Have you ever found yourself driving to the far reaches of your state for medical care? You put wear and tear on your car and expend fuel, yet you are hit with a huge healthcare bill at the end. Unfair, right?
Traveling extensive distances for medical care is common due to provider shortages in rural and remote areas. Although many of us face medical bills that create hardship, what should you do when it’s time to pay up after an exhausting road trip?
In this article, we’ll discuss whether you may be eligible for additional compensation if you have to travel to receive health care services!
For many North Carolinians, medical treatment centers may not be conveniently located. If you live out in the country, you could end up driving miles into the city every time you need to visit your doctor — And as we’ve mentioned before on our blog, frequent visits with your doctor can be incredibly important for maintaining your benefits.
Sometimes people need to travel long distances for medical treatment because the care they need is only available in certain places. For example, specialized medical treatments or surgeries might only be available at certain hospitals or facilities – and those facilities might be located in another city. If a person’s local hospital isn’t equipped to handle their ailment, they may need to travel even further distances to locate appropriate care.
Additionally, certain areas have become known for being medical tourism destinations – meaning that patients have traveled to distant locations specifically for medical attention or surgery. People often go abroad for elective surgeries like cosmetic procedures, dentistry services, orthopedic operations, fertility treatments and more due to favorable cost-savings on those treatments when received away from home.
It’s important to understand why one needs to travel long distances for medical treatment in order to assess reasonable expectations with regard to potential reimbursement opportunities that might be available. Generally speaking, some form of compensation is typically acknowledged and provided by employers if the employee has no alternative but to seek out mental or physical healthcare many miles away from their home base of operations.
What is considered a significant distance for traveling to receive medical treatment depends on the type of medical treatment and the patient’s condition. Generally, if the patient has to travel more than 1 hour (driving or public transportation) than in most cases it can be considered a significant distance.
In some cases, patients may have to fly to another city or state in order to receive specific medical treatments that may not be available in their local area. Depending on the location and circumstances, some patient may also receive compensation for their travel expenses such as airfare and lodging.
The exact rules of what is considered a ‘significant distance’ can vary from one jurisdiction to another and depend on each individual case. Therefore, it is important for any potential claimant to contact an experienced attorney in their area who can provide advice about their own unique situation.
The good news is that if you have to travel 20 miles or more round-trip for your medical treatment, you may be entitled to compensation for your mileage. This includes travel completed during the first seven days following your accident, when compensation for work is not yet due.
In order to claim compensation for travel, you must file a Form 25T with the North Carolina Industrial Commission to track your medical mileage. It is important to keep track of your mileage to ensure you are properly compensated. North Carolina adjusts the rate of reimbursement each year, so you may receive a different amount based on when you had to travel.
How do you achieve closure after a workers’ compensation claim? Chances are, you’ve been involved in filing and following through with all of the necessary steps of a claim for months.
It can be incredibly frustrating trying to navigate a workers’ compensation case without a clear solution. Fortunately, there is something called the clincher agreement that could offer some much-needed resolution.
In this article, we will explain what the clincher agreement is, how it works and when to use one. So, if you want to make sure your workers’ compensation case ends with a positive resolution then keep reading!
A clincher agreement is there to provide final resolution for your workers’ compensation case. The Clincher Agreement is a final resolution of your workers’ compensation case. It serves as a release agreement between you and the insurance provider, lawyer or adjuster in which you agree to settle your case in return for money.
In addition to settling the terms of compensation, the Clincher Agreement also releases both parties from future obligations should additional complications arise. That means if you experience a flare up of aggravation or even exacerbate an already existing condition due to work, you will be exempt from follow up examination or financial settlement with the insurer.
The Clincher Agreement outlines everything that was agreed upon during past negotiations and informs all parties involved exactly what is expected from each individual. The agreement should also include timelines of when payments should be made, how benefits will be distributed once they are approved.
This agreement states that all parties have reached a final agreement, and it is only allowed by the North Carolina Industrial Commission when it meets all of the requirements of Rule 502. So, rest assured that there are legal steps that your employer must take to ensure that you have been treated fairly.
