunt got shot because he took a courageous stand against gangs, according to analysts at the North Carolina Industrial Commission. But after the shooting, instead of trying to do right by the principal, his employer fought his workers’ comp case at every step along the way.

Fortunately, if you or a family member or a close friend got injured or sick at work, you don’t have to battle your employer (or your employer’s insurance company) on your own. Talk to qualified experts at a North Carolina workers compensation law firm to review your best next steps.

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Principal Hunt’s story

Website devoted to finding the shooter

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.

More Web Resources:

North Carolina Industrial Commission (NCIC) website

going back to work “too soon”

Few industrious workers dream of spending months or years out on North Carolina workers’ compensation, earning less than they had been earning and struggling to break through the red tape put up by employers and insurance companies. That said, workers often pay surprisingly little attention to easy preventative measures that could drastically reduce their likelihood of going on workers’ comp. Here is a primer on common mistakes and how to avoid them.

1. Fail to Take Breaks

Do you sit for 10 hours a day at a computer and type or do work on the web? Do you work at an industrial facility and engage in repetitive motions? The longer you perform an activity, and the more repetitious that activity is, the more likely you will be to get hurt from that activity. Even mousing on your computer too much can distort your musculoskeletal system, cause inflammation, and force you to compensate in awkward and potentially dangerous ways.

In addition to getting better ergonomic equipment and more variation in your job, make sure to take breaks. Don’t expect to take them automatically. Use a computer program (or app on your phone) to remind you to take breaks every 15 minutes or 30 minutes.

2. Fail to Review Safety Information

Imagine your first day on an assembly line job where you deal with hot liquids, giant pieces of machinery, and huge blades slicing through things. Chances are, you will pay a lot of attention to your supervisor as she walks you through safety tips and procedures. Now cut to eight months later. You come in for a standard, typical day – in the same dangerous setting. Do you think eight months into your job, you will be as respectful of the machinery as you were on Day One? Probably not. The machines are just as dangerous, though!

To prevent getting lulled into a “disrespect” of workplace dangers, set a calendar reminder to review safety procedures and protocols. Make your safety reminders as vivid as you can so they’ll stick in your mind.

3. Give into a “Culture of Danger”

Human beings are notoriously susceptible to social influences. If you work at an office where every employee cleans up, adheres rigorously to safety protocols, and logs all mistakes, chances are that you will take those actions too. On the other hand, if you work in a place where employees slack off and ignore glaring problems, chances are that you will ignore problems too.

There is a way to combat this tendency. First off, if you are a supervisor or owner of a company, be on the alert for “slacking off” and take immediate measures to stop it. If you work at a place where employees disrespect workplace dangers, consciously strive to “break” from this culture of danger and follow safe and proper conduct. It takes a tremendous amount of effort to go against the grain in a workplace culture, so it’s easier to have management work on this for you. But if you can’t make headway, at least start with yourself and see if you can’t recruit a few other likeminded individuals to join you in creating a culture that’s more safety conscious.

To get efficient help with your claim, contact a North Carolina workers’ compensation law firm. Whether your employer is withholding benefits or the responsible insurance company is holding up your benefits in red tape, a good attorney team can make an enormous difference.

More Web Resources:

Culture of Carelessness at work

power of social influences

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

Last Wednesday, the Montana House of Representatives passed a piece of legislation barring illegal immigrants from being able to collect workers’ comp benefits – the measure has set off a vigorous debate among North Carolina workers’ compensation and illegal immigration analysts.

Here’s what’s going on and why:

The Montana Legislature is gearing up to “fight” illegal immigration and the negative consequence of this immigration. In addition to HB 71, which bars illegals from collecting workers’ comp, Montana lawmakers will likely vote soon on a bill that will require driver’s license applicants to verify their immigration status through a Federal database.

Last Wednesday’s 69 to 31 vote in favor of HB 71 was hailed by supporters, who believe the law will curtail workers’ comp costs and disincentivize employers from hiring illegal immigrants. Opponents, however, argue that hurt workers will now be forced to use hospital emergency services; the costs of their care will be passed down to consumers and insurers. They also argue that businesses which hire illegal immigrants – even accidentally – can now be penalized with serious lawsuits – suits big enough to destroy companies. A Republican from Sydney, Representative Walter McNutt, remarked: “It might only be four cases, but it could put an employer out of business… think hard before you vote for this. You may not be doing the best thing you can for the business people and employers of the state.”

