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Medical Examiners: Whose Side Are They On?

It is unavoidable that workers get injured on the job or acquire certain occupational diseases. When this happens, workers are entitled to workers’ compensation, wherein the insurance covers medical expenses during the temporary or permanent impairment.

In such instances, doctors and medical practitioners are employed to assess the physical condition of the workers. Their reports would serve as medical proof, which could determine whether or not the worker would be able to avail of the benefits. The professional medical examiner can be retained by the claimant or the employer or insurance company.

There have been cases all throughout the country where the examiner retained by the insurer has favored the insurance company, so that the company won’t have to pay for the compensation. On the other hand, there are also instances where the examiner exaggerates the claimant’s medical results to ensure that he or she avails of the benefits. Medical examiners, regardless of whether they are provided by the claimant or the insurer, are prone to certain financial and professional bias.

In order to understand the medical examiner bias in the context of a personal-injury claim, we should examine how and why such biases occur.
Worker’s Treating Physician’s Bias

Workers have an option to choose and provide their own medical examiner in the context of compensation claims. After an initial consultation, the physician could claim that there is indeed an injury, regardless of whether there really is one or not. By accepting the worker’s declaration of injury, it would be financially beneficial to the doctor to provide treatment over a certain period of time. Moreover, family doctors have the tendency to be biased towards his or her patient, and would most probably accept or believe the patient’s complaint, even in the absence of any pathology. This is because refusing to treat or contradicting the patient would drive him or her to look for and consult a different physician.

The (Not-So) Independent Medical Examiner

In the case that a treating physician retained by the claimant states the occurrence of an injury that could be a basis for claiming the benefit, insurance companies or the employer have an option to request for an additional examination. They would provide an Independent Medical Examiner (IME) that could either ensure or dispute the legitimacy of the claim. Although most IMEs are qualified and are assumed to be objective and fair, there is still a possibility that some are biased against the worker or claimant. These IMEs would favor the defendant or the insurance company, mainly to maintain a certain “partnership” where the doctor would continuously receive referrals from the insurer. The supposedly independent medical examiner would report that there is no apparent injury regardless if whether there is one or not.  When this happens, the insurer does not have to compensate for the worker’s claim.

Given these biases, disputes relating to treatment and medical providers invariably occur. To avoid these situations, it is best to seek legal advice from a Denver workers compensation attorney. In the context of work-injury claims, the Denver workers compensation lawyer will make sure that the worker would get the proper treatment and unbiased medical examination that he or she deserves.

Contact Kaplan Morrell to discuss your workers compensation claim in the Greeley and Denver areas. For over 15 years, experienced workers compensation and disability attorneys have been successfully helping workers in Colorado claim what is due them.

5 Fall Protection Protocols Every Responsible Company Should Follow

Construction workers who work in high places such as buildings, bridges, amusement park rides, stadiums, billboards, and cranes put their lives at risk every time they come to work. According to statistics, falls are the leading causes of injuries and deaths in the construction industry. Most of these accidents happen because of the company’s failure to follow fall protection regulations.

Employers have the responsibility to deal with hazards of the workplace. Failure to provide fall protection to workers essentially leads to Denver workers compensation attorneys would soon come banging on their doors.

To avoid facing charges and to protect workers, every employer must follow these 5 necessary protocols for fall protection. As workers, meanwhile, you should make sure that the following are given importance at your office.

  1. Recognizing fall hazards

Do a thorough inspection of the site. In the ocular,watch out for possible safety issues and problem areas. Knowing the possible hazards will help you mitigate the situation early on and take appropriate actions to protect the workers. This step is very crucial, as it could prevent accidents in the future.

  1. Manufacturer’s safety guideline and instructions

After identifying fall hazards, select the necessary safety equipment. The equipment should meet the American National Standards Institute (ANSI) standards, like being able to withstand specific weights, for example. They come with the manufacturer’s instructions, which indicate certain limits on the product use, and thus ensuring safety and security of workers and passersby.

