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.

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

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

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

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

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

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

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

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

In Part 1 of our series on how complacency at work impacts the North Carolina workers’ compensation system, we discussed how both workers and employers alike often act far more cautiously during the first few weeks and months of tenure.

After a certain amount of time, both the worker and the boss become comfortable with the processes and procedures, and a certain amount of slack sets in. This “slack” can be benign, neutral, or harmful. It can be benign when workers do their jobs in a more natural, fluid, resourceful way. It can be neutral when it has no impact. And it can be malignant when it creates the conditions for laziness, inaccuracy, and recklessness.

How can we prevent this third category – the malignant situations – from wreaking havoc and creating needless North Carolina workers’ compensation cases?

The “knee-jerk” response to this question might be: “The answer depends on the circumstances and specifics of the line of work.” And there is some truth to this response. An industrial worker who works with potentially dangerous equipment, like lathes or bulldozers, might require incremental training “refreshers” to stay sharp and focused and avoid malignant complacency. An office worker, on the other hand, at risk for developing carpal tunnel syndrome due to bad postural and typing habits, might require a very different kind of intervention. For instance, he or she might benefit from periodic massage or physical therapy, or even from changing around the office furniture every two months or so.

Businesses in general could do more to reduce worker/employer complacency. So could the government: state or even federal regulations could require certain businesses to retrain and resystematize their processes at regular intervals, for instance, to prevent malignant over-complacency. Of course, there are dangers with inherent over regulating, as well. So the policy problem is certainly a tough nut to crack. However, we should not give up on the dream of forging global-scale solutions to the complacency problem.

All this theory aside, however, you and your loved ones need help with a case. Connect with an experienced North Carolina workers’ compensation law firm to get insight into your problems right now.

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The dangers of complacency

Beating Complacency

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

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

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

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

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

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

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

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

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

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

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The Perils of Catastrophic Thinking

David Allen’s System for Controlling E-mail

Maybe you’ve been searching for reliable information on the North Carolina workers’ compensation system for just a few minutes – or maybe you’ve spent the better part of a day or even a week analyzing tips, tricks, do’s, don’ts, and resources online. Unless you have very clear and specific goals in mind, you are likely to encounter a certain degree of stress because the internet is so overstuffed with potentially useful information.

What can you do about this problem?

The problem transcends North Carolina workers’ compensation issues and affects everyone who uses the web. Unless you engage with the web in a very specific, predetermined way, your searching may expand beyond your expectations, eat up a lot of time and energy, and, worst of all, leave you feeling more stressed and less sure than you were before the search began.

For instance, let’s say that you really hurt your wrist after engaging in some kind of chronic office work in the Raleigh area. You think you might have “carpal tunnel syndrome,” but you are not sure what the real problem is.

You also think your employer should be held responsible to pay for your time off and therapy, but you are not sure exactly how to go about making that happen, and you are certainly not clear on the applicable laws and paperwork that might pertain to your situation.

By dipping your toe in the internet to search for solutions, you will certainly get a lot of information. But you will also get way more information than you need — not all of it reliable. Do you really need to read the fine print of your employer’s workers’ comp insurance policy? Even if you could get this information, how would you interpret it and put it into context? Can you self-diagnose your pain using seemingly smart-sounding information you find online? Possibly. Or possibly not. The introduction of all these uncertainties creates tremendous stress, which you might not be aware of until someone points it out to you.

The solution?

There is no single solution. But the more you can “outsource” your tasks to reliable entities, the better. For instance, a North Carolina workers’ compensation law firm can help you take care of the paperwork and ensure that employers and insurance companies play fair.

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Information overload – it’s getting worse

Is the web the cause of our ADD epidemic?

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

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

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

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

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

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

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Med students think they have every disease

Increased knowledge leads to increased anxiety

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

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

What about the rest of us?

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

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

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

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

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

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

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

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

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North Carolina free enterprise foundation

NC general assembly is more business friendly?

Last week, per the St. Petersburg Times, Florida Insurance Commissioner Kevin McCarty announced that the Sunshine state’s workers’ comp rates will be jacked up by nearly 9%, effective January 1, 2012. It’s a move that has many experts, analysts, and small business owners in the North Carolina workers’ compensation community mulling over the ramifications.