The Court of Appeals in the District of Columbia (DC) recently voted to overturn a similar measure that said employers did not have to provide workers’ comp for illegal immigrants.

If you or a coworker or relative faces difficulties collecting from an employer or an insurance company, get good, reasoned assistance as early as you can in the process. Talk to a North Carolina workers’ compensation law firm about what you can and should do to make the process faster, simpler, and more economical.

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HB 71

Bill to deny workers’ comp to illegal immigrants clears House

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

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.

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O’Tonious Raynor’s story

Cherry Hospital

Many in the North Carolina workers’ compensation community have spent some serious time looking over the $1.5 million settlement award handed out to prison guards at Menard Correctional Center in Illinois. In case you haven’t been following the news, this massive case has drawn attention throughout the nation not just because of its size but also because it represents (to some pundits) an example of systematic waste.

55 workers – most of them guards – will collect between $22,000 and $120,000 to pay for damages stemming from chronic hand, wrist, and elbow injuries they sustained while locking and unlocking manual crank wheels and keys. Approximately 10% of guards at Menard experienced serious repetitive trauma. The prison’s warden, 35 year-old David Rednour, will collect more than $75,000 not because of injuries he sustained at the correctional center but because of injuries he sustained at an earlier job working for the IL police department.

The $1.5 million settlement – and, in particular, Mr. Rednour’s settlement – has angered many local Illinoisans, including State Senator Kyle McCarter, who responded to the news with this passionate statement: “The abuses and the fraud in the workers’ compensation system in Illinois have gotten out of control and are costing tax payers more than they ever will know… we have to take a strong stand against this while helping out workers who are legitimately hurt on the job. The fraud and abuse has got to go. It’s driving business out of the state.”

Rhetorical opponents of the Senator in Illinois (and here in the North Carolina workers’ compensation community) would likely retort something to the effect of: “Yes, sure: abuse and fraud corrupt the system and generate problems for everyone touched by it. That said, is there a better way to deal with the costly and painful occupational injuries that these workers are stuck with? And if so, what is it?”

Unfortunately, debates over workers’ compensation often devolve into essentially political tantrums. One side says the workers’ comp system is bloated and corrupt. The other side says that benefits are essentially always appropriate.

Instead of this unproductive conversation, it might help to look for ways to shortcut problems. For instance, what if the injured correctional facility workers got better treatment for their repetitive stress problems? A growing body of evidence suggests that repetitive stress injuries are not merely “local” injuries. Rather, they involve chronic distortions of muscle, soft tissue, bones and ligaments. Therefore, they should be treated not necessarily with an array of modalities, such as strength training, trigger point massage, and enhanced body awareness.

The point here is that, rather than see cases like the Menard case devolve into shouting matches, let’s quit the blame game and get on to the business of drafting creative and results-oriented solutions.

To that end, if you or someone you care about has been struggling with a benefits-related issue, get immediate and confidential help from a top level North Carolina workers’ compensation law firm.

More Web Resources:

Menard Correctional Center

Debate over Menard Compensation

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

The typical case of North Carolina workers’ compensation fraud involves only one kind of crime. But a breaking case out of the Bronx has been getting special attention throughout the workers’ comp community for its sheer complexity. On December 15th, New York police arrested 60-year-old Rosa Rivera, after prosecutors investigating her for federal tax fraud discovered that she had collected over $135,000 in workers’ comp benefits from New York State illegally. Ms. Rivera’s compounding legal woes illustrate just how seriously the government takes any fraud. Her story serves as a cautionary tale for those who have been toying with the idea of skirting the workers’ comp laws, rules and regulations.

It all began in 2002. Rivera, who had been working as a bookkeeper, hurt her elbow, ankle and knee at work. She claimed the injuries prevented her from working. The NY Workers’ Compensation Board awarded her $400 a week in benefits. Meanwhile, in 2004, right under the nose of authorities, she began operating an income tax filing service out of her home. She ran this business for 5 years, until she was stopped in October 2009 and charged with fraud for filing false tax returns for her business. In September, Ms. Rivera pled guilty to the federal charges and got ordered to pay restitution in excess of $150,000. She also faces a two year probation.