  1. Creating your own safety policy

The company should create its own written hazards and safety equipment policies to minimize risks at work. While following the requirements of the Occupational Safety and Health Administration (OSHA)is a must, you have an option to adopt certain ANSI standards or even make your own internal policies.

  1. Comply with OSHA’s mandatory requirements

Know by heart the OSHA requirements and make sure that the company’s safety procedures and policies comply with them. Following these regulations is mandatory. It is important to note that OSHA can adopt certain ANSI standards. When this happens, compliance to the said regulations will also become mandatory.A company who fails to comply with OSHA standards will be subjected to a fine.In the event that an accident happens, the Greeley and Denver workers compensation attorney can use this noncompliance as grounds fora compensation claim.

  1. Comply with ANSI standards

As mentioned earlier, the ANSI is a committee of manufacturers who developed voluntary standards that are considered best practices. ‘Voluntary’ means the company has an option of whether to comply with the standards or not. However, the standards become mandatory when OSHA adopts them by amendment.

There are definitely more pointers to consider but this list should give you the basics. Just remember that a company or employer who fails to provide fall protection because of non-conformity to these protocols may be subjected to fines or be faced with criminal litigation.

For more information about your rights as workers, consult with an experienced Denver workers compensation attorney from Kaplan Morrell. Contact us at (866) 356-9898 for a FREE CONSULTATION.

 

Effects Of Marijuana on Worker’s Compensation

A Denver worker compensation lawyer can explain to you that when it comes to matters of workers compensation, federal law is always above the state law. According to Colorado’s Workers Compensation statute, an employee’s benefits can be affected if they were injured and tests positive for marijuana use. Monetary compensation will be decreased to half of its value if it was proven that the employee was impaired due to the effects of marijuana. However, the employee should still receive medical and permanent indemnity benefits.

Moving Forward
There are still a lot of things to work out when it comes to this issue. Employees should be well aware that the state law cannot protect them from the repercussions of using marijuana on the job. To further understand the laws that cover marijuana use and the benefits that you are entitled to, it is best to seek the help of Greeley workers compensation attorneys and Denver workers compensation attorneys.

Workers’ compensation can be difficult, confusing, and very complex especially when use of drugs such as marijuana is involved. Kaplan Morrell has helped thousands of employees since 1997 to get the benefits that they deserve. Contact us here or call us at (866) 356-9898 for your free consultation.

 

 

 

Things You Should Know if you’re 420 and an Employe in Colorado

The use of marijuana has been steadily increasing in the past few years. This has been brought about by the move done by several states to legalize its use in addition to the sensationalized effects the “420 culture” can do to the user. However, one must not deny the fact that this drug can also be harmful and may even cause accidents in the workplace. It is important to understand what an employee is getting into and the consequences he might suffer by continuing to be a marijuana user whether it is for medical purposes or otherwise.

What the law says about the use of marijuana


Colorado has passed a number of amendments to the law in relation to the use of marijuana in the state. In 2000, Amendment 20 was approved which is a comprehensive measure that allows the lawful use of medical marijuana for those that are suffering certain conditions. In 2012, Amendment 64 legalized the recreational use of marijuana by adults. However, employees should not use this as a security blanket. A part of the amendment states that an employer is not required to permit or accommodate the use of marijuana in the workplace. Neither does this law affect the ability of the employee to enforce policies that restrict the use of marijuana by its employees.

Despite the number of states that have approved similar legalization rulings, federal law still classifies marijuana as an illegal schedule-1 drug together with heroin and ecstasy under the Federal Controlled Substances Act.

The famous case of Brandon Coats

The case of Brandon Coats sheds light on the true status of marijuana use in the country. He was a telephone operator for Dish network. He was paralyzed in a car accident and had to resort to marijuana to control his leg spasms. He possesses a medical marijuana card and consumed cannabis off-duty. He was then fired in 2010 upon failing a random drug test. He challenged the company’s zero tolerance drug policy claiming that his use was lawful under state law. He also argued that the medical marijuana is what allowed him to perform his job. His case was upheld in both trial court and the Colorado court appeals. It was then escalated to the State Supreme Court. Nine months after oral arguments from the two sides were heard, the court sided with the firing of Mr. Coats. It ruled that the term “lawful” refers only to activities that are legal under both state and federal law.
Workers’ compensation can be difficult, confusing, and very complex especially when use of drugs such as marijuana is involved. Kaplan Morrell has helped thousands of employees since 1997 to get the benefits that they deserve. Contact us here or call us at (866) 356-9898 for your free consultation.

