Who are Nurse Case Managers and Are They on My Side?
If you sustain an injury at work, you may have a nurse case manager appointed to your case. Many of my clients are unaware of the role of a nurse case manager, and many of them have never even heard of one until they begin their workers’ compensation case. A nurse case manager is a neutral third party in your case. They don’t work for the insurance company, nor are they a part of your medical team. It is their job to report information on your condition to the insurance carrier, the hope being that doing so will speed up your case.
It’s important to understand that a nurse case manager is supposed to be objective. Everything you say to them will be reported to your insurance provider. Therefore, be careful: Don’t say anything that could be misconstrued or harmful to your case. We recommend looking over all of the notes that your nurse case manager passes along, and make sure to dispute any discrepancies. You should be receiving copies of these notes. Moreover, your nurse case manager should not be speaking to your doctor if you are not present.
If you feel that your nurse case manager is acting in a way that is harmful to your case, or representing you in an unfair light, be sure to contact an experienced attorney to help you negotiate with them. You should always tell your attorney if you feel that your nurse case manager is not protecting your rights (for example, if they are not providing you with copies of their correspondences or attempting to speak with your doctor without your presence).
If you have any questions about working with a nurse case manager, or if you are concerned that your nurse case manager is not representing you fairly, don’t hesitate to contact one of our experienced attorneys for a free consultation.
What is Permanent Partial Disability and How Do I Qualify for It?
Recently, I had a client who inquired about permanent partial disability. They were curious about what it was and whether not they would qualify for it. I thought I’d pass along that information, as it might be relevant to you as well and others who are unfamiliar with permanent partial disability.
Essentially, permanent partial disability is used to compensate for permanent physical damage sustained during a work injury. Here, “partial” refers to the fact that you still have some use of the injured body part. In other words, you still have some functionality, but the benefits cover the injuries that have prevented your body from returning to the functionality it once had.
A doctor will determine the amount of disability using a scale of 0 percent to 100 percent. 0 percent means that there is no permanent injury at all. 100 percent would mean you have a permanent and total disability. Injuries that range from 1 percent to 99 percent are eligible for benefits.
You are eligible for permanent partial disability regardless of whether or not your injury prevents you from performing your old job. The reasoning is this: With permanent partial disability, you are being compensated for your loss of ability in your injured body part rather than for your ability to work.
Compensation is calculated at 2/3 of your regular weekly salary, based on your last 12 months of employment with your current employer. However, it’s worth noting that compensation is capped at $816 per week.
Permanent partial disability is there to compensate you for loss in functionality due to your injury. It’s based on your body’s ability rather than your ability to work. If you have any questions about permanent partial disability, don’t hesitate to speak with an attorney.
I’ve Been Injured on the Job and Cannot Go Back To Work! When Will I Start Receiving Compensation Checks?
After you’re injured on the job, we know that funds can be tight. From medical bills, to not being able to return to work, to the general expenses of daily life, a work injury can lead to tough financial situations for yourself and your family — leaving you wondering, “When will I start receiving my workers’ compensation checks?”
Under the Workers’ Compensation Act, “no compensation shall be allowed for the first seven calendar days of a disability resulting from an injury.” This means you’ll be waiting at least a week. In this time, we recommend reaching out to an attorney — the sooner the better. In the event that your injury leaves you disabled for more than 21 days, you may be allowed compensation from the date of your disability.
While you are allowed to use sick days or vacation days to cover the first week you’re out of work due to your work injury, you are not required to use this limited resource. Constantly, we see employers and insurers misinforming injured workers about their use of paid time off.
Hiring a lawyer early on in the process will ensure that you’ve got someone on your side who understands all the laws and nuances of dealing with a workman’s compensation case. With more than $275m in settlements and awards, we have the experience to guide you through the workers’ compensation process and ensure that your rights are being protected.
By law, you are not able to receive workman’s compensation until a week after your injury. If you have any questions about the workers’ compensation process, don’t hesitate to contact an experienced attorney.
What Happens When My Workers’ Compensation Adjuster Does Not Pay Me On Time?
For an injured worker, weekly workers’ compensation benefits are essential for paying the bills and putting food on the table for a family. Not knowing when your weekly check will arrive can put added stress on an injured worker. Unfortunately, there’s a good chance your insurance adjuster won’t pay you on time. And to add insult to injury, in most cases, there’s nothing you can do to force them to pay on time because there is no law saying they have to pay you on the due date.
In the case of self-insured employers, they are often required to periodically send money to the insurance company. In those instances, we’ve heard adjusters use the excuse that they are waiting for money from the employer — but at the end of the day, that’s just an excuse. Ultimately it’s the adjuster’s responsibility to make sure they receive their payments and have the necessary resources to make sure that you are being paid.
By law, workers’ compensation insurance must pay you within 14 days of the date the check is due. If the insurer does not pay you in that time, you may request a 10 percent penalty against the workers’ compensation insurance by filing a motion with the North Carolina Industrial Commission.
While the insurance companies are not required to pay on time, they are required to pay you eventually. If an insurance company is withholding checks from you, or taking more than two weeks to pay you, be sure to contact an experienced attorney. We work with you to make sure that your rights are being protected.
When it comes to dealing with insurance companies, it’s always good to have a partner who’s got your back. Even better to have one who also understands the fine print surrounding workman’s comp. With more than $275m in awards and settlements, Oxner + Permar has the experience to fight for you.
Temporary Total Disability vs. Temporary Partial Disability: What’s the Difference and What do They Mean to You?
When it comes to workers’ compensation benefits, there are two major kinds: temporary total disability and temporary partial disability. If you find yourself injured at work, you may have heard both of these term. You might also be wondering, “Just what exactly do these terms mean and what is the difference between the two?”
Temporary Total Disability
- Temporary total disability is when you are temporarily out of work completely. In other words, because of your injury, you are unable to work at all. However, the expectation is that you will improve and eventually return to work. This is not a permanent disability.
- If you qualify for temporary total disability, you will be paid at the rate of 2/3 of your average weekly wage. If you make $360 dollars a week you will be compensated approximately $238 a week — pretty straightforward.
Temporary Partial Disability
- Temporary partial disability is for when you are unable to work your regular job due to your work injury, but you are able to do some work. Because you are not working your old job, chances are the pay will be lowered to match the work you are doing.
- When you’re on temporary partial disability, you will be paid at the rate of 2/3 of the difference between what you made on your old job and what you are able to make on your new job. For example, if you made $360 a week at your old job and $200 a week at your new job, you would be compensated approximately $106 from your temporary partial disability benefits — meaning your weekly total would now be approximately $306 a week.
Unfortunately your employer can have you perform whatever job they’ve created for you (e.g. something as menial as counting paper clips or sitting in a chair) until you recover and are able to work at your regular rate. We refer to these as “make-work jobs.” If you refuse to do this job, then you are giving up your right to weekly disability checks and medical benefits.
Sometimes an employer will find a reason to fire you while receiving temporary partial disability benefits. Unfortunately in the state of North Carolina, there is no law against firing you while you are on disability benefits, just so long as your employer cites another reason for your termination. If you are fired while you are receiving temporary total disability, your checks will continue.
If you have any questions about temporary total disability or temporary partial disability, contact one of our experienced attorneys at Oxner + Permar. We are devoted to keeping our clients informed of their rights and helping them navigate the ins and outs of workers’ compensation.