Now, with this additional workers’ comp fraud charge — a fraud amounting to $135,000+ allegedly purloined from the New York State Insurance Fund (NYSIF) — she may face up to 7 years behind bars. Her hearing at a Suffolk County Court has yet to be scheduled.

Defrauding the North Carolina workers’ compensation system – or any state system – can get you in serious trouble, even if you plead things like hardship or extreme circumstances. For instance, Ms. Rivera’s benefits of $400 a week certainly could not be considered lavish by any standards – particularly by New York City standards. So it’s understandable that individuals on worker’s comp might want to find ways to supplement their income. But if you skirt the law or bilk the system by lying about your injuries — pretending they’re worse than they really are — not only do you cheat the legitimately injured, but you also create hostility and distrust amongst the various participants in the NC workers’ comp system.

If you’ve been having trouble with an insurance company or employer — or with the bureaucracy in general — a qualified North Carolina workers’ compensation law firm can provide crucial, timely guidance. Empower yourself today by getting a better education in workers’ comp rules.

More Web Resources:

New York State Insurance Fund (NYSIF)

Rosa Rivera’s Double Trouble – Tax Fraud and Worker’s Comp Fraud

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

Often, debates about the efficacy and fairness of the North Carolina workers’ compensation system revolve around isolating an “at fault” constituency and punishing that constituency. For instance, there is the “insurance companies are to blame” school; there is the “stingy/unethical employers are to blame” school; there is the “lazy lying workers are to blame” school; and there is the “entire system is broken so there’s really nothing any well-intentioned person can do anymore” school.

Unfortunately, by dividing up the participants in the North Carolina’s workers’ compensation system into “good guys” and “bad guys” – irrespective of the rightness or wrongness of those categorizations – we may be overlooking some easy “win-win” solutions that could improve the system’s efficacy and effectiveness without causing pain to any participants.

One important strategy involves information sharing and information processing. Like most state workers’ comp systems, the North Carolina workers’ compensation system often finds itself gummed up by needless bureaucracy, long wait times, and paperwork. Almost all organizations – state run and privately run – find themselves overloaded with information these days. This overload makes it difficult to sort the wheat from the chaff — harder to make good decisions.

Practically speaking, this might mean that an injured woman who needs back pain medication may have to go through a grueling wait process to get approved. Or it might mean that an employer gets stuck dealing with tons of workers’ comp paperwork and has to spend dozens of man-hours dealing with claim forms instead of attending to his business. Even insurance companies suffer from the stifling bureaucracy. All of the paper shuffling and information mis-management that goes on at big insurers surely drains these companies’ bottom lines. Insurers may then end up passing these costs down to consumers.

So how can we go about in some systematic, industry-wide way cutting through the clutter and eliminating bureaucracy? Obviously, this is way too big a topic for one small blog post to handle. But consider these suggestions:

1. Solicit ideas from people “in the trenches” about how/where we can collectively save time, money and resources.

Talk to everybody involved, from the state insurance commissioner down to claims processors, injured workers, and small business employers, about their frustrations and innovations. There is no need to impose “top-down” solutions to cut through bureaucracy – often, the people “in the trenches” intuitively and immediately understand what needs to be done.

2. Simplify Simplify Simplify

Apply the “KISS” (Keep it Simple, Stupid) principle throughout the system to identify and do away with needless complications, paperwork, and restrictions.

3. Restrict the flow of information to find liberation.

Author Timothy Ferriss in The 4-Hour Work Week, talks about the benefits of a “low information diet.” By allowing information to pour into your environment, office, insurance company, or wherever, you set the stage for info overload and overwhelm. The easy fix is to turn down the informational faucet – to eliminate all but the most essential, need-to-know info from your life and business.

If you or someone you care about got hurt at work or suffered a job-related chronic illness, you may have lots of questions about how to handle your benefits case. Connect with a North Carolina workers’ compensation law firm today to explore methods for getting more out of your case.

More Web Resources:

Getting Things Done — Better information processing philosophy

Information Overload dangers

On December 8, New York police arrested Kevin Schwebke, a 26-year-old corrections officer, for felony grade workers’ comp fraud. North Carolina workers’ compensation pundits and others who follow stories about fraud and corruption in the world of workers’ comp, have been hotly discussing the legal and even moral implications of this matter.

