Workers Compensation | MCV Law

3 Reasons Why You Should Have an Attorney

Potential clients often ask us whether or not they need an attorney. The short answer to this question is no, injured workers are not required to have an attorney. However, there are 3 key reasons why we believe injured workers should have an attorney.

1. Your Rights – Injured workers need someone on their side. The insurance company will have an attorney representing their rights, so it is important to have someone looking out for your rights. The insurance company does not work for you. In fact, their main goal is to save money. A common misconception is that the insurance company must explain what they are doing to you, but this is not true. The insurance company has no obligation to inform you of your rights or even explain the law to you. Additionally, the Judge does not work for you. While the Judge’s role is to administer justice, the Judge has no obligation to fight for your rights. As claimants’ attorneys, we are on your side and it is our role to see that you receive every benefit you are entitled to under the law.

2. The Paperwork – The Workers’ Compensation system has over 50 forms for injured workers to use for various reasons. In addition to the forms designated for you, there are numerous other forms designated for insurance carriers. If this is not enough, injured workers often receive paperwork from the Workers’ Compensation Board pertaining to their case. This creates a lot of mail and can be very overwhelming for an injured worker simply trying to get better. Also, much of the paperwork can be very difficult to understand. At MCV Law, we help our clients understand the paperwork they receive and help them decipher what is important and what is not.

3. Medical Care – Although most injured workers trust their doctors, many of them are confused by what their doctor is saying in their medical reports. As attorneys, we work to help clarify what is in your medical reports and how it will impact your case. For example, if your doctor has you at 75% temporary disability, he or she is saying something about your ability to return to work.

Although you can Google the law, call the Workers’ Compensation Board, read Blogs, etc., this is not the same as working with a team of dedicated attorneys, client advocates, paralegals, and other important staff that are focused exclusively on representing your interests. Every case is unique and our attorneys strategize, plan, and execute based on the particular facts and circumstances of each case – something the other sources cannot do for you.
Bethany Nicoletti

Email: barliss@mcvlaw.com

Phone: 315-471-1664

Bethany Nicoletti is a graduate of Ithaca College where she earned her B.A. in Communication Studies. She graduated cum laude from University at Buffalo Law School in 2013 and was admitted to the New York State Bar in the Fourth Judicial Department in 2014.

Quick Answers By MCV Law: Just What Is New York Workers’ Compensation Law?

Posted by: William Crossett In: Quick Answers, Workers Compensation 08 Jul 2015 Comments: 0 Tags: hurt at work, Injured Worker, mcv law, new york state workers' compensation, New York Workers Compensation, syracuse attorney's, Syracuse Injured Worker, syracuse workers compensation, workers comp, workers' compensation

New York’s Workers Compensation Law is an employee’s only remedy for injuries arising “out of or in the course of employment”. This means that if you are injured or hurt while at work or develop a sickness or disease that is caused by your employment, you are entitled to Workers Compensation benefits. In most cases, the Worker’s Compensation law prevents you from suing your employer, with the exception being an intentional act by the employer, such as an assault.

If your injury, sickness, or disease is a result of the negligence of a third party who is not a co-employee, you may have the right to bring an action in addition to your Workers Compensation case. This is commonly referred to as a third party action.

Some examples of third-party actions are:

An action against a property owner who has a statutory duty to provide a safe place to work. This usually occurs on construction sites, particularly regarding falls from elevated heights.
An action against an owner of an automobile or truck that caused a serious injury to an employee driving in the course of employment.
An action against the manufacturer of a machine or device that caused injury due to a defect or lack of warning.

If a recovery is made in the third-party action, the Worker’s Compensation carrier is entitled to be reimbursed for what was paid in the Workers Compensation case.

In New York, Workers’ Compensation benefits include lost wage benefits and medical care that is causally related to the injury, sickness, or disease.

For a more in depth look at workers compensation, click here.

Disclaimer: Quick Answers by MCV Law is provided by the attorneys and Meggesto, Crossett and Valerino, LLP. The content contained in this post, as well as on the website as a whole, is provided for informational purposes only and should not be construed as legal advice on any matter.

My Two Cents on Respect and Our Mission

Posted by: William Crossett In: Workers Compensation 24 Jun 2015 Comments: 0 Tags: bill crossett, Injured Worker, New York Workers Compensation, Syracuse Injured Worker, syracuse lawyer, syracuse workers compensation, workers' compensation

INJURED WORKERS DESERVE RESPECT

Recently, a significant part of the national conversation has been about respect. Respect for Black and Hispanic lives, respect for those accused of crimes, and respect for police and law enforcement officials. Certainly, this conversation is important and overdue.

