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).
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.
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.
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 stress an injured worker. Unfortunately, there’s a good chance your workers compensation adjuster does not pay on time. And to add insult to the work-related 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.
Ultimately it’s the adjuster’s responsibility to ensure they receive their payments and have the necessary resources to ensure you are being paid.
By law, workers’ compensation insurance must pay you within 14 days of the check’s due date. 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 withholds checks from you or takes more than two weeks to pay you, contact an experienced attorney. We work with you to make sure that your rights are protected.
The first thing that comes to mind when someone mentions workers’ compensation is that they will get paid. That’s what we all want, right? We want our money to pay bills or buy groceries as soon as possible. But not everyone gets their money on time. Some adjusters take months to even respond to claims. If you don’t hear from them within 30 days of filing your claim, you should contact an attorney immediately.
When you file a claim, there is usually a form that you need to fill out. You may be entitled to legal representation if the insurance company denies this form. You would need legal representation because the insurance company will try to deny your claim based on something that was written down incorrectly or wasn’t filled out correctly. It could also be that the insurance company did not give you enough information about how they would handle your case. If you receive a denial letter, you should call an attorney immediately. You may be able to appeal the decision, but may want the assistance of an experienced workers’ compensation lawyer.
When workers’ compensation adjusters fail to pay you on time, there are legal rights you should be aware of.
If your injury was due to negligence, your employer might be liable for damages. And if your injury was due to intentional misconduct, your employer may be liable for punitive damages.
But wait, there’s more! If your injury was due to gross negligence, your employer might still be liable for compensatory damages. Gross negligence means that your employer knew or should have known that his actions were dangerous and likely to cause harm.
The bottom line is this: if your workers’ compensation adjuster fails to pay you on time or pays you too little, you have legal recourse.
When it comes to workers compensation benefits, there are two significant kinds: temporary total disability and temporary partial disability. You may have heard both of these terms if you find yourself injured at work. You might also wonder, “Just what exactly do these terms mean, and what is the difference between the two?”
Your doctor may recommend you take a leave of absence from work. If this is necessary, you should notify your employer in writing.
Once you’re cleared to return to work, contact your supervisor and request a light-duty assignment. Again, your employer may offer you a different type of position than the one you had before being injured.
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 can work at your regular rate. We refer to these as “make-work jobs.” If you refuse to do this job, 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. Your checks will continue if you are fired while receiving temporary total disability.
When applying for temporary disability benefits, you need to document your inability to work. Include information about the date and nature of your injury, your medical treatment, and dates when you were out of work and receiving benefits.
Documenting these events helps prove that you couldn’t work during the period you applied for benefits. Also, include copies of bills showing the cost of your medical care.
Don’t forget to submit proof of your earnings history. You should list your pay stubs and W2 forms if you worked full-time. If you worked part-time, you should include copies of your paycheck stubs and tax records.
