Category: Workers’ Compensation

The doctor just took me out of work but the adjuster said she isn’t paying me yet. Why?

Workers' Compensation

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.

Can they really put a private investigator on me?

Workers' Compensation

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.

Can private investigators take pictures of my family?

Workers' Compensation

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.

Can an adjuster just close my file?

Workers' Compensation

This may, or may not come as a shock to the adjuster but the answer is “absolutely not.” While she may think that enough has been done it is up to the treating doctor to say that you don’t need any more medical treatment. Even then, the adjuster must ask the Industrial Commission to sign off on closing your claim. If that has not happened your claim is still open regardless of what the adjuster may be telling you. There are deadlines and technicalities involved in this so it’s wise to give us a call and let us point you in the right direction.

I’m not sure I’m ready but the doctor has released me to return to work.

Workers' Compensation

This may be for a couple of different reasons. First, the doctor may have a standing agreement with your adjuster or employer that he won’t keep workers’ compensation claimants out of work as long as your employer will find something, anything, for you to be doing.

Second, many doctors believe there is a healing power in being active and out of the house. While we think that this may be overstated sometimes we’ve seen plenty of instances where clients were worse off sitting in the house afraid to go out because of the network of private investigators working for the insurance company than they would be if they could be active and stay in shape.

Third, the doctor may honestly not have a good idea what your job actually entails. Part of this is that they live in their own world sometimes, but we have seen a lot of instances where a rehabilitation professional gave the doctor a job description which had been edited – sometimes by the RP, sometimes by the employer – to remove all the heavy lifting from it. Thus the doctor is relying on what he believes to be an accurate statement of your job. Don’t count on your employer or your nurse showing this to you in advance. More than one client has reported having a nurse whip out a job description unannounced and presenting it to the doctor.