$70,000 Work Comp Settlement for Nurse’s Injury On the Job

Nurses have some of the toughest jobs around, and the continuous hard work causes repetitive/cumulative injuries for many of our front line workers. Over the years ICL has represented nurses and hospital workers, and has found that often injuries go un-reported due to these hard workers tough attitude and drive to help others over helping themselves. When injuries are reported, unfortunately we have found that hospital HR and supervisors downplay the severity – or send employees to in-house clinics that immediately recommend return to work. We’ve even had one case where a hospital employee had a severe shoulder tear but the in-house hospital industrial doctors refused to request an MRI and tried to return our client to work immediately with nothing but over the counter medication.

ICL is happy to announce a $70,000 settlement for one of our nurse clients with shoulder and low back injuries. This senior nurse’s job duties over the last 20+ years included constant patient care including lifting/carrying and moving large patients from beds.

Despite clear evidence of injury over a ~20 year dedicated career, the employer still tried to avoid responsibility for the cumulative trauma injuries. The Applicant had to go through her own insurance and get limited EDD benefits for a year as we fought the insurance every step of the way. She paid over $6,000+ for her own treatment, which we were able to get reimbursed, along with mileage and travel costs for appointments.

As a final note, we’d like to say THANK YOU to all medical workers in California and across the US. Your hard work and sacrifice keeps all of us safe in these troubling times. If you ever need advice or have questions, we are here to help day or night!

ICL $175,000 Settlement for Injured Worker Fall On The Job

Injury Compensation Law PC is happy to announce a $175,000 settlement for one of our top clients in Los Angeles. This Applicant fell at work causing serious injury to the back, hip, and shoulder that eventually led to surgery and multiple complications (including psychiatric, internal/gastrointestinal, and knee).

Defendant insurance tried their best to deny medical treatment, reduce future medical care provisions, and force the Applicant off medications and durable medical equipment in an attempt to save final settlement costs. Defendant even tried to send limited medicals (leaving out vital QME and other medical legal reports) to Independent Medical Review to try to uphold their improper Utilization Review denials. After forcing litigation on the issue, Defendant agreed to continue authorizaton for the treatment originally denied.

Using medical and settlement experts, Injury Compensation Law PC was able to obtain a large settlement for the Applicant that not only covers future medical care, but also limits the reduction of social security benefits! Thank you to all of our experts for the assistance resolving this claim!

InjuryCompLaw Fights for Medical Legal PTPs and QMEs/AMEs as Auditors Recommend Fixes

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In a recent November 19th Report from the DIR, auditors found failure to adequately administer the QME process may delay injured workers’ access to benefits.  The recommendations by auditors included potential increases to the medical legal fee schedule, increased number of doctors on panels, and potential changes to the process for quicker access.

While the number of PQMEs able to write medical legal reports is absolutely a serious issue, we believe the more serious issue is access to doctors willing to work on denied cases on a lien basis.  In some areas finding a doctor is hard or there are extremely limited options.  Finding a specialist (like sleep, neuropsych, or internist) or surgeon on lien is near impossible even in populated areas. How are Applicants suppose to prove up their injuries with substantial medical evidence if no doctor will write a report?

Injury Compensation Law represents doctors that write medical-legal reports for collections and Petitions for Determination of Non-IBR Medical Legal Disputes.  We have found that many doctors do not know that they can write medical-legal reports as PTPs under Title 8 CCR 9793(c)(2) (as well as other code sections and case law).  We have also found that when the proper documentation such as PTP designations/proper billing and proofs of service/timely objections to EORs/etc are present we can get attorney fees under Title 8 CCR 10451.1(g)(1-2) and get the doctors their entire bill plus penalties and interest.  We have one medical-legal provider group that has been using our services and has never paid a dime to our office since we get attorney fees every time due to their proper documentation and following the rules.

Judges are seeing these Petitions more and more nowadays as providers try to get paid.  Some Judges have even started immediately issuing orders for payment of the full bill, 10% penalty + 7% interest per Labor Code 4622, and even attorney fees.  Others have been setting Status Conferences/MSCs on the issue where we then set for trial.

If you are a Medical-Legal Provider (PTP, QME, AME, or even secondary physician) and are currently paying a collection agency with hearing representatives to take a cut – perhaps consider contacting InjuryCompLaw. Since we are attorneys, we get attorney rates/fees from the court.  That means a better chance that you get your entire bill paid (plus P&I!), without having to give anyone a percent.  You get better representation from a real attorney, advice from someone legally allowed to provide litigation answers/work, and you could pay less than what you are paying your current hearing representative/collection company.