Firefighters Compensation : Denver workers compensation

Firemen, also referred to as firefighters, are important to public safety. Unfortunately, they have one of the highest rates of wounds, injuries, and illnesses of all professions. Their job issimply to pull out people from burning cars, building fires, and other dangerous situations. While those who want to get involved in the fire department often think of the encouraging side of the job, including a pay of over $50,000 as of 2014, there is also a setback.

Being a firefighter is having your one leg buried in the ground, always on the brink of death.Firefighters work in often dangerous and complex environments that boost their threat of on-the-job death and injury. A fireman normally puts himself at risk because of fire but most eminently, from exposures to many other job-related infections and hazards. Although many died on duty, firefighters face a relatively high chance of being injured even under training.

Surprisingly, burns, an injury commonly associated with fire, are not the major cause of their wounds.

Below are circumstances and incidents that result to firefighters obtaining wounds, injuries, and long-time diseases:

  • Exposures to infectious diseases

In 2014, the National Fire Protection Association (NFPA) estimated that around 10,000 firefighters were exposed to infectious diseases, such as HIV, hepatitis, and meningitis. Hospitals that encountered medical runs by firefighters name infectious diseases as one of the common causes of death among firemen.

  • Exposures to hazards

NFPA said that approximately 25,000 injury cases related to the firefighting profession are caused by hazardous conditions. Trying to control fire and respond to medical emergencies, firefighters’ lives are put to risk often due to exposures to fumes, asbestos, radioactive materials, and hazardous chemicals.

 

  • On fireground operations

Firefighter injuries are often incurred while rescuing people and saving properties from structure fires, vehicle fires, and brush fires. Major types of injuries obtained from fireground operations are strains and sprains, wound cuts, bleeding, bruises thermal stress, and burns.

 

  • During non-fire emergencies, training activities, and on-duty activities

Over the past few years, NFA noted a relevant rise in the number of non-fire emergencies. Yet in spite the quick increase, the number of injuries that occurred as such incidents lowers by the minute.

Wearing heavy equipment such as thick coats, face masks, and combat boots does not guarantee complete safety for firefighters. It is imperative to be aware of the said risks before choosing firefighting as a career. Whilewider understanding of how these fatalities, injuries, and illnesses arise can assistin recognizingremedial actions that could help reduce the intrinsic risks, it is also important to consult trusted Denver workers compensation attorneys.

Workers’ compensation can be tricky, perplexing, and very complex. However, Colorado firefighters can rely on Kaplan Morrell to help you and thousands others who are looking to claim the benefits you deserve. Call your Denver and Greeley workers compensation attorney sat (866) 356-9898 for a FREE consultation and learn how a Denver disability lawyer could further assist you fight for your rights.

Top 5 Reasons Disability Claims are Denied in Colorado

Greeley Workers Compensation LawyerA disability claim filed before the Social Security Administration may be approved based on two findings: (1) that the claimant has a medical condition which satisfies the requirements in the listing of impairments, and this condition lasted, can, or is projected to last for a minimum of one year; and (2) that the medical condition that a claimant experiences must be severe enough to limit his capacity to work and earn a considerable income. These findings must coincide with each other.

Every year, the Social Security Administration approves around 32% of disability claims and denies approximately 68%. Here are some common reasons why disability claims are denied. Find yourself a Denver disability lawyer to avoid these mistakes.

  1. Failure to provide sufficient medical evidence.

You must ensure that you have all the pieces of evidence to show that you are entitled to the claim. Doctors’ notes, x-rays, and other medical records should be submitted to the proper office. If they cannot be submitted because they are with the hospital, make sure to give the Social Security Administration permission to view your medical records. Remember that it is not you who will evaluate but the Social Security Administration. Prepare the records based on their standards, not yours.