Also overdue, in my opinion, is the conversation about respecting the men and women who are injured every day at work. Injuries occur in every line of work without discrimination. Certain injures, however, seem to garner more respect. Is that because certain lives are more important than others or because certain injures are undoubtedly going to result in a permanent disability?

I think not. Rather, I suspect that we perceive certain circumstances as repugnant. No one asserts that an on-the-job injury is desirable. However, an acute injury is more likely to be accepted than an injury that is not readily apparent.

Time and time again an injured worker tells us that they thought their back pain would go away in a couple of days or over the weekend, or that they did not want to report their injury due to fear of being labeled a complainer, a bad employee, or a person on compensation. Injured workers commonly tell us that they need to work, that they like their job, or are unsure of what was wrong and just wanted to see their doctor first.

Why don’t employers value the word of their employees? Have they hired cheaters? I doubt it. Rather, I believe that there is a stigma attached to both the injured worker and employers – a stigma that both want to avoid.

No one seeking to get ahead wants to be an injured employee collecting compensation to support their family instead of working and earning real wages. The lifestyle of spending days and nights in pain, trekking from medical appointments, to therapy, to court, just to stay above water is far from appealing.

No employer wants to have to report that something went wrong and an employee was injured, specifically if the injury resulted from one of the employer’s own processes. Nor do employers want to incur additional costs and expenses associated with an injury.

Despite this, it eludes me as why conversations about this topic rarely take place – a conversation in which both parties respect each other’s perspective and a realistic plan is formulated.

Instead, the process often starts with no respect. For example, employers often challenge that an injury even occurred, especially if it was not immediately reported or witnessed. Typically following this is litigation, where the employer challenges both the underlying circumstances and the medical treatment needed thereafter.

While I do believe the recent procedural, regulatory, and legislative changes were well-intended, they have had unforeseen consequences that have made medical treatment harder to find and understand. These consequences have resulted in even more litigation, and delays in the injured worker’s recovery, which adds costs to both sides. This results in a further lack of respect for the injured worker.

At MCV Law we strive to understand the issue posed above, and to ensure that our clients are respected not only by us, but by their employers, insurance carriers, and the Workers’ Compensation system.

Just what is Medical treatment and how do I find it?

Posted by: William Crossett In: Workers Compensation 19 Jun 2015 Comments: 0 Tags: bill crossett, Injured Worker, New York Workers Compensation, Syracuse Injured Worker, syracuse lawyer, syracuse workers compensation, william crossett, workers' compensation

The law says that an injured worker is entitled to causally-related medical treatment. This simply means medical treatment related to an injury or illness that occurred at work. In the real world, this means that you can see a doctor or medical provider, such as a chiropractor or a physical therapist, who accepts New York State Workers’ Compensation insurance, has been approved by the Workers’ Compensation Board to treat injured workers, and completes the required forms.

It is often difficult to find medical providers to treat injured workers. In fact, many family doctors and internists have elected not to treat injured workers even if they generally provide them with routine medical care. Thus, conservative care for a back or extremity injury that was once offered by a family doctor is now referred to the big orthopedic practices, which are set up to handle Workers’ Compensation. In other specialties such as lung, heart or hearing loss cases, familiarity with the forms and procedures is limited, because these injuries are rarer. A list of board authorized medical providers can be found here: http://www.wcb.ny.gov/hps/HPSearch.jsp.

The medical providers are paid according to a fee schedule prescribed by the Board and are required to complete special forms. The forms are referred to as the “C-4 family” and can be found here: http://www.wcb.ny.gov/content/main/forms/Forms_HEALTH_PROVIDER.jsp.

Many medical providers have opted out of the Workers’ Compensation system because they believe that the fee schedule is inadequate, especially given the time and effort that is required to complete the forms. While a new fee schedule was proposed, it was withdrawn and is now being reworked to encourage more universal acceptance.

Consequently, injured workers with injuries to their back, neck, upper, or lower extremities, will most likely find themselves at an orthopedic practice shortly after their injury. Treatment for these sites is now subject to the Medical Treatment Guidelines. The Guidelines lay out acceptable treatments, as well as the sequence and duration for such treatment. If your doctor or medical provider wants to vary from the Guidelines, a variance must be filed and authorization must be obtained. A link to the Guidelines can be found here: http://www.wcb.ny.gov/content/main/hcpp/MedicalTreatmentGuidelines.

