Many larger employers may have Short Term and Long Term Disability benefits available if you can’t work. These are usually tied in with your rights under FMLA and Americans with Disability Act protection.  This is an important benefit if you have a prolonged non-work related medical condition, or if you are hurt at work, and the claim is denied by workers’ compensation.

stockfresh_4489991_work-accident_sizeS-300x208Short Term Disability benefits usually last between three and six months. Usually, you can’t collect Short Term Disability benefits if you are receiving workers’ compensation. People expect that you usually can’t “double-dip,” which means you won’t receive both a full comp check and a Long Term Disability benefit.  Therefore, Long Term Disability benefits typically, but not always, will be reduced by your workers’ compensation benefit.  However, it may be advisable to apply for LTD anyway. In some cases, you may only be entitled to a small monthly benefit in addition to workers’ compensation, sometimes more if you have paid for extra LTD coverage.  Your LTD may also provide additional benefits when you settle your workers’ compensation case. Keep in mind that usually, your employer won’t encourage you to apply for LTD while you are on worker’s compensation. Continue Reading

Many questions have arisen since the outbreak of Legionnaires’ disease among visitors to the North Carolina Mountain State Fair held at the NC Agriculture Center in Buncombe County. Some questions surrounding the outbreak are related to the health risks associated with the disease, and other questions concern legal issues. The N.C. Department of Health and Human Services reported there were 97 confirmed cases and one death associated with the outbreak at the fair as of October 1 and officials continue the investigation to determine the cause of the outbreak.  The outbreak legionnaires1-300x300has affected people in 16 North Carolina counties and 6 cases have been reported in South Carolina.  The highest number of cases have reported in Buncombe and Henderson counties.

I remember when Legionnaires’ disease first hit the news in 1976 when a large group of American Legion members staying in a hotel in Philadelphia contracted a mysterious disease. Over 180 persons contracted the condition, and 29 died. Ultimately, it was diagnosed as a type of pneumonia that was spread by contaminated water vapor in the hotel HVAC system. Dubbed “Legionnaire’s Disease,”  the illness occurs with some regularity.  It is not spread by person to person contact; instead the bacteria thrives in warm water and is spread by breathing in aerosolized water. The bacteria thrives at 95 degrees F and can be found in hot water tanks, cooling towers, and evaporative condensers of large air conditioning systems, and evaporative coolers, among other places.

Symptoms of Legionnaires’ disease include chills, cough, fever, shortness of breath, diarrhea, and vomiting. Persons experiencing those symptoms should contact their health care provider immediately and talk to them about Legionnaire’s disease. Urine testing can confirm the presence of legionella, the bacteria known to cause the diseases. Symptoms typically appear within 2-14 days after fair attendance, and the condition is typically treated with antibiotics.

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Tragically, there are work-related deaths in NC.  What if your husband or wife dies in a work accident or from an occupational disease?  In the sad event, an employee dies from injuries sustained at work, there are rules which govern the compensability for the dependents/beneficiaries of the deceased.  The State does have provisions for widows and widowers or other dependents of the person killed at work.stockfresh_8850471_woman-with-lily-flowers-and-coffin-at-funeral_sizeM-300x200

A death claim is different from the claim the injured worker had while he or she was alive.  The death claim is brought in the name of the person(s) entitled to benefits.

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Many times, a Veteran’s service-connected condition leads to a new disability or illness.  A classic example of this is when a Veteran’s service-connected left knee condition leads to later problems with the Veterans left hip or right knee.  When a new condition was caused by or aggravated by a service-connected condition, that new condition can be service-connected by way of secondary service connection.stockfresh_7705090_vet-tiled-letters-concept-and-theme_sizeM-300x218

38 C.F.R. § 3.310(a) states that a “disability which is proximately due to or the result of a service-connected disease or injury shall be service connected.”  This includes conditions in which there is an intermediary step in the process.  For example, it is easy to understand that a Veteran who has service-connected hypertension my, later on, develop heart trouble or headaches, due to the increased blood pressure.  Continue Reading

38 C.F.R. pt. 4 (§§ 4.1 – 4.150) contains the VA’s Schedule for Rating Disabilities.  This is the law that the VA applies the facts of a specific Veteran’s claim for disability compensation to in order to rate that Veterans condition.  For example, let us say a Veteran submits a claim for a mental health condition. After assisting the Veteran with developing his or her claim, the VA determines that this condition is service-connected and that the Veteran suffers from:

  • mild memory loss,
  • chronic sleep impairment, and
  • occupational and social impairment with occasional decrease in work efficiency due to anxiety.