First, the facts. Schwebke had been working at the Coxsackie Correctional Facility in 2009 when he got into an accident on the job that damaged his ankles. After undergoing surgery, Schwebke went on workers’ compensation. Up until Wednesday, he had amassed $34,000 in payments. Meanwhile, Schwebke continued working for the Cairo Police Department on a part-time basis – in violation of his workers’ comp arrangement. The Chief of Police, Chris Sprague, said that he had not been aware that Schwebke had been collecting workers’ comp.

If convicted of the class E felony charge, Schwebke could face a seven-year state prison sentence. He will appear at Albany County Court to face the charges at a later date.

This seemingly simple case has some very interesting implications. Let’s just say that the 26-year-old did in fact lie about his physical condition to collect the $34,000 illegally.

Is it really fair to punish someone for this level of minor fraud with seven years in state prison? Doesn’t that seem somewhat excessive, from a common sense standard? Obviously, you don’t want to reward workers’ comp fraud or encourage it in any way. But at least theoretically, it’s odd that someone who commits such a relatively minor crime (from a purely monetary standpoint) should be subjected to such a harsh potential jail sentence, especially when you consider that much more serious white collar crimes, like corporate fraud and embezzlement, often carry less punitive consequences.

On the other hand, North Carolina workers’ compensation fraud is a profound problem, not just in terms of the money it leeches from the system but also in terms of the culture of distrust it creates. When insurers can’t trust whether claimants are telling the truth, they ratchet up investigations and force legitimately hurt workers to jump through more hoops. When stories like Schwebke’s break, employers become more suspicious of their workers. It’s hard to quantify how all this distrust percolates through the system, but the toxic atmosphere surely drains time, resources, and money and makes it more difficult for the system to function effectively – that is, to rehabilitate legitimately hurt workers and get North Carolina’s workforce up and running at maximum effectiveness.

Have you been having trouble collecting your benefits due to your employer’s lack of cooperation or an insurance company’s recalcitrance? Whatever your issues, you may benefit greatly from engaging in an free confidential consultation with a reliable North Carolina workers’ compensation law firm today.

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Kevin Schwebke’s arrest

Corrections officer accused of fraudulently accepting $34,000 in workers comp

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

Whether you are a freshly injured worker who’s had to go on North Carolina workers’ compensation due to a computer typing injury or construction injury; or you are a healthy worker who wants to avoid on the job accidents or diseases, you may benefit from the following tips about how to stay safe over this holiday season. As joyous as the December holidays can be, problems at office Christmas parties, schedule changes, and icy winter weather can all make your work more treacherous than it is typically. Let’s analyze these issues.

1. Winter weather

Although North Carolina does not often get blitzed by blizzards, inclement winter weather, such as cold spells, sleet, snow, slush and freezing rain, can make your job more hazardous. If you are a delivery worker, for instance, it’s easy to envision yourself getting lost on an icy North Carolina road, sliding off into an embankment, dislocating your shoulder, and having to go on workers’ comp for all of 2011. This is something you want to avoid. To that end, pay extra attention during the winter to weather conditions. Go to weather.com to look up your local forecast. And keep your co-workers informed of any upcoming storms or squalls as well.

2. Watch the alcohol

The Yuletide season is a time of much carousing. You’ve worked hard in 2010, and you deserve to engage in a little frivolity and fun. But clowning around at an office Christmas party can result in serious injuries to you or your co-workers, even if you don’t work in an environment that contains heavy machinery, toxic chemicals or fire hazards. Remember: alcohol and other intoxicants and work do not mix. So if you are organizing or participating in a holiday party, rigorously adhere to safety standards. Obviously, you don’t want to be a “stick in the mud,” but neither do you want to spend the bulk of 2011 out of work at home in a back brace and on North Carolina workers’ compensation.

3. Beware of schedule changes

This is a tricky one. During December, work hours shift suddenly and become irregular. Obviously, many people take off the Christmas holiday. Others take off Hanukkah. Still others take off extended vacations to visit family out of state. This means that your shift lengths may change, and there may be a more lax and casual atmosphere at the office or work site as a result. Changes in schedule, substitutions, and shifts in your work environment can be a surprisingly terrifying cocktail. They can cause increased risk for accidents and injuries.

If you or a co-worker has experienced an injury or disease or other work-related health problem, protect your benefits by discussing your needs with a North Carolina workers’ compensation law firm ASAP. The faster you get good advice, the easier it will be for you to move forward with your life and enjoy a healthy and prosperous 2011.