McCarty’s office rejected a proposal by the National Council on Compensation Insurance (NCCI), stating that the methodology the NCCI used was faulty. He defended the fact that Florida will still have “the lowest workers’ comp rates among large states and the lowest rates in the southeast.” Prior to the changes in FLs workers’ comp laws back in 2003, the Sunshine state “consistently had one of the country’s highest workers’ compensation rates.”

Not surprisingly, Florida’s Director of the National Federation of Independent Business was less than pleased, calling the 8.9% hike “a very substantial increase in the cost of labor over the course of two very difficult years for small employers.”

So what can we make of this rate hike, especially in light of this year’s reforms to North Carolina workers’ compensation laws? Do they indicate a regional trend? Will the subtle changes in Florida and North Carolina rules and regulations impact the flow of business across the region? If so, how? How can one accurately measure this impact, if it exists at all?

These questions are obviously theoretical, but answering them is vital if we want to ensure fairness for hurt and injured workers and help small businesses in the region position themselves for growth, flexibility, and opportunity.

Finding the “perfect rate” for workers’ compensation is a balancing act that never ends.

The sheer diversity and number of variables involved would blow the circuits of even the world’s biggest super computer. That’s why it’s important to test and reassess how changes like the ones in North Carolina and Florida impact businesses, insurance companies and even the relative “joie de vivre” of the workers’ themselves.

For more specific, grounded help with a workers’ comp question, connect with an experienced, highly respected North Carolina workers’ compensation law firm for a free consultation.

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Florida workers’ comp rates to rise 8.9%

The National Federation of Independent Business official website

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

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

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

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

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

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


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

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

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

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

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Workers’ Comp Case Upheld in Cell Phone Related Crash

Nurse Injured While Glancing at Cell Phone Due Workers’ Comp

Few people dream of committing North Carolina workers’ compensation fraud. But the temptation to “cheat” on your paperwork and collect a little more than you might be legally entitled to can lead to life-changing disasters.

Witness the fate of 31-year-old Patrick Rosenzweig, a New Yorker charged on October 6 with attempting to defraud The New York State Insurance Fund out of $3,973.24. According to a report in a local newspaper, The Wayne Post, “[Rosenzweig] was charged with workers’ compensation fraud, making a fraudulent statement in workers’ compensation insurance applications, offering a false instrument for filing the paperwork and grand larceny.”

Rosenzweig now faces a smattering of felony charges. If convicted of any of them, he could face over a year in jail… all for trying to obtain workers’ comp while he was still working.

What can the Rosenzweig ordeal teach us? First of all, note the cost benefit analysis. Assuming he had gotten away with this alleged scam, he would have collected an extra $4,000. But he didn’t, and he now faces huge fines and possibly significant time behind bars. Assuming he ordinarily made something along the lines of $60,000 a year, and he gets three years of jail for the felonies, he will be out close to $200,000 for committing a crime that would have only netted him around $4,000.

All this is to say that North Carolina workers’ compensation fraud does not pay off.

That being said, one can still be sympathetic and compassionate here. Hurt workers often lack the job training, skills, and resources to make ends meet. If you are a mother of two who got hurt at work – not badly enough to receive workers’ comp, but badly enough to struggle with day-to-day activities – you might be tempted to break the law and lie on your paperwork. The impulse comes from a place of wanting good help. Instead of making reckless, illegal decisions, however, make responsible choices.

For instance, connect with a North Carolina workers’ compensation law firm to review your options for getting more compensation or to find other resources to make ends meet.

More Web Resources:

Canandaigua Man Charged with Workers’ Comp Fraud

Making the Most Out of Your Reduced Income

What can be done to reduce or even eliminate North Carolina workers’ compensation fraud?

To solve this dilemma, we need to look beyond our state’s borders and pick apart relevant news stories, data, analyses, and arguments compiled by experts. It’s all well and good to theorize about different methods to deal with, manage, or punish North Carolina workers’ compensation fraud. It’s another story altogether to operate in the “real world” and get good results.