The clincher agreement has several benefits that make it an ideal resolution for a workers’ compensation case. With this agreement, you can receive the compensation you deserve without having to go to court or through a lengthy legal process.
First and foremost, the clincher agreement is designed to provide fair and reasonable compensation more quickly than traditional legal processes. This means that you will not have to wait months or even years to receive the compensation that is rightfully yours. Furthermore, because this option requires no trial or hearing, it eliminates costs associated with a traditional court case such as lawyer fees, court costs, expert testimony, etc.
Another great benefit of the clincher agreement is that it often results in a much lower settlement payment amount than would be available in a traditional lawsuit. This means that while there may be less money involved overall, your settlement may still cover all related medical bills and any applicable lost wages.
Perhaps most significant of all is that both parties are able to retain their dignity throughout the process. Since no public disclosure or appeals are necessary for resolution, the whole ordeal remains private with only those directly involved knowing about it. This makes for an amicable ending to an otherwise contentious dispute and allows everyone involved to put this difficult situation behind them once and for all!
There are a few things of which you should be aware if you are in the process of formulating a clincher agreement with your employer.
Whether or not it seems fair, it’s a fact that many employers seek to obtain a resignation and release of all employment claims at the same time they get a clincher of the workers’ compensation claim. Why? A previously injured employee is a future liability. In their view, and it makes good economic sense to secure an employment resignation and release at the end of the workers’ compensation claim. To ensure things go smoothly, there are a few things to consider before you discuss a resignation and release.
It is important to know that you cannot be forced to resign from your employment. If you are not willing to voluntarily and willfully resign your position, make that clear to your employer.
If you are considering entering into a clincher agreement, it is important to seek the advice of an experienced workers’ compensation lawyer. A lawyer can help to ensure that your rights are fully protected, and that all paperwork is properly completed and filed. They will also be able to provide sound legal advice so that you make the most informed decision possible.
At Oxner + Permar Law, our attorneys are highly experienced in workers’ compensation law and can provide you with the legal guidance and representation needed to ensure that your rights are protected throughout this process. Contact us today to learn more about how we can help you with your clincher agreement!
Dealing with workers’ compensation often means a whole lot of headaches and jumping through hoops to get the benefits you need. It can be frustrating when dealing with insurance companies, especially when you have to go to the hospital or doctor that they prescribe. Of course, the reason they can choose the hospital or doctor is because it is your employer’s insurance that is covering you, not your own insurance. However, if you feel that your diagnosis is inaccurate, is it okay to ask for a second opinion in a workers’ compensation case?
A second opinion is incredibly important in a workers’ compensation case. Often times, the initial diagnosis or course of treatment prescribed isn’t enough to fully address the injury and/or pain associated with it. A second opinion isn’t just about getting another medical professional’s input—it’s about taking an extra step to make sure you get the comprehensive care and appropriate settlement you deserve for your injury.
By seeking out a second opinion from an independent medical professional who isn’t affiliated with your employer, you can rest assured that their advice won’t be biased. Their only focus is in optimizing your recovery without any personal stake in the outcome of the workers’ compensation case. Plus, if more than one physician gives you a similar diagnosis, it’s often taken as confirmation of your injury, which could mean stronger evidence for court.
Most importantly, getting a second opinion regarding your injury can provide additional information and perspectives that may reveal other courses of treatment or alternate diagnoses that could lead to improved healing results and better legal settlements. Ultimately, making sure that your rights in the workplace are respected is crucial and so it always pays to get a second opinion on your work-related injuries – no matter how small they seem!
The answer is yes! If you feel that your diagnosis is inaccurate or that you are not healing as quickly as you should, then definitely ask for a second opinion. However, you cannot just go to a different doctor and expect it to be covered. The first step is to get written permission from your employer to see another physician. This should include the name and address of the physician you wish to see. If your employer gives written permission, then you can schedule your appointment.
So, what if your employer doesn’t respond or give permission for you to see another doctor? Well, there is another option. If this first step fails, then you can appeal to the North Carolina Industrial Commission for a second opinion. If the Commission agrees to a second opinion, then your employer must follow through and allow a second opinion. Generally, you will need to prove that a second opinion will increase your recovery time or will improve your wellbeing.