The Guidelines also require pre-authorization for more complicated treatments, such as fusion of the vertebrae of the low back. This process brings further requirements for doctors to follow. Specifically, doctors must complete and properly file a C-4AUTH form and wait 30 days for the Carrier to respond. The Carrier may approve or deny the request. To properly deny, the Carrier must provide evidence to support their denial, such as an opinion from an Independent Medical Examiner. Although a denial can be challenged in court, the process is still complicated and lengthy.

Are you paying out of your pocket for treatment for your comp case?

Posted by: William Crossett In: Community, General, Personal Injury, Workers Compensation 17 Apr 2015 Comments: 0 Tags: Accident attend bill crossett carriers doctor crossett & valerino degree of disability disability Doctor exaggerate hurt at work Illness IME IMe's Injured Worker injured workers insurance insuranc, mileage, rate, reimbursement

Are you paying out of your pocket for treatment for your comp case?
Can I get my co-pays for the doctor back?
Can I get reimbursed for mileage to and from the doctor?
Can I get reimbursed for my medications?

At Meggesto, Crossett & Valerino, LLP, we make sure our clients do not pay out-of-pocket for costs associated with their claims and that they receive the reimbursement they are entitled to.

Medical professionals, doctors, hospitals, and facilities treating you in New York State for your Workers’ Compensation injuries cannot bill or charge you for any costs. All billing is to be sent to the Insurance Company responsible for your claim. This is the law of New York State.

Sometimes, especially at the start of a claim, it may be unclear who your Workers’ Compensation insurance carrier is, or how they should be billed. If you happen to pay for any treatment, keep your receipt for reimbursement. Injured workers are not responsible for co-pays.

Likewise, if you are prescribed medications and the pharmacy is unable to bill the insurance carrier, you can be reimbursed for any costs you incur as a result. We encourage you to keep a receipt of such costs in order to be reimbursed.

In addition to the above reimbursements, you are also entitled to reimbursement transportation costs. This includes mileage reimbursement to and from your doctor visits. If you use a private vehicle to get to your appointments, the current reimbursement rate is $.56 per mile as of 1/1/2014. Below is a table of mileage rates for the past 5 years A complete listing of mileage rates is available and linked here http://www.wcb.ny.gov/content/main/SubjectNos/sn150_18_1.jsp

1-1-10	50
1-1-11	51
7-1-11	55.5
1-1-12	55.5
1-1-13	56.5
1-1-14	56

Mileage is paid round trip from the location you departed to attend the appointment to the point you returned to. Generally, this includes mileage from your home to the doctor or therapist and back home again. If you use public transportation or pay for parking or tolls, you should keep those receipts too for reimbursement purposes.

There is no required form to claim mileage or other out of pocket costs for reimbursement. A reimbursement request must be sent to the insurance carrier and must include the date you traveled, the location you went to, and the mileage to and from that location. Form C-257 can be used to submit mileage to the insurance carrier. That form can be found at located here: http://www.wcb.ny.gov/content/main/forms/Forms_CLAIMANT.jsp#C257

Also many times your medical providers can supply you with a listing of the dates and locations you attended treatment.

At Meggesto, Crossett and Valerino, we recommend that you submit requests for reimbursement promptly, going back no longer than six months from the date of your appointments. Older and lengthy requests take longer to be processed for payment by the insurance companies and often become the subject of a dispute. Please note that mileage not associated with treatment is not generally reimbursed, this includes mileage to hearings, the pharmacy, or your attorneys’ office. Mileage to an IME is reimbursable.

We also recommend you keep a copy of any submission you make to the Insurance carrier, including forms and receiptsand also make a record of when you send in such paperwork. If you haven’t received a response within 60 days, you should contact your attorney for assistance in following up on the request.

For more information on workers compensation, click here.

What can I do when I am on Workers’ Compensation?

Posted by: William Crossett In: Workers Compensation 10 Apr 2015 Comments: 0 Tags: Accident, degree of disability, injured at work, permanent disability, syracuse attorney's, Syracuse Injured Worker, syracuse lawyer, syracuse workers compensation, workers' compensation

Some typical questions include:

Should I stay inside?