Even “small scale” cases of fraud can yield surprisingly relevant and far-reaching lessons, if we understand how to appreciate these stories in context. Consider a small bore story about workers’ comp fraud in Des Moines, Iowa. As the AP reported on September 23, the president of DES Staffing, Dinesh Sethi, plead guilty last week to wire fraud: “He acknowledged that he participated in a scheme to defraud Travelers Insurance and Liberty Mutual between 2006 and 2009 by giving the insurers’ false information to calculate the firm’s premiums…he and his Director of Finance shifted payroll from high-premium job classification codes to lower-premium codes such as clerical workers.”

Per the plea arrangement, Sethi’s five other charges have been dropped, and prosecutors will not go after either his company or his family. He will face sentencing at the end of December.

So is it really possible for us to extrapolate from this small case and learn more widely applicable lessons?

Maybe so.

Here are three lessons:

Lesson number one: Outsized punishments can affect criminals who commit even small, technical crimes.

In the grand scheme of things, Sethi’s wrongdoings (or alleged wrongdoings) are relatively tame, if you measure them against other criminal acts, like felony murder, vehicular manslaughter while DUI, and massive multimillion-dollar Medicare schemes. But he could still face jail time and other career-ending punishments for what he did.

Lesson Number Two: Schemes can go on for a while before the authorities step in, but con artists are never safe.

According to the AP article, Dinesh and his finance director perpetrated fraud for approximately four years before getting busted. The long arm of the law, however, finally caught up.

Lesson Number Three: It’s almost always worth the time and effort to ensure you are operating fairly, ethically, and legally.

Many people who commit fraud do so inadvertently, or at least without knowledge of the consequences. A sick mother on workers’ comp leave, for instance, may take a second job to try to earn a little extra money for her family, oblivious to the fact that taking the second job violates her workers’ comp arrangement.

To protect your rights and ensure that you stay within the bounds of the law, always consult with an experienced North Carolina workers’ compensation law firm.

More web resources:

Des Moines exec pleads guilty to insurance fraud

Ankeny man pleads guilty to insurance fraud

According to a recent article in the Charlotte Business Journal, business leaders throughout the state are still in a state of giddy glee regarding recent changes to North Carolina workers’ compensation law. According to the President of North Carolina’s Chamber of Commerce, Lew Ebert, the reforms – the first such changes to the law in 17 years – have helped make the state more competitive. Ebert and other business leaders long complained that North Carolina had gotten “behind” other states in terms of their workers’ comp laws.

They pointed out that our state’s injury rate is one of the lowest in the United States; whereas the average cost per North Carolina workers’ compensation claim was pretty high at $42,000. According to the Charlotte Business Journal, the changes in the law will also influence insurance premiums for businesses, thus helping them stay competitive. Lat Williams, a marketing vice president based in Charlotte, told the Business Journal: “North Carolina is probably B or C” but thanks to the changes, the state “will probably upgrade to B, and it might even go up to A.”

Manufacturers also see other “wins” including:

• The size of the North Carolina industrial commission has been shrunk;
• The reforms allow certain employers to more easily communicate with employee physicians and give workers temporary, light-duty jobs.

Lawmakers designed the law, ideally, to help both employers and employees. For instance, the Charlotte Business Journal article details one provision that, at least in theory, might help both workers and employers: “Workers on light duty will still earn as much as if they were on workers’ comp, or up to two-thirds of their previous salary. If the new job pays less, workers’ comp makes up the difference.”

So is it all a win-win? Manufacturers and employers win as well as workers?

At this point, it’s too early to tell. From a worker’s perspective, the final compromised bill passed in June was certainly better than the original draft proposed – the earlier drafts were tilted even more towards industry.

But if you need assistance with a claim or a possible claim, you don’t have to deal with your situation in a vacuum. A qualified, competent, experienced North Carolina workers’ compensation law firm can help you figure out your next steps.

