Meggesto, Crossett & Valerino, LLP

H00C8974   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.

 

william crossettPicture21. 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

New York Workers' Compensation

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.

If you are planning to take Social Security Retirement Benefits before full retirement age, are you doing this because you want to stop working or because you have an illness or injury that is forcing you to stop working?

If you are taking early retirement due to an illness or injury, you should consider filing a claim for Social Security Disability Benefits. You can do both, meaning you can collect your Reduced Retirement Benefit while you are waiting for a decision on your Social Security Disability Claim. If Social Security approves your disability claim, Social Security will pay you the difference between your Disability Benefit and your Reduced Retirement Benefit for the months that you are eligible for both. Thereafter, you will continue to receive your Disability Benefits.

-Kimberly Slimbaugh

Email: kslimbaugh@mcvlaw.com

Kimberly Slimbaugh