You have a Facebook page; You tweet; You Instagram – and you have an injury at work.
Whether you intend to or not – you are leaving an evidence trail. While you may believe what you are posting is just for your friends and family, the information may be discoverable. That is a fancy way of saying you may be asked or required to hand over any information which you posted or shared which, in any way, touches on your injury. That information may be used to create doubt about your injury or your work limitations. It can be used to question your credibility and your reliability as a witness.
It is not likely to be something obvious. There isn’t going to be a ‘smoking gun’ admission that you are faking the whole thing. It’s going to be something subtle. A picture of you dancing at a wedding the day after your knee injury. Sure, your knee was hurting you, but it was just one dance . . . A picture of you and your buddy at the football game (GO HAWKS!) But you just testified you can only stand for 15 minutes . . . ? A picture of you holding your two-year old Granddaughter . . . ‘Look how big she’s gotten!” . . . . . Well, how much does she weigh? Why can’t you return to work at your job which requires lifting the same weight?
It’s not that these activities are a secret. It’s more that defense counsel would never think to ask you about something so specific, without the picture floating around out there. The first thing a good defense attorney does when they get a new case is look up the injured worker on Facebook. If everything is private, he’s not going to see much. Maybe there follows a formal discovery request for social media posting, maybe not. That decision will depend on what’s at stake in any given litigation. But imagine the ‘Ah Ha’ moment when the the postings aren’t private. Or, there is a rich and detailed instagram record of . . well . . everything that you’ve done since the date of your injury.
Social Media is so instant. It is a very contemporaneous record of what you are doing, saying, thinking, and sometimes even feeling.
Some of it is very, very permanent.
Is a structured settlement of your L&I claim right for you? I know the department sends out form letters to injured workers who are at least 50 years old and have allowed claims informing them that they may be eligible for a structured settlement of their claim. What is a structured settlement, and is it in your best interest to “settle” your claim.
The Legislature called them structured settlements because you do not get the total agreed to amount in a lump sum. It is parceled out to you based on what can only be described as a weird formula. (payments of at least 25% but not more than 150% of the State’s average monthly wage – who makes this stuff up!?) The idea is the funds will provide a soft landing back into the world without L&I. In exchange for the settlement, your claim is closed with only the possibility of payment for future medical treatment if the claim is reopened. That means no future time-loss, vocational benefits, PPD or Pension awards. Is that a good idea for you?
Maybe – maybe not. There are a lot of things to consider.
What is the status of your medical treatment? While a structured settlement leaves open the possibility of reopening your claim for medical treatment, moving forward with a settlement if you are still actively treating for your work injury is probably not a good idea. Reopening a claim for medical treatment can be an expensive proposition if there are any disputes about whether your condition has objectively worsened.
Are there disputes in your claim? There probably are, if you are being offered or are considering a Structured Settlement. Is there a sum of money for which it makes sense to walk away from those disputes? Perhaps. It depends on what the dispute is about, what you have to gain, and how much it may cost you out of pocket to litigate the issue. Do you have more to gain than lose? These are questions an attorney can help answer.
Can you support yourself without payments from L&I? Do you have a real plan to return to work, are you on Social Security Disability or Retirement? If L&I is out of the picture, can you make ends meet? You have to be honest with yourself about your financial situation. Whatever the amount of your Structured Settlement, it will be paid in full at some point, and there will be no further payments from L&I, no matter what your situation.
These are only a few of the things you should consider. Deciding to accept or negotiate a structured settlement is a big step. It may be right for some injured workers in some situations, but it is certainly not a one size fits all answer. Make sure you understand what is being offered and what you will be giving up. Ask questions. Get legal advice. Give yourself the best possible chance to make the right choice for your particular circumstances.
There have been some changes to the choices you have when you have been found eligible for Vocational Retraining. You will still work with your vocational counselor to develop a retraining plan, which will include a specific job goal approved by your medical provider as appropriate for your injury. The plan will be submitted to L&I for review. Once the plan is approved you have a choice to make.
You can participate in the retraining as proposed. Or you can choice Option 2. Taking Option 2 means you will receive some additional payments (similar to your time loss), you will not participate in the retraining program, and your claim will be closed with whatever permanent impairment has been rated for your particular injury. Then, anytime in the next 5 years, you can use the training funds to pursue re-training on your own. You simple contact the department, enroll in an approved or accredited school or course, and the department will pay the costs.
Here’s where the changes are. Instead of 6 months of Option 2 additional payments, you will get 9 months. That’s an extra 3 months of biweekly payments to help provide a soft landing as your claim closes. You can also delay making the Option 2 choice. Instead of having to make the choice shortly after the retraining plan is approved, you have some time. You can actually start the retraining plan, and see how you do. Time-loss will continue while you are participating in retraining. Anytime within the first quarter of training, or within 3 months, you can decide to stop participating in the program and elect Option 2. At that point the 9 months of payments will be reduced by the amount of time loss paid starting with the first day of the retraining program, and you will be entitled to the remainder of the Option 2 payments
This change allows you to try out a retraining program, see how you do, decide whether the program is a good fit, and then make a more informed decision about whether to continue the retraining. For most injured workers, school days are a distant memory. The routine of going to class, studying, completing assignments, and taking tests can be an overwhelming idea. Now you can try it on for size without losing the benefit of the Option 2 payments.