Based on these symptoms, the VA may assign a rating of thirty stockfresh_4360615_soldier-having-counselling-session_sizeS-300x200percent (30%).  This is because 38 C.F.R. § 4.130 (Mental Disorders) list these symptoms as justifying such a rating.  A problem arises when a Veteran files for a condition that is not listed in the rating schedule.

Suppose a Veteran of the Persian Gulf Wars filed for a number of claims, including: Continue Reading

In the industry, these medical payments are called “Medpay.” Medpay is money you can get from your own insurance when you have been hurt in a car accident.  It doesn’t matter who was at fault for you to make a claim for this money, you could have been at fault, and you can still make a claim for it.  You will normally see this as an amount like $1,000.00 – $2,000.00, though some insurance companies have been known to sell people some for $10,000-50,000.  In order to get this money, propertydamagefront-300x199you have to send your carrier the bills you have received. They will then send you a check for the amount you owe or have paid, up to the amount of your coverage.  You do have to show them that you have gotten bills, meaning you can’t just call them and tell them you were hurt and they will send you a check.  Also, you can’t get the money to then get treatment; this aspect can be most frustrating as it can be hard to find the money to get the treatment you need first.  You have to have medical bills to obtain this money. Continue Reading

If you suffer a compensable accident at work or an occupational disease, the North Carolina Workers’ Compensation Act determines what benefits you are entitled to receive.  An injured worker is entitled to receive, at no cost to him or her, the medical treatment for any item which is reasonably calculated to provide relief, lessen the period of disability or effect a cure for the injured worker.  The workers’ compensation carrier is entitled to pick the medical providers, with some exceptions.

stockfresh_9551054_manual-worker-helping-injured-colleague-in-construction-site_sizeM-300x200In addition, the injured worker is entitled to receive a weekly indemnity check while he or she is either completely written out of work for the injury, or is restricted to work that the employer cannot accommodate.  This money is referred to as a temporary total disability payment.  The amount of this check may be calculated using different methods, depending on factors such as the employee’s length of employment prior to the injury.  The goal is to most nearly approximate the amount the injured employee would be earning if not for the injury.  The weekly check may continue for up to 500 weeks under the law, with some possibility of extending it beyond that in certain cases.

Alternatively, if the worker can do part-time work, he or she would be entitled to a partial check while not able to earn the amount earned prior to the date of injury.  This is known as a temporary partial disability payment and is essentially two-thirds of the difference between the pre-injury average weekly wage and the post-injury average weekly wage.

As of writing this article, blue water Vietnam Veterans are entitled to the same presumptive service connection as if they had boots on the ground in the Republic of Vietnam.  The United States Court of Appeals for the Federal Circuit has ruled that blue water Vietnam Veterans are entitled to receive benefits for illness because of exposure to Agent Orange.

stockfresh_6621310_military-ship_sizeM-300x201Vietnam Veterans know that for many years the VA has distinguished between what is known as “blue water Veterans” and “boots on the ground” Veterans.  Blue water Veterans are Veterans who served aboard ships off the coast of the Republic of Vietnam, or in Vietnam’s deepwater ports, between January 9, 1962, and May 7, 1975.  Boots on the ground Veterans are Veterans whose feet physically touched the ground in the Republic of Vietnam, even if just for one second, during that same period.[1]  For the sake of brevity, “brown water” Veterans (those who served in Vietnam’s navigable rivers and in-country waterways), Veterans who served on airbases in Thailand, and other Veterans who have been added to the presumptive service-connection list will simply be included under the category of “boots on the ground” Veterans.