More web resources:

How changes in workers’ comp will affect NC manufacturers

An overview of the new NC workers’ compensation laws

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

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

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

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

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

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

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

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

Here are five solutions:

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

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

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

4. Regularly re-read the serenity prayer.

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

More web resources:

The serenity prayer

A rising tide lifts all ships

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

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

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

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

2. Collect everything in one place.

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

3. Make backups and secure potentially sensitive materials.

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

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

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

More web resources:

David Allen’s “Getting Things Done” System

Tools, Tricks and Traps of Organizing

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.

More web resources:

The Importance of Writing Things Down

Outcome Visualization

What will the North Carolina workers’ compensation system look like 50, 100, 200, 500 years from now?

This isn’t just an absurd exercise in speculation. It is an important visualization. If the North Carolina workers’ compensation community is collectively going to make progress, break through obstacles, help people achieve better care, help businesses and insurers get a squarer deal, and so forth, then we must collectively have a conversation about the long-term future.

In a recent blog post, we discussed some of the boundaries and principles of this kind of prognostication exercise.

Now we are going to have some fun and speculate:

• Radical changes in dietary policy coupled possibly with pharmaceutical breakthroughs will help North Carolinians and the rest of the American populous defeat or at least make substantial progress against the so-called diseases of Western civilization, including obesity, diabetes, cancer, and dementia. The resulting transformation will ease our healthcare burdens substantially, but also introduce new problems.

• Amazing new technologies will make certain kinds of common workplace injuries either completely uncommon, or at least not as dangerous as they once were.

• Data sharing technology, pattern recognition software, and complex systems analyses will allow us to recognize certain dangerous activities that cause or exacerbate workplace illness and injuries – and allow us to create far more targeted approaches to wellness.

• Certain core problems based on evolutionarily limits of the human body will confound even the most futuristic technologies – at least for a long, long, long time. For instance, repetitive stress damage to the musculoskeletal system (e.g. repetitive stress syndrome, thoracic outlet syndrome) may persist and even get worse and contribute to more and more North Carolina workers’ compensation problems.

• In retrospect, the technologies, solutions, and transformation of workers’ comp will seem “obvious” to our children, grandchildren, and beyond. Just like we now think of the internet and television as “obvious” and easy to use, so too will our successors think of today’s and tomorrow’s innovations as “obvious.”

Speculation can be fun and interesting and ultimately generate powerful insights, but speculation doesn’t replace the common sense and knowledgeable insight you can get from a compassionate and proven North Carolina workers’ compensation law firm.

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Futurism

Limits to Futurism

The doomsdayers and cynics fret that the North Carolina workers’ compensation system is in sad shape, and it’s only going to get sadder and scarier as the baby boomer generation ages and the state and national economies stagnate or contract. And we may very well face tough times in the years – and even decades – ahead.

But what about the really long term? What’s going to happen to the North Carolina and the U.S. workers’ compensation systems in 50, 100, 200 years from now?

Speculation about the future is riddled with artifacts from present day bias. No matter how farsighted we may think we are, we are inevitably trapped in the present moment – culturally, intellectually, and otherwise. So we tend to see the future through the lens of the present, and that colors our vision of what might be possible and what might be impossible.

For instance, if you look at old science fiction made in the 1950s and 1960s, you will see references to technologies that are still way, way, way out of our reach, such as sentient robots, flying cars, etc. You’ll also see references to technologies that are, by our modern standards, totally outdated. For instance, very few thinkers back then could even conceive of something like the world wide web, and these fictional worlds are often laughably “backwards” because of their lack of incorporation of something like the web.

This isn’t to say that the future of the North Carolina workers’ compensation system is forever out of the grasp of present-day minds. Indeed, it’s probably worth it to at least take a few educated guesses. Even if these guesses are wrong, this kind of visualization can powerfully guide our thinking.

Here are a few rules of thumb:

• “Correct” future predictions will almost certainly be confounded or complicated by “incorrect” assumptions or predictions. In other words, even the most astute futurists only get some of the stuff right, some of the time.

• Certain fundamental truths about human behavior and about our relationship with technology can help guide us and shape our vision;

• Problems that seem intractable today may disappear or even be made irrelevant due to the technologies or insights of tomorrow;

• Similarly, there is a good chance that the grand visions of today will be rendered less relevant in the future due to the same kinds of disruptive innovations and insights.