Whether to take Option 2 or participate in retraining is an important decision. There are a lot of factors you should consider. (That’s another post!) This change allows you to take a bit more time and, hopefully, make the decision which is best for you. If you do not already have an attorney, this may be a good time to make an appointment and ask some questions.
If you have a Longshore* claim, and have not settled future medical care with an 8(i) agreement – then you have lifetime medical coverage for conditions related to your injury. That sounds great – but I like to tell my clients this does not mean treatment is automatically authorized, it means you have the right to fight about it.
The responsible carrier is always going to look for an argument that treatment is related to some new injury or workplace exposure. Such a new injury or worsening related to work activities can serve to shift liability to a more recent employer. That is not necessarily a bad thing – If your condition has worsened or been aggravated by a new injury or work conditions, it may well support a new claim. This may actually benefit the worker if wages have increased over time.
Whether to seek medical care under an existing or older Longshore claim versus filing a new claim will depend in large part on individual circumstances and the opinions of your treating medical provider. Either way, sorting out your best arguments based on your specific circumstance is something a qualified longshore attorney can help you with.
- This includes non-appropriated fund and DBA claims, which are covered through extensions to the Longshore and Harbor Workers C0mpensation Act.
This post is a reminder that it is OK to pick up the phone and call me. I know that sounds a bit odd. But, I can tell from the stats on this blog that traffic is up since the first of the year. I get it, you have questions. You’re an injured worker; it’s the first of the year; you want to get moving- take charge of your claim. Nope – take charge of your life again. So, you’re noodling around on ‘the line’ to see if you can get your questions answered.
You can. Just Call.
I had a couple in here a few days ago. Spent an hour or so answering their questions. She didn’t need an attorney, but she felt more at peace from having talked to one. They stopped at our front counter on their way out to pay their bill. Nope. That’s not how it works. Consultations are no charge. If you need an attorney, then we can talk about how fees are paid (hint: it’s a percentage of benefits obtained on your claim) But I am always happy to answer questions, walk you through where you are in the process and explain what to expect.
Workers Compensation claims are weird animals in a weird legal/administrative world. Spend some time talking to someone who understands the lingo and the terrain.
Segregation Orders matter – sometimes a lot. If you receive an order from the department which says it is denying responsibility for a medical or mental health condition, do not ignore this order. You have a brief window – 60 days- to protest or appeal. If you do nothing the order becomes final, and that denied condition will not be covered under your claim. The department is trying to segregate this condition from your claim.
It might sound like splitting hairs. So what, if osteoarthritis in the lateral compartment of the knee is excluded or denied – you had a meniscus tear which was repaired in the medial compartment. The department is accepting that condition, so why should you worry? You should worry, because the next thing that may happen is some physician who examines you at the request of the department will conclude ALL of your problems with your knee, all of your work restrictions, are due to the osteoarthritis in the lateral compartment. The department isn’t responsible for that condition, so your benefits stop.
Some conditions are correctly excluded from a claim. If you have a work related back injury and cut yourself shaving, obviously the shaving injury should not be covered under your claim. But, if challenged, many attempts to deny conditions are overturned, which can preserve your benefits and your right to treatment. This is one of those issues you should talk to an attorney about. We can review the medical records, talk to the medical providers, and determine whether the denied condition should be accepted, and how best to work toward that outcome.
For those with claims under the Federal Longshore and Harbors Workers Compensation Act, much of what has been written about Washington State L&I claims does not apply to you. I thought a series of posts specific to Longshore Claims would be helpful.
Let’s start at the beginning. When will you have a Longshore claim rather than a state L&I claim? Generally, and without getting bogged down in a discussion of legal concepts like situs and status – If you work on or near navigable waters, are engaged in maritime employment, including Longshore operations and ship building and repair, and you have a work related injury, you will be covered under the Longshore Act.
There are also several extensions of the Longshore Act which include employment which have absolutely nothing to do with maritime employment. The extensions which we see the most of in this part of the country are those for Defense Base Act claims and Nonappropriated Fund claims. Nonappropriated Fund claims include those who are employed as civilians of armed forces instrumentalities inside the U.S., such as the base exchanges, child care, and food services on base. These employees are not military, but they are employed by the military to provide services on base. Defense Base Act claims include employees who work for a company who is under contract with the U.S., where services are provided in another country. This includes civilians employed at oversees military bases, working on construction projects for the U.S. oversees, and those civilians who are assist the military in a variety of ways with operations overseas, but are not service members.
In most instances, your employer will know whether any work injury is covered under the Longshore Act or state workers compensation, and should assist you in completing the correct paperwork. Medical providers may not understand the difference. We see many instance of a state L&I claim being filed, only to be rejected because proper jurisdiction is under the Federal Longshore Act. Not a problem, the filing provides timely notice, and it’s a simple matter to refile as a Longshore claim. There are gray areas, some parts of a bridge being built may be exclusively land based and not covered under Longshore, while other parts of the construction are most definitely maritime; some ship repair may be done in a shop setting miles from the water; the Port has employees who have strictly administrative positions – if there are any doubts or questions – you should talk to an attorney to make sure your claim is timely filed in the right place, to avoid any unnecessary delay in your medical treatment or benefits.
Coming up –who chooses your medical provider; what wage replacement will you receive if you can’t work because of your injury; is vocational retraining available; how is permanent disability compensated.