More Web Resources

To Drink or Not To Drink?

Alcohol Abuse at Work

Steve Poizner, the outgoing Insurance Commissioner for the CA Department of Insurance, has slapped down a request to hike Califonia workers’ compensation rates up by 27.7% for 2011, a move that has North Carolina workers’ compensation analysts talking. The insurance industry, represented most vocally by the Workers’ Compensation Insurance Rating Bureau, is not exactly singing Poizner’s praises. Last year, the group asked for a 30% rate hike, but the Department of Insurance denied the hike. They claim that, since 2008, actual premiums have only increased by 3% – due perhaps to competition and employer adaptations.

The state compensation fund will hike up its rate by 5.2% starting first of the New Year – similar to the premium increase the fund adopted in 2010.

Poizner has been at loggerheads with insurers in the past. In 2009, he spelled out more than two dozen efficiencies that insurers could avail themselves of to cut costs. He struck a disappointed tone in a recent statement: “workers’ compensation insurers have failed to demonstrate that they have adopted procedures to control costs so that they are operating efficiently.”

Poizner aims to push through several reforms to improve the review process to make everything. Those in the North Carolina workers’ compensation system are paying attention. His proposed reforms include:

1. Come up with advisory premiums based on the real rates that insurers file as opposed to theoretical benchmarks.

2. Include clear tables to help employers classify their workers, so that they can understand how rate changes will impact their businesses.

3. Use better data monitoring and filing techniques to help consumers understand how insurance pricing actually works and to avoid getting lost in the details, which can often get quite byzantine (i.e. complicated), even for professionals in the field.

If you or someone you care about has been struggling with a benefits issue – maybe an insurance company has stalled on approving a claim; or maybe your employer claims you got hurt at a previous job and not at your current one – avail yourself of the resources of a quality North Carolina workers’ compensation law firm.

Don’t fight a complicated, technical legal battle on your own. Even if you school yourself on all applicable rules and regulations, you could still make small errors which could have catastrophic consequences for your benefits, and, more broadly, for your ability to return to full health and productivity.

If the U.S. Postal Service defaults, what will happen to North Carolina workers’ compensation for postal workers? According to an August 29 article in Reuters, USPS might default on an enormous $1.2 billion payment in 2012, putting postal employees who rely on North Carolina workers’ compensation at risk of a possible loss of benefits. Reuters summarized the sobering news as follows: “The mail carrier, which has been losing billions of dollars each year, has more than 560,000 full-time employees, the largest pool of workers covered by the Federal Employees Compensation Act.”

It may not be time to panic just yet. The Postal Service should have no problem paying these benefits at least through the first three quarters of 2012. But starting in the last four months of fiscal year 2012, more than 2 million federal employees and USPS employees could be impacted.

Fortunately, the Postal Services is not sitting idle. In June, USPS suspended paying into a retirement fund to save approximately $900 million to pay down the workers’ compensation bill due. The agency is dealing with a two-fold problem – a sharp cut in the volume of mail due to electronic communications coupled with “skyrocketing employee costs.” The USPS has begged Congress to overhaul aspects of its business model and also offer some relief from upcoming payments. But the bruising fight over the deficit and debt ceiling may make it difficult for the USPS to get any significant reforms on the floor. Moreover, “the Labor Department said…that there is no penalty if the Postal Service skips the workers’ compensation payment.”

This is all pretty scary news, even if your North Carolina workers’ compensation benefits are in no way tied to the Postal Service or to any kind of federal program. The reason that it’s scary is because it implies that workers’ comp funds may be more brittle and less sacrosanct than hurt and sick workers would like them to be. In other words, we depend on workers’ comp as a kind of crutch to help us get back on our feet. But if/when that crutch gives out – due to poor fund management or some other deep structural flaw in the fund’s business model – then individual beneficiaries could suffer a hard landing.

There are so many aspects of the workers’ compensation system that are way out of your control – the USPS crisis is just one of tens of thousands – so it is important to concentrate on what you can control. Similarly, you want to avoid getting caught up in thinking and worrying about worst-case scenarios and, instead, focus on what you want to occur and what resources you need to achieve your financial goals. To that end, you might find it useful to talk to a North Carolina workers’ compensation law firm about what steps you should (or should not) take to ensure the best outcome for your situation.

More Web Resources:

U.S. Postal Service default?

Federal Employees Compensation Act

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