 

  1. Incorrectly completed forms.

When you apply for a disability claim, you will meet various kinds of forms which need to be completed. Take your time in answering the forms. Do not rush, and make sure you input the correct pieces of information. Otherwise, the Social Security Administration assessor might mistake your improperly filled out form as an act of fraud. If you are not confident in filling up those forms, visit a Denver disability lawyer who will explain to you what you should and should not write.

 

  1. Failure to conform to other medical requirements.

Depending on the listed disability, the Social Security Administration would often require you to visit a third-party medical expert who will conduct a consultative exam on you. Comply with this requirement. Otherwise, you will get your application denied.

 

  1. Your case is not just strong enough.

Your claim will be approved if you can prove that your disability does not permit you to work at all. Should the Social Security Administration discover that you can perform other types of work, your application will surely be denied.

 

  1. Failure to talk with a Greeley disability attorney.

A lawyer specialized in handling social security benefits claims will help you prepare the necessary paperwork and pieces of evidence. Find one to help you especially in the critical areas of your application to ensure that your claim will be approved.

Preparing a disability claim is very taxing, and complicated. Kaplan Morrell has helped thousands of clients since 1997 to get the disability benefits they truly deserve. Contact our Denver Workers Compensation attorneys now or call us at (866) 356-9898 for your FREE CONSULTATION.

New Workers, Old Workers, Refresh your Knowledge on Workers Compensation (Part 2)

Continuing our discussion on the basics of worker’s compensation, let’s now get into a few details about the Colorado worker’s compensation program. There are terminologies that you need to be familiar about as they seem to be challenging to understand.

Below are some terms that you should know. Remember that being well-informed about the system can help you protect your rights.

 Medical benefits

All medical expenses incurred by an injured worker is covered by the worker’s compensation insurance or the employer. These include hospitalization, therapy, medical procedures, doctor’s appointments and other medical supplies needed by the injured worker.

 Temporary disability benefits

Also known as lost wage benefits. While seeking medical attention, you may not be able to return to work because of doctor’s restrictions. Thus, you are entitled to receive temporary disability benefits.

There are two types of this benefit:

  • Temporary total disability means an injured worker is fully restricted from working and will receive a pay 2/3 of the average weekly wage. This amount up to $800 per week and this limit may change every year.
  • Temporary partial disability means an injured worker can still perform limited roles at work most likely at a lower wage. You will then receive a pay 2/3 of the difference between your previous wage and your current reduced wage.

 

 

Permanent disability benefits

Can be classified into two: Permanent total disability and permanent partial disability. Permanent total disability means an injured worker is not able to return to any type of employment. In order to receive a permanent total disability benefit, an injured worker needs to be found totally unable to make any wages.

On the other hand, permanent partial disability means an injured worker has a permanent impairment that could be permanent to his life but still can perform a job and make wages. This is determined when you reach the maximum medical improvement (MMI) and your doctor assigns an impairment rating.

Your permanent partial disability benefit may vary depending on which part of your body is severely injured or non-functional. This could be best explained to you by an experienced Colorado workers compensation lawyer.

 

Monetary benefit for disfigurement

This is an amount given to an injured worker who suffers from disfigurement like scars that don’t fade away and atrophies. These disfigurements may affect your personal image in the workplace and your job performance as well.

 

Death and funeral benefits

If unfortunately a worker losses his life while on-their-job duty, their dependents are entitled to death benefits which pay 2/3 of the workers weekly wage. The surviving spouse will receive the death benefit for a lifetime or until he/she settles into another marriage. Children (including adoptions) will receive the death benefit until 18-21 years of age.

Meanwhile, other dependents like parents and siblings over 18/21, can receive the death benefits if they are proven dependent to the worker at the time of his death. More of that, funeral expenses are covered up to $7,000, and all other medical expenses by the workers compensation insurance or employer.