A subsequent blog post will tackle specific prognostications. But if you have actionable, present-day question about workers’ comp issues, connect with a reputable, strategic North Carolina workers’ compensation law firm to work through your issues and achieve success.

More Web Resources:

Being right and wrong at the same time

The future is fundamentally opaque

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.

More Web Resources:

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

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

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

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

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

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

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

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

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

Connect with a North Carolina workers’ compensation law firm.

More web resources:

Breaking Free from Your Cigarette Addiction.

Breaking Free from Your Sugar Addiction.

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.

More Web Resources:

Too Much, Too Soon

Why we push ourselves

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

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

Here are three ideas:

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

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

• Get help.

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

• Get good legal assistance to reduce uncertainty.

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

More Web Resources:

The journey of a thousand miles begins with a single step

Importance of quantifying your goals

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…

More Web Resources:

Tighten Your Budget

Rediscover Your Passions

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

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

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

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

Sounds pretty good, doesn’t it?

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

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

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

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

More Web Resources:

Universe is Abundant?

Reboot Your Career

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

North Carolina – and the rest of the United States – is caught in a vicious heat wave that has some North Carolina workers’ compensation analysts concerned. During extreme weather, vulnerable workers – such as the elderly or those with physically demanding industrial jobs – can be subject to fainting spells, dehydration, delirium, and general fatigue. If you fail to monitor yourself, your coworkers, and your employees – the dog days of August can cause, or contribute to, a disaster or illness that can dog you long after the dog days have had their last bark.

Here are some examples of how hot weather can precipitate accident/injuries.

Example Number One: House Painters Use Red

A house painter in Greensboro forgets to pack his typical iced drinks and sodas. Instead of going back to get them, he figures, why not log a few hours first? So he climbs a ladder and begins painting. He gets so wrapped up in his work that he doesn’t feel that he is overheating in the hot sun. Sweat drips onto his ladder, creating a slippery surface. He misses a rung, slips, and falls 15 feet into the bushes below, where he breaks his leg, severs a tendon, and gets scratched up. Thanks to the dog days, he is forced to miss 15 weeks of work.

Example Number Two: Too Hot in the Office

An elderly woman who works as a receptionist at a small business just outside the Research Triangle feels faint. Her boss had failed to fix the air-conditioning, so she brought in a small fan. But today, the fan is not enough. While typing a report, she passes out from the heat and has to be hospitalized due to dehydration.

Example Number Three: Air Conditioner Repair Disaster

After the elderly worker’s unfortunate dehydration incident, her boss decides that it is time to fix the air conditioner. She goes out back and tries to do it herself, but, since she lacks the training and tools to do the job right, the air conditioner condenser explodes. The wind is knocked out of her, and she receives lacerations, sending her, too, to the hospital with injuries.

Moral: The dog days present a surprising number of risks for workers. If you, or someone you know, has recently been hurt or made ill during the dog days (or at any other time), a North Carolina workers’ compensation law firm can help you understand how to get compensation, how to protect your rights, and how to deal with insurance companies.

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Dog Days of August in Carolina

heat waves and elderly

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

A new study released by the Workers’ Compensation Research Institute (WCRI) has worried many in the North Carolina workers’ compensation community. The report, Interstate Variations in Use of Narcotics, suggests that injured workers often abuse and/or misuse narcotics prescribed to treat workplace injuries. According to a WCRI press release, “In certain states…patients who begin treatment with narcotics are more likely to end up using narcotics on a longer-term bases – California, Louisiana, Massachusetts, New York, North Carolina, Pennsylvania, and Texas.” Louisiana was the worst offender – with a rate of 1 out of 6 injured workers who possibly misuse/abuse narcotics. According to the WCRI, “In a typical state, the figure is 1 out of 20.”

So let’s dig a little deeper here. Why would North Carolina workers’ compensation beneficiaries who need medication for pain fail to follow a doctor’s orders and either take more narcotics than necessary or otherwise abuse prescriptions?