Can I go to the grocery store?

Can I drive?

Can I watch my grandchildren?

Can I mow my lawn?

Should I cancel my vacation?

At Meggesto, Crossett & Valerino, LLP, we advise injured workers to pursue their normal activities as much as their condition allows, and to use common sense when doing so.

Injured Workers’ activities should be consistent with their doctor’s restrictions and degree of disability. Doctors and other medical providers, will usually make recommendations of which activities to avoid or suggest limitations, not only regarding work, but also regarding activities of daily living. If the medical provider does not make such recommendations, be sure to ask for them and obtain them in writing whenever possible.

Most often after a traumatic injury or a surgical procedure, medical providers will opine that an injured worker has a temporary total disability. In these instances, it would be inconsistent to undertake activities such as lawn mowing, snow shoveling or physical, recreational activities. For example, we would not recommend that a claimant go bowling, skiing or dancing. We would also recommend refraining from strenuous hobbies, such as homecare and car repair. However, if you recently underwent surgery, it would not necessarily be inconsistent to take a planned vacation south to recover.

The question of “What can I do when I am on Workers’ Comp?” becomes particularly troublesome when your doctor suggests a partial degree of disability. Many times when this happens, the employer will not allow an injured workers to return to work, with restrictions. Nevertheless, Workers’ Compensation benefits may be reduced as a result of the partial disability and many wonder if looking for work elsewhere will jeopardize their Workers’ Compensation benefits.

When your doctor suggests a partial degree of disability, it becomes particularly important to understand exactly what restrictions your doctor recommends. At MCV law we recommend that our clients discuss their abilities, including their activities of daily living, with their doctor. We recommend that the injured worker obtain written restrictions so as to avoid any misunderstanding. Some medical providers use a functional capacity evaluation to assist in setting restrictions and limitations.

Additionally, we encourage injured workers not to exaggerate their injury or disability and to be candid with their doctors and Independent Medical Examiners about their activities of daily living, including any hobbies and volunteer activities. Importantly, we encourage injured workers to use common sense to avoid an allegation that the injured worker has committed fraud under Section 114 of the Workers’ Compensation Law.

Section 114(a) is essentially a fraud provision that imposes both mandatory and discretionary penalties for claimants who violate this provision. Typically, a Section 114(a) violation will result in a suspension of benefits. False statements made to doctors or Independent Medical Examiners are often the basis for a Section 114(a) violation. Therefore, is very important to be candid with your doctors and Independent Medical Examiners about your condition and daily activities.

In conclusion the answer is, use your common sense. Be candid and open with your Medical Providers, document the restrictions or limitations suggested and do not exaggerate or over play your degree of disability. For more information on workers compensation, click here.

Is it Disability, Compensation or Something Else?

Should I file for Disability, NYS Workers Compensation or something else?

Often people call MCV Law requesting help with a “Disability Case. “ They are injured, unable to work and looking for help to pay the day-to-day bills. The first thing the Attorneys and Staff at MCV Law do is listen.

We carefully listen to your story. We’re listening for particular facts and circumstances that will help us determine what remedy or remedies may be available to you. We ask targeted questions, to determine where you may or may not be in the process of making a claim.

Generally we are trying to determine whether or not you have one of the following:

A New York State Disability Case.
A New York Workers’ Compensation Case.
A No Fault Motor Vehicle Accident Case.
A Personal Injury Action.
A Private Short or Long-Term Disability Case.
A Social Security Disability Case.

Sometimes, there is more than one type of case arising from a single event. For instance if you’re involved in a Motor Vehicle Accident, while Working you have both a Workers Compensation claim and a No Fault Motor Vehicle Accident case. If the Accident was caused by a third-party you may also have a Personal Injury Case. If the injury is life changing you may have a Social Security Disability Case as well.

Of course, every type of case has different rules, the most important of which is the Statute of Limitations. That is the time in which the injured person must act to protect their rights. Often, especially in cases dealing with municipalities or other quasi-government entities, the statute limitations is extremely short. Therefore it is important to seek legal advice shortly after your injury or injuries. MCV Law does not charge you for the initial consultation.

At Meggesto, Crossett & Valerino, LLP, we pride ourselves on being able to assist the injured person with regard to all of the cases listed above. Instead of looking only for one type of case, we look at the injured individual as a whole. We work to craft a legal strategy that is most likely to produce the best result for you, in a timely and cost-effective manner.

Be sure to click here for further information on workers compensation, and here for a more in depth look at social security disability.

6 Things to Know about Independent Medical Exams

1. Do I have to attend? Yes, the insurance carrier is entitled to have you examined by their doctor. If you do not attend it will harm your case. Your benefits may be stopped, and your treatment and prescriptions suspended.

2. What is the purpose of the exam? Generally the carrier is seeking another opinion on the nature and extent of your injuries, your need for treatment, and your level of disability.

3. What can you expect at the exam? An IME is not like a visit to your doctor – the IME is not treating you. The exam is likely to be very quick and focused on your degree of disability or the need for treatment or prescriptions. You may be asked to complete a questionnaire prior to the exam. Answer the questions carefully, and be sure you tell the doctor about any prior injuries or new injuries. Do not exaggerate or overstate your injury.

4. What is the IME looking for? The IME doctor will look for any inconsistencies in your behavior. This could include simple observations or may involve video surveillance. The carrier often has an investigator record video of you the day before the exam, the day of the exam, and the day after the exam to try to find inconsistencies. Be frank with the IME and your doctors about your activities of daily living. Also let the IME know of any side effects of your medications.

5. What occurs after the exam? The IME exam generates a report that is sent to all parties generally within 10 days. The report may or may not agree with your doctor and often will vary, especially in assessing your degree of disability. When the carrier receives the report, they will typically request a hearing to change the level of benefits paid. If the dispute cannot be resolved, litigation will start.

6. What is the role of your attorney when you have an IME? Your attorney is aware of your IME. It is best to talk to your attorney before you attend. Your attorney will also work with you to obtain evidence to counter the IME’s conclusions before a hearing.

5 Things Every Newly -Injured Worker Should Know

5 Things Every Newly-Injured Worker Should Know

New York Workers’ Compensation

1. The New York Workers’ Compensation System is driven by medical evidence.

2. If you are injured at work, see a doctor right away, and continue to see the doctor while you are out of work.

3. Give a complete, consistent, and accurate history of your injury or illness.

4. The New York State Workers’ Compensation Law has a two-prong Statute of Limitations. You have 30 days to notify your employer that you were injured on the job or have a work-related illness. You then have 2 years to file a claim for Workers’ Compensation benefits.

5. Having a “Carrier Case Number” does not mean that you have a New York State Workers’ Compensation case. The Workers Compensation Board assembles cases when they have both a claim and medical evidence to support a work-related injury or illness.

7 Predictions for New York Workers’ Compensation in 2015

Posted by: William Crossett In: Workers Compensation 02 Jan 2015 Comments: 0 Tags: bill crossett, crossett & valerino, hurt at work, mcv law, mcvlaw, meggesto, new york state workers' compensation, syracuse attorney's, syracuse workers compensation, william crossett, workers' compensation, workers' compensation 2015

The Team at MCV Law and I have put together our predictions for New York Workers’ Compensation in 2015.

In 2015 injured workers /claimants will see:

1. Confusion over lost wage payments – we all miss the Form C-8 that has been eliminated by the Board. Keep track of your payments or at least your stubs.

2. Reliance on electronic forms – which seek standardized answers to complicated issues, especially for degree of disability. If your disability is less that Temporary Total try to obtain specific written restrictions regarding your employability.

3. Chaos over the implementation of the Non Acute Pain Guidelines that became effective in December of 2014. Discuss with your doctor potential limitations on the medications prescribed.

4. More challenges from insurance companies and Special Funds Conservation Committee regarding long term pain medications. Understand your long term medications and discuss with your doctor how they help you work or complete the activities of daily living.

5. Fewer primary care doctors accepting Workers’ Compensation – we think the fee schedule should be changed so as to encourage participation by all medical providers.

6. Challenges from the Business Council to the Schedule Loss of Use (SLU) portion of the law. MCV Law will continue to work with the Injured Workers Bar Association and the Workers Compensation Alliance to protect your rights.

7. Aggressive pursuit on the part of insurance companies to stop lost wage payments by argument a claimant’s failure to remain “Attached to the Labor Market.” Work with and documents your efforts with the “One Stop Centers”, Keep an active Job search using the Boards form C-258 and participate with Acces-Vr.

William Crossett and the Disability team at Meggesto, Crossett & Valerino, LLP.

Email: crossett@mcvlaw.com

Phone: 315-471-1664