Can the Claims Adjuster Discuss My Medical Care with My Doctor?
There are several subjects the claims adjuster is allowed to discuss with your doctor, but your medical care is not one of them. Unless you give the adjuster permission to speak with your doctor they may not call and ask questions concerning your care.
There are many complicated rules regarding communication with medical providers. Defendants are allowed to obtain medical records, medical bills, and address non-substantive matters, but they can not discuss important matters like treatment without the authorization from you, the injured worker.
The statute is clear about the type of written communication that is allowed as well, and provides specific questions that can be asked without your consent.
It can be confusing when an adjuster calls you and asks if they can discuss a certain topic with your doctor. What you say in an unplanned moment may hurt your case. If you suspect improper communication has occurred you should contact an attorney to discuss the issue.
Call us today for a free consultation. With more than $275 million in awards and settlements, Oxner + Permar has the experience to stand up for you.
Amends to Legislation to Clarify What Injuries Are Accepted
The North Carolina General Assembly passed a new law that will impact those who are seeking medical treatment after being injured on the job. This was done to strike down the North Carolina Supreme Court’s ruling in Wilkes v. City of Greenville. In Wilkes, the Court cited the previous version of this legislation and held “an admission of compensability…entitles an employee to a presumption that additional medical treatment is causally related to his compensable injury.” In other words, this meant that once the claim was accepted on a Form 60 or 63 section 1, the burden of proof shifted to the employer to disprove that the requested medical treatment was not related to the injury.
The new legislation now says that an accepted claim on a Form 60 or 63 section 1 “shall not create a presumption that medical treatment for an injury or condition NOT IDENTIFIED in the form prescribed” by the Commission on a Form 60 and 63 section 1 “is causally related to the compensable injury.” Therefore, if the body part that the injured worker is requesting treatment for is not listed on the Form 60 or 63 section 1, then they bear the burden of proof. This is the case even if the Defendants have been paying for the medical treatment for weeks, months, or years.
If the injured worker has been receiving medical treatment for a body part, directed by Defendants, and it is not listed on the Form 60 or 63 section 1 for an extended period of time and the Defendants deny ongoing care, the injured worker must go through the formal hearing process and prove that the body part is related to the claim. This is not only a reversal of our North Carolina Supreme Court’s ruling in Wilkes, but also causes harm to the injured worker if Defendants one day stop providing care—months or years down the road.
If you have been injured on the job and have questions about how this new legislation will impact your workers’ comp claim, don’t hesitate to give us a call for a free consultation. With more than $275 million in awards and settlements, Oxner + Permar has the experience to handle all kinds of workers’ comp cases.
I Was Injured During My Lunch Break, Am I Still Covered?
One common misconception people have about experiencing a work injury is that they have to be physically doing their job when injured in order to be covered under workers’ comp.
Although most cases involving workers’ compensation injuries do happen when you are clocked in, at the job site, and doing your work, that isn’t always the case. No one can control when and where an accident will take place. The Workers’ Compensation Act understands that and offers some additional protections.
These cases can be very fact-specific, but some of the most common times you can be covered are prior to clocking in, during breaks at work, and at lunch. There are many other circumstances when you may be covered but a lot depends on the location of the accident, the timing of the accident, as well as who owned and maintained the property where your accident happened.
It is best to contact an attorney if you got hurt before clocking in, during a break, while at lunch, or after clocking out—but while you were still at work. Your injury may fit into one of the fact patterns where you are still protected by the Workers’ Compensation Act.
If you experienced an injury and you’re not sure if you’re covered, give Oxner + Permar a call for a free consultation. We will go over the details to help you determine if you are covered.
…su estatus migratorio, no afecta la capacidad de recibir beneficios de compensación laboral?
No importa cuál sea su estatus migratorio, en el estado de Carolina del Norte si usted se lesionó o accidentó en el trabajo, usted tiene el derecho de comenzar una demanda de compensación laboral, lo que le proporcionará tratamiento médico, y cheques semanales por su tiempo fuera del trabajo.
Además, ni la compañía de seguro de su empleador, ni el abogado que representa a la compañía de seguro, pueden divulgar su información personal, como por ejemplo: al Servicio de Inmigración y Control de Aduanas de Estados Unidos (ICE, por sus siglas en inglés). Tampoco, existe el riesgo de que su empleador lo amenace con reportarlo a oficiales de inmigración, por el simple hecho de haberse lesionado o accidentado en el trabajo. Muchas veces, esto ocurre para evitar que usted presente una demanda en contra de ellos, porque saben que usted tiene ese derecho bajo la ley.
Si usted se ha lesionado o accidentado en el trabajo, es recomendable que se contacte con un abogado con experiencia, y así asegurarse de obtener los recursos necesarios para proteger sus derechos. Nuestra firma, Oxner + Permar, cuenta con un gran equipo de abogados y asistentes que lo pueden ayudar en su idioma, nos enorgullece decir que le conseguiremos el resultado que usted se merece. Tenemos oficinas a lo largo del estado de Carolina del Norte, tales como en Raleigh, Charlotte, y Greensboro, entre otras. ¡Llámenos!
Why Should I Have to Submit to a Drug Test for My Workers’ Comp Case?
If you’ve been injured at work and have filed for workers’ compensation, then you’ve probably been asked to take a drug test. If this feels like a pointless invasion of privacy, don’t worry — we agree. Unfortunately, there’s nothing you can do to avoid this: it’s the law.
Of course, we don’t condone the use of illegal drugs or drugs that were not prescribed to you; however, that doesn’t mean we think the insurance company should be allowed to drug test you. In reality, there’s not much of a relationship between what you possibly took at a party two weeks ago, and how a coworker drove a forklift into you yesterday.
The scenario that we see more often than illegal drug use is people taking prescription drugs that aren’t prescribed to them. For example, if while waiting to see the doctor, you take some of your wife’s prescription painkillers, you could test positive for drug use. In that case, you could lose your right to benefits.
Taking someone else’s painkillers might not seem like a big deal, especially when you’re in a great amount of pain, but the reality is that it is illegal. Don’t put your case in jeopardy by taking medication that’s not prescribed to you.
If you’re concerned that a drug test may prevent you from receiving workers’ comp benefits, be sure to contact an experienced attorney. We can help you determine whether or not your case will be affected.
If you’ve been injured at work, don’t hesitate to contact Oxner + Permar for a free consultation. We can help guide you through your case and ensure that you get the benefits that you deserve.