 

Injury Compensation Law Opens New Office in Costa Mesa California – Personal Injury, Workers Compensation, Social Security Disability (soon)

Injury Compensation Law PC is proud to announce a new office location now open in Costa Mesa!  We will continue to take personal injury and workers compensation claims (and lien litigation), and in the near future will be expanding into Social Security Disability! Stay tuned for more updates!

You can still call us and schedule appointments in our Anaheim and San Diego offices! For Orange County/Los Angeles call 714-627-2622, for San Diego call 619-550-2111!

Car Accidents, Crashes, and Injuries – February Rain Hits Los Angeles, Orange County, and San Diego

Over the last month of rain, car accidents and crashes have been happening all over Los Angeles, Orange County, San Diego, Riverside, and San Bernardino.  Many accidents/crashes have been due to heavy rains and slick roads, as well as other dangerous road conditions.

A violent fatal crash happened in Chatsworth on DeSoto Avenue and Plummer Street this weekend between a Infiniti and Toyota, including serious injury to a 9 year old girl who is in critical condition.  Another man from Granada Hills was also injured, while the driver and passenger for the 9 year old girl died at the scene.

A suspected DUI crash happened near Central Avenue and 33rd, injuring all seven people in the Honda Accord. Multiple passengers have head traumas (including one thrown from the car 80 feet), and the driver fled on foot but was later found and arrested.  Of the seven people in the car, only one was wearing a seat belt.

The rains (and even snow!) has caused serious car crashes and accidents from Los Angeles to San Diego.  Snow even covered San Diego mountain areas closing some roads and forcing San Diego Sheriff’s Department to ask drivers to stay home due to dangerous driving conditions.

As we know from our previous post about weather conditions, they can seriously increase the rate of accidents and crashes.  These cause serious injuries like whiplash, neck and back pain, broken bones, head traumas, and a variety of strains/sprains.  Please be safe and always wear a seatbelt!  Also make sure you have proper tires (and chains if needed) when heading up into the mountains for a snow adventure.  Watch out for black ice and slick roads after rain and snow.

If you have been in a car accident or crash, first get to a safe area and call an ambulance for any injuries.  Make sure to obtain a police report, contact your insurance company, and immediately call a attorney like those at Injury Compensation Law (714-627-2622).  Always get checked out by a doctor immediately, and pay attention to any pain that arises in days/weeks following the accident. A personal injury (or workers compensation if driving on the job) attorney can help you navigate the complicated insurance system, send you to the best doctors, and get you back to your life as soon as possible.

What Are Policy Limits? How Do They Affect My Personal Injury Claim?

While everyone is required to have car insurance (read as: required, but may not always have), many of my clients don’t understand how the policy limits for their insurance coverage work until they are in a car accident. By that point, it can be too little, too late.

So let’s start from the beginning. Policy limits are the maximum benefit an insurance company will pay for a policyholder if/when an insured event occurs. Meaning, the limits are the maximum amount your insurance company is contracted to pay in an accident. Now, don’t confuse that to mean that is how much they will pay in any accident. It just means that your insurance company is not required to pay any more than what you agreed your policy limits would be.

Typically, your policy limits are expressed as three numbers. For this explanation, we will use the California minimum, 15/30/10. The first number, 15, represents your per person, bodily injury limits of $15,000. Meaning, if someone gets hurt and you are found liable for the accident, your insurance will cover up to (but not exceeding) $15,000 of any one person’s damages. The 30 represents $30,000 total bodily injury coverage per accident, meaning your insurance will not pay over $30,000 for the entire accident. So, if multiple people are involved, they all have to share that $30,000, not matter what the circumstances. The last 10 in the series translates to $10,000 property damage per accident.

So, how does this affect your accident? Depends on which side of the table you sit.

If you are found liable for the accident (i.e. the accident is your fault), your limits will be the maximum amount your insurance covers for any damages. On the plus side, your insurance will cover you. On the downside, if the other person(s) involved in the accident suffer damages much higher than your policy limits, you can be found responsible for the difference.