Getting a second opinion for any type of workers’ compensation case is always beneficial. It can open up new pathways and provide insight from additional perspectives that are outside of your current support network. Here are some of the key benefits:
A second opinion allows you to validate what you have heard from your current physician. This way, you know if their medical diagnosis is valid and supported by another medical professional.
A second opinion often reveals opportunities for new treatment plans, alternative therapies, specialized equipment or other assistance that may not be available through your existing provider or insurance policy.
A second opinion can also help connect you to higher level specialists in the area such as orthopedic doctors or neurosurgeons who may offer unique treatments and procedures depending on the situation you faced involving your workers’ compensation case.
By comparing two different opinions side-by-side, it gives you an understanding of what options are available to pursue within your case and how this might affect both the duration and outcome of your claim evaluation process and potential settlements resulting from it.
It is important to get a second opinion in a workers’ compensation case when you feel uncomfortable with the information provided by the primary doctor. If you have any doubts or worries about what your doctor said, it is always a good idea to get an outside opinion from an objective party. It can also be beneficial to seek out a medical expert that specializes in the field in which you sustained your injury. A second opinion will help ensure that all aspects of your case have been taken into consideration and that no critical information was missed or ignored.
It’s also important to consider getting a second opinion when the severity of your injury is debatable. A medical specialist may provide additional insight on how serious or long lasting the injury could be and be able to provide further evidence if necessary. Additionally, seeking multiple opinions can help with determining whether or not you need rehabilitation for your injury and which course of action should be taken. Getting more than one perspective can give you peace of mind and make sure that every possibility has been explored before making any final decisions on treatment or settlement amounts.
If you have any questions about how to obtain a second opinion be sure to contact an experienced attorney. It’s always good to have someone on your side who is willing to fight for your rights and dedicated to ensuring that you get the best care in order to make the fastest recovery.
At Oxner + Permar Law, we have years of experience fighting for the rights of individuals in workers’ compensation cases. Our team of experienced attorneys can provide you with the representation and guidance you need to ensure that your rights are protected and that you get the best outcome for your case. Contact us today for a free consultation.
If you’re filing for workers’ compensation, chances are you’re going to be dealing with a lot of paperwork: some that you fill out and some that you will receive from an insurance carrier or employer. Paperwork is never fun. Especially when something as important as your workers’ compensation benefits is riding on it. The process can be made even more tedious by the fact that many of the forms are labeled by number rather than what it actually is they do. One of those many documents is likely a “Form 63”. You may be asking yourself now, “What does a Form 63 mean? Is it important that I file it?”
Also known as “Notice to Employee of Payment of Compensation Without Prejudice (G.S. § 97-18(d)) or Payment of Medical Benefits Only Without Prejudice (G.S. § 97-2(19) & § 97-25),” Filing a form 63 means that the insurance company is still investigating the claim and is accepting the claim in whole or in part for the time being. There are two sections in a Form 63.
Section 1: If section one has been checked, this means you will receive lost wages and medical compensation. If 90 days pass and the insurance company does not formally deny or accept your workers’ compensation claim, then the claim is deemed accepted.
Section 2: If section 2 is checked, then you will receive medical compensation but not lost wages.
Form 36 is used when a workers’ compensation claim is still under investigation, but the carrier wants to provide medical benefits for the injured employee while the investigation is ongoing.
In both cases, the insurer has not accepted responsibility for the claim yet, and therefore they are not admitting any liability. They are simply accepting that you have been injured and will provide medical treatment until a full investigation is complete.
It’s important to remember that Form 63 does not mean your claim has been accepted or denied. It is simply the insurance carrier’s way of providing medical treatment for your injury while they investigate your claim further.
Different forms in Workers’ Compensation are filed by different parties. For Form 63, the one who should file it is the employer. The employer is responsible for filing Form 63 in order to ensure that the injured employee is provided medical care while their claim is being investigated. The employer will submit this form when they believe that a claim should be accepted, but they need more information before officially accepting it. This allows the injured employee to receive medical treatment, even if their claim has not been fully accepted yet.
The best way to navigate a workers’ comp claim is by working with an experienced attorney. We can help you understand exactly what paperwork you will encounter and what it means. Insurance carriers deal with these forms every day, but chances are you’ve never seen them before. Make sure you understand the process, every step of the way.
Recovering from an injury when you’re out of work can be frustrating and stressful. You’re dealing with physical pain, worrying about money for bills and healthcare expenses, and your emotional state is suffering as a result. You might be wondering, “Do Workers’ Compensation Claims pay for pain and suffering?”
Pain and suffering are an intangible concept that represents the emotional, physical, and mental stress caused by an injury. Examples of pain and suffering include mental anguish, emotional distress, loss of companionship or consortium, fear or anxiety, humiliation or embarrassment, inconvenience due to a disability caused by the injury, loss of wages due to missed work from being disabled from the injury, physical impairment from the injury, as well as disfigurement.
Pain and suffering do not necessarily require visible signs or proof of your subjective experience but must be serious enough for a reasonable person in similar circumstances to understand. Pain and suffering are usually assessed by evaluating all relevant evidence presented on behalf of a claimant such as medical records detailing other symptoms that can’t be observed visually. In addition to physical pain there must also be an emotional component present in order for pain and suffering to exist.
One of the trade-offs in workers’ compensation is that you receive no direct payment for pain and suffering. You’ve undoubtedly heard this phrase being used in the context of people who bring lawsuits for auto accidents, slip and falls, medical malpractice, etc. Basically, if you bring a claim in District or Superior Court you may make a claim for pain and suffering. But you usually don’t receive anything from the defendants in your claim until the entire claim is settled.
Workers’ Compensation claims do not operate in the court system, and they don’t operate under those laws. Rather than going to court, your case is under the jurisdiction or control of the North Carolina Industrial Commission. The Industrial Commission is the government agency which handles all workers’ compensation claims in North Carolina.
If there is a dispute the workers’ compensation case is heard by a deputy commissioner, not by a jury and a judge. And you cannot bring a claim for pain and suffering. The tradeoff was that in accepted claims you don’t have to wait until the end of your claim to get paid. While that may not seem fair now imagine receiving no weekly checks and no medical treatment. That’s not how it works today. This tradeoff of getting fewer benefits under workers’ compensation but getting them more quickly was part of the political deals which lead to the workers’ compensation laws and system we have today.
While you don’t receive direct payment for pain and suffering as a direct part of your workers’ compensation claim, pain is a component that a doctor is supposed to consider when assigning the permanent partial disability rating. While some doctors appear unclear on this the Industrial Commission rating guide does include it. This is where a workers’ compensation attorney can come in. Because we have dealt with many of these doctors on many occasions, we can easily show them the workers’ compensation documents from the Industrial Commission which should get the doctor to change the rating as necessary.
Claims for pain and suffering are not often eligible to be collected via workers’ compensation claims. However, there are other avenues that you can pursue in order to gain relief financially and emotionally from your injury or illness.
One of the easiest ways to seek reimbursement for your pain and suffering is to approach your employer directly for a financial settlement. If you feel that the company was negligent in any way that resulted in your injury or illness, then this can serve as grounds for negotiating a settlement between the two parties. Legal expertise from a specialist in workplace injuries can be very useful if your employer requires convincing.
You may also have legal grounds to sue your employer or a third-party if they were proven to be negligent in any way related to the incident causing the pain and suffering. This type of case should always involve legal representation since it can be difficult to prove negligence without an experienced professional giving advice.
In addition, many people look into filing personal injury suits with the assistance of an experienced lawyer so they can collect financial damages associated with their pain and suffering such as medical expenses, loss of wages due to missing workdays, and lost earning capacity due to disabilities caused by accidents at work.
It is important to consult with an experienced lawyer if you believe that you are entitled to compensation for your pain and suffering. An attorney will be able to evaluate your claim and advise you on the best course of action to take in order to seek a financial settlement or pursue legal action against any negligent parties. They will also be able to provide you with advice on how to ensure that any potential lawsuit is successful. Contact Oxner + Permar Law today to learn more.