This may seem like a silly and somewhat obvious question to ask. But it’s an important one. Because we need to understand the root causes if we want to figure out how to tackle the problem. A typical answer might be something in effect of “narcotics are addictive.” Or “when everything else is going wrong in your life, narcotics can help make the pain go away.”

But these answers are in many ways unsatisfying.

They suggest that hurt workers are helpless and foolish. They suggest that they don’t understand the implications of abusing or misusing narcotics. These thoughts are insulting to hurt workers. Could there be another explanation that’s somewhat more oblique but also more satisfying. According to a Harvard University psychiatrist, Dr. Lance Dodes, addictions to medications may have psychological origin – as opposed to physiological origin. Dr. Dodes points out that soldiers who fought in Vietnam became addicted to opiates while overseas – physically addicted, that is. They kicked their addictions easily after being removed from the battlefront. This suggests that psychology, as opposed to physiology, should be implicated in at least a certain kind of addiction.

Dr. Dodes proposes that addiction is in essence an empowerment response – when a hurt worker feels frustrated, angry, overwhelmed, or even just irritable about his/her situation, he/she wants to reassert control. Using or abusing medication helps the hurt worker regain a sense of control.

Dr. Dodes’ theory is deep and interesting – it runs counter to the grain of the conventional wisdom about addiction. But it’s an interesting philosophy, and if you or someone you care about has been hurt at work, and you need the help of a North Carolina workers’ compensation law firm to figure out what to do, it might also behoove you to examine Dr. Dodes’ thinking.

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Workers’ Compensation Research Institute (WCRI)

Dodes’ research

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

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

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

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

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

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

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

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

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Patient Protection and Affordable Care Act (PPACA)

medical e-billing

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

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

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

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

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

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

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

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

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

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

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Overcoming fear

Going back to work after a long absence

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

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

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

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

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Carl Fuller

Florida Department of Financial Services

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

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

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

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

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

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

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Pinnacol Assurance

Martin Lobatos fraud

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

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

1. Educate yourself as a patient

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

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

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

3. Actively seek out help

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

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Educate yourself as a patient

Keeping a journal

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

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

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

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

To protect your interest, hew to the following principles:

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

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

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

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

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Beating “analysis paralysis”

Listen to your gut?

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

As lawmakers mull over how and whether to reform the North Carolina workers’ compensation system, first responders, firefighters, and other volunteers are fretting about what might happen to the Volunteer Safety Workers’ Compensation Fund. This is a fund paid in part by the state and by premiums from 1,300 members, such as firefighters and first responders, to offset North Carolina workers’ compensation coverage costs. It was established in the 1990s, and its current custodians estimate that the fund needs $2 million from North Carolina to survive.

Problem is, the current House budget has allotted just half of that – $1 million – for the fund, and the state may not even make that allocation permanent. In other words, the fund might get $1 million this year, but $0 million the next year. When the fund was established, the original plan was that North Carolina would provide $4.5 million over a period of seven years, until the fund could become self-sustaining. But that amount has been chipped away for various political and financial reasons.

The Executive Director of the North Carolina State Firemen’s Association, Paul Miller, recently voiced concerns about what might happen if the fund fails to be viable. Essentially, the assigned risk pool would have to inflate rates, and this would ultimately lead to the loss of savings that Miller argues are “used to buy equipment, uniforms, and pay for trainings so that North Carolinians can rest assured that they have the very best fire and safety services available.” State Insurance Commissioner, Wayne Goodwin, weighed in on the side of the volunteer workers: “I implore our legislators to fund the Volunteer Safety Workers’ Compensation Fund in a way that allows it to continue to meet its obligation to its members.”

Until the House resolves the debate over potential changes to the law, even a stellar North Carolina workers’ compensation law firm might have a difficult time suggesting an appropriate strategy for firefighters, volunteers, and sick and injured workers. The fact is that, as long as the state’s workers’ comp system remains in a state of limbo, it will be difficult for people, institutions, and funds like this to get a grip on what’s the most appropriate strategy.

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Volunteer Safety Workers’ Compensation Fund

North Carolina State Firemen’s Association

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