In Procopio v. Wilkie, 2017-1821 (January 29, 2019)[2] (click here for the decision), the United States Court of Appeals for the Federal Circuit held that Congress had always intended all members of the uniformed services who served within the twelve nautical miles territorial sea of the Republic of Vietnam to be entitled to the presumptions detailed in 38 U.S.C. §1116.  Congress, the Court states, never had any intention of differentiating between blue water Veterans and boots on the ground Veterans.  The Court goes further to state that the VA never had the authority to add the boots on the ground requirement at a later date.  In adding this later requirement and subsequently denying Veterans who had served in the territorial waters off the coast of the Republic of Vietnam for Agent Orange related presumptive service-connected conditions, the VA ceased applying the applicable law accurately.  As of the day this article was written, February 1, 2019, the decision in Procopio had not been appealed.

If the accident wasn’t my fault, why does my insurance have to pay? Why am I responsible?  We hear this all the time when clients first come to our office.  The simple answer is yes; you should give the hospital your health insurance information. It benefits you to file your health insurance for several reasons.  First of all, even if the hospital says they will file the at-fault-drivers car insurance, you still are the responsible party on that bill.  There is also a common misconception that car insurances will pay the bills as you get treatment.  This is simply not the case.  stockfresh_8864104_physiotherapist-fixing-knee-braces-on-womans-leg_sizeM-300x200The hospital or doctors offices are merely just waiting to get paid out of YOUR settlement, and until there’s a settlement, they come knocking at your door for the payment.  Because people involved in serious accidents may end up receiving treatment for months or years, these bills can languish and sometimes even go to collections. People often don’t even know the bills are owed or going to collections because they think the liability insurance pays immediately like health insurance.  But that is not the case.  You are the one responsible for those bills.

There are a few other reasons to make sure your providers have your health insurance information, beyond saving your credit.  There are laws about how hospitals can bill people, for these laws to be used to your advantage by your attorney at the end of the case, it is very important that you do a good job documenting that you at least advised the hospital that you had health insurance.  Even a simple note to yourself of when you gave them your health insurance information and who you spoke to.  If possible, even encourage them to make a copy of your card and document if they refuse.  This is helpful regardless of the type of insurance you have, private, Medicare or Medicaid.

A third reason to make sure to give providers your health insurance card is because the adjusters want you to.  If you give your health insurance information to the medical providers, your health insurance will pay a lower amount than is charged in other situations because they have agreements with providers to cut down the costs.  This, in turn, saves money for the insurance company when calculating your medical costs.  Adjusters will claim you have not “mitigated” your damages, meaning you have not done your best to cut down the medical treatment costs, and will then try and pay a smaller amount on a bill, even though, you of course still owe the WHOLE bill.  In these instances, it is very helpful for your attorney to have documentation of who you tried to give your health insurance information to.  It comes down to the simple fact that hospitals think they will get paid more by the car insurance company rather than your health insurance.  Don’t let them bully you, push them to file your health insurance.   How to best handle all your medical bills from a car wreck is very complex, but a skilled attorney can help you navigate these complicated issues. Please call us today if you have any questions.  There is no fee to discuss your injury case.

There are many health reasons to give up cigarettes for good, and you can start today as part of the American Cancer Society’s Great American Smokeout, but if you need another reason to quit you may be motivated by knowing that smoking could lead to a doctor refusing to perform surgery on you.  In February 2018, the Charlotte Observer reported that a growing number of physicians have begun to ask patients to quit smoking or at least stop four to six months before and after the surgery.

stockfresh_3942704_cigarette-butt-no-smoking_sizeS-200x300According to the Observer, smokers do not fare as well as non-smokers following spinal fusion surgery and joint replacements, and one study found that smokers had an 80 percent higher chance than nonsmokers of needing repeat surgery after a joint replacement because of complications from an infection. This is because smoking inhibits blood flow, which in turn inhibits healing.

The Observer also reported that most doctors are paid through fee-for-service systems under which they are reimbursed for every appointment, test, or procedure and, thus, make more money when a patient has complications. Some surgeons who perform spine surgery and knee and hip replacements in Charlotte, however, have started using “value-based” systems in which a single “bundled payment” is accepted for each patient encounter. A doctor or hospital keeps the savings when care is delivered for less than the contract price but must absorb the extra cost when there are complications for which the patient requires additional care.

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