If you are the injured party, the at-fault party’s limits will control the maximum policy limits that will be paid out by the insurance company. The good news, the other party has readily available funds to help with your damages. However, those funds are limited which can leave you in a tough spot. The limitations become even more apparent when there are multiple cars involved in the accident. The policy limits are the maximums per accident, and they are not increased no matter how many people or how severe the accident may be. There are way to protect yourself through your own insurance by paying for uninsured/underinsured motorist coverage.

Policy limits can have a huge impact when you are in a car accident, and you need to know what that could mean for you. If you have been in an accident, consult with a personal injury attorney to help navigate your accident and make sure you understand your rights and protections. The lawyers at Injury Compensation Law PC provide excellent service and quick resolution, and there are no fees until compensation is obtained.  You can reach the Los Angeles/Orange County/Inland Empire office at 714-627-2622 or the San Diego office at 619-550-2111. Drive safe!

 

 

ICL Wins Trial on Temporary Disability and Earning Capacity for Union Construction Worker – Labor Code 4453(c)(4)

In a recent trial, Injury Compensation Law Attorneys won against defendant on the issues of temporary disability and earning capacity for an injured union construction worker.

In this case, defendant had previously obtained a court order that the applicant’s average weekly wage was $290.76 based on just under 2 weeks (9 days) of wages prior to injury.  The applicant had just started working at the construction employer when he sustained injury to the back and elbow due to an incident.

Unfortunately defendant obtained that rate with incorrect calculations of days and hours worked, and refused to acknowledge earning capacity calculations based on Labor Code 4453(c)(4) where the applicant worked for less than 30 hours per week.  The Judge set aside the prior order under Labor Code 5803 for good cause, including the fact that Applicant’s prior attorney improperly sent a hearing representative instead of a attorney on the day of trial.

Using the Applicant’s Sheet Metal Union 60% journeyman membership documents and prior employment, Injury Compensation Law was able to prove his actual earning capacity under Labor Code 4453(c)(4) was $1,062.80 per week.  This resulted in significant increase in temporary disability benefits for the union worker awaiting surgery, as well as back-pay of over $20,000+ in benefits owed by the insurance carrier.  The court provided excellent analysis of 4453(c)(4) including reference to California Supreme Court case Argonaut Insurance Company v. Industrial Accident Commission (1962) 57 Cal. 2d 589, 594 [27 Cal. Comp. Cases 130, 133].

In a comment to bLAWg.blog, Attorney and Founding Partner J. Grant McCreary said: “This is a big win for our client, as he was almost evicted due to defendant paying less than $200 per week in temporary disability benefits.  Now he can comfortably pay his bills and support his wife and kids as he awaits surgery and recovery.  This case shows that injured workers should not settle for questionable firms with hearing representatives that don’t know the law.  Union workers should always find a knowledgable aggressive attorneys that can work with their union representatives to make sure proper benefits are paid in full.  A special thanks to Sheet Metal | Air | Rail | Transportation (SMART) Local Union 105 for their help providing documents and support!”

Southern California Rain Storms Increase Auto/Car Accidents, Crashes, & Injuries

If you live in Southern California (ie Los Angeles, Orange County, San Diego, Riverside, San Bernardino) areas you know it’s been raining heavily over the last couple weeks.

The Department of Transportation estimates 21% of all auto/car accidents and crashes are due to weather conditions.  Water levels and lane submersion can cause sudden decreases in speed, delays, hydroplaning, and fender benders.

These kind of accidents and crashes can cause serious injuries, including whiplash, neck injuries, back injuries, broken bones, sprains, strains, concussions, bruises, and even deaths.

According to the OCRegister (and National Highway Traffic Safety Administration), the I-10 was the 4th most dangerous highway in America and the I-5 was the 7th most dangerous.  In 2016 alone, 8 fatal crashes occured within just a quarter mile of the I-405 and the I-605 interchange. In 2016, 56 fatal crashes occurred on I-10 between Santa Monica and Beaumont, a distance of about 100 miles.  The top reason: driving too fast.  The top involvement: drivers under 34 years old.

If you have been injured in a car accident, make sure to get to a safe place, exchange information with the other driver, obtain a police report, and then call a knowledgeable attorney.  The lawyers at Injury Compensation Law PC provide excellent service and quick resolution, and there are no fees until compensation is obtained.  You can reach the Los Angeles/Orange County/Inland Empire office at 714-627-2622 or the San Diego office at 619-550-2111

The latest Work Comp, Personal Injury, Social Security Disability, and Lien Litigation News/Updates

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