 

Worker’s compensation may sound complicated but it is a must that you understand the whole system for you to receive what you are due. Our attorneys at Kaplan Morrell will provide you more information. Call us at 866 356 9898 for a FREE CONSULTATION.

Workers’ Compensation: A Mutual Benefit

In any company in the US, it is an important priority that workers are protected when they are on their jobs. Knowing that they are safe and can perform their duties would mean stability not only of the workforce but the company as a whole.

For this reason, the Occupational Safety and Health Administration (OSHA) has been tasked to enforce certain rules for workplace safety. Companies have to follow the rules to maintain a safe workplace and to keep themselves away from penalties and fines. But there are cases that accidents may still be possible because of negligence and outside factors. A worker might injure himself while doing his job or worst might lose his life.

You need to speak with an experienced Denver Workers Compensation Lawyer in order to get the benefits you are entitled to by law.

Workers Compensation Whats in it for you?

Benefits are being provided to workers who are injured on the job. The Workers’ Compensation system in Colorado provides benefits that include:

  • Medical treatment benefits
  • Lost wages benefits
  • Money for disfiguration
  • Money for permanent disability

Work injuries are classified into two: accidents and occupational diseases.

Dependents of workers who unfortunately lost their lives on the job can receive death and funeral benefits. Hardships may come after an injury or fatality while on the job that is why workers’ compensation is designed to protect workers and their dependents. Its intention is to benefit the employee and employer alike.

So it is also important to note that a worker can’t sue an employer or co-worker for the injuries. For an instance, you encountered an accident together with another employee or you acquired a disease over time because of the current working conditions, you cannot sue your co-worker, employer or anyone who works for your company. Protecting the employer from lawsuits is one of the main purposes of the Workers Compensation law.

The Right Things to do

Workers must follow certain rules and procedures in order to receive the benefits. Keeping your employer informed about your injuries is an important thing to remember.

It is stated in the Colorado Workers Compensation Statute that you have four days to inform your employer about your injuries through writing. Failure to comply will result to serious problems when collecting benefits at a later time. It is also stated that the employer has a choice of doctors who provide treatment to the injured worker. If the employer doesn’t send the injured worker to a doctor, the worker can go to any doctor that he chooses.

Expected Wage Increase

All the way from the Mountain States Employers Council, the latest annual Colorado Compensation Survey denotes that Colorado employers are expecting to raise the wages of their workers by an average of 2.8 percent in 2015, same increase they projected for 2014. This is a survey done to 444 Colorado employers with a combined 38,884 employees from different business sectors. The two consecutive years of projected 2.8 percent increases for 2014 and 2015 are the highest since 3.3 percent increase in 2008. This may lead to a positive outcome of an increased Workers’ Compensation as this is based on the workers’ wages. Taking the example of the Lost Wages benefit:

Temporary Total Disability Benefits – If an injured worker is not able to work for more than three days due to the treatment process, the insurance company is obliged to pay two-thirds of the worker’s average weekly wage. This benefit continues until the injured worker is capable of going back to work in full duty or the doctor states that he already reached the maximum medical improvement.

 

Benefits sound good in the workplace, however claiming your benefits is quite a tedious and painstaking process if one does not know his rights and responsibilities. Before you lose the opportunity of receiving what you deserve, it is best to have legal assistance. Speak with a Denver Workers Compensation Lawyer today.

Workers Compensation Trends: What to Expect these Days

In recent years, the workers compensation market has shown its propensity to maintain a steady incline. This upward trend is brought about by a lot of factors – both national and local in scope – and continues to trigger workers compensation costs to rise beyond limits. Higher compensation costs result to higher business expenditures and, as history always proved, bigger employment issues eventually. Let’s take a look at the top three most critical issues hounding the workers compensation market today and see how these affect the way business is done in and outside the state.

 

Re-entry of Middle East war veterans into the workforce

Out of the 2.4 million Americans deployed during the Iraq and Afghanistan wars, more than 50,000 soldiers sustained injuries and are now returning in droves to re-enter the US workforce. And with the Administration’s promise of getting all US soldiers out of combat by 2016, the reintegration of these veterans, injