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Sometimes, and, if they can get away with it. A while back a well-known neurosurgeon based in Raleigh spoke at a closed-door meeting with adjusters at a meeting sponsored by a law firm, which represents mostly insurance companies and employers. During the course of his presentation he stated that he believed a lot of injured workers underwent unnecessary surgeries and ended up being out of work longer than necessary as a result. What happened next? Clients who lived in Mount Airy, in Lexington, even in Charlotte were being sent to him for second opinions.

This happens more often than you would believe. In this particular case we objected to the Industrial Commission. The defense attorney, coincidentally a partner in the firm that sponsored the private meeting, argued that the law regarding second opinions didn’t require that the doctor be fair or neutral. The only limitation was in terms of geographical reasonability. The Industrial Commission seems to have bought into this theory. Your best defenses against a second opinion are that it’s too far away and that the adjuster has already had a couple of second opinions. At some point the adjuster has to concede that she’s only shopping for an opinion that she wants to hear and isn’t really looking for sound medicine anymore. While that seems patently obvious to some people it’s considered bad form to admit to it when you’re at the Industrial Commission.

To be fair, we have our own lists of doctors as well. One advantage of our law firm is that we’ve been keeping records and notes on doctors, adjusters, rehabilitation nurses, etc., for years now. We know which ones tend to unnecessarily favor the employers and insurance companies and we know which ones put their patient’s interests first. So when it’s our turn to pick a doctor we know who we’ll recommend.

Yes. And they do. All the time. They didn’t use to be allowed to do that, but very very often they did anyway. Successful lobbying with Gov. McCrory and the political leaders in the legislature lead to a huge change in the law. Now employers can talk to your doctor but are not required to tell you immediately that the conversation occurred or what the details of the conversation were.

Is this necessarily bad? While we doubt that doctors are engaged in conniving with adjusters we don’t really understand what all the secrecy is about. The old law required the adjuster or employer to write to the doctor but to let the injured worker see the letter before it went out so that they could ask for anything to be added. That seemed really fair. Why did insurance adjusters and employers want this changed? It doesn’t seem to be an exaggeration to say they must have had a motive if they were going to lobby the government to change that requirement. So it’s fair to say that they specifically want to be able to communicate with the doctor.

One of the laws that Gov. McCrory enacted prohibited the Industrial Commission from forcing an employer to decide to accept or deny the claim within a month of having actual written knowledge of the claim. Thus the adjuster has thirty days within which to hold back on all payment without any repercussions against her whatsoever. It is our observation from speaking with a lot of claimants with modest injuries that they are sorely tempted to give up their claim and beg the doctor to return them to full duty because they cannot afford to go a whole month without pay. While some adjusters may dispute the insinuation that this is a goal of theirs, the fact that it occurs is beyond dispute.

If you do not have a note from a doctor taking you out of work, and if the doctor wasn’t one the adjuster or the employer sent you to, then you can be assured that the checks are going to be a little slower getting started. And if you have a note returning you to work but you haven’t gone back because it hurts too much – without another out-of-work note from the doctor it’s going to be difficult. It can be done but it often requires an attorney’s help in doing so.

They can and they will. It makes no sense to us but it is legal for private investigators to follow you and film you. Why this isn’t stalking is beyond our understanding. Some insurance companies such as Stonewood use private investigators in a very large percentage of their cases. We should note that Stonewood has repeatedly complained that we say this and have, through their attorneys, suggested that they would file ethics charges against us if we didn’t stop. Yet even some of those attorneys admit that what we are saying is true.

The law is that a private investigator is not supposed to trespass, nor are they supposed to be peering into your windows after dark, tapping into your phone lines, or placing a tracking device on your vehicles. We’ve heard numerous stories of investigators violating all of those rules.

Unfortunately, the answer to this is yes. We have pretty credible evidence of investigators following spouses of injured workers. In at least some of these instances it’s been done in a way that scared the heck out of the client’s wife. In another, case the investigator closely followed the teenage girlfriend of our client’s son, doing so for 15-20 minutes down a dark country road at night.

We’ve also taken issue with investigators who take what we believe to be unnecessary pictures of clients’ minor children. We’ve repeatedly argued against this practice at the Industrial Commission – even letting them hear tapes of the investigators laughing about forcibly shaving the head of a young African American child – but nothing has come of it. Similarly we’ve asked that insurance companies be prevented from hiring convicted child abusers to do private investigation work.

Until Gov. McCrory and the legislature intervene on these issues the best defense is a strong offense. If you have even a hint that you are being followed you should definitely call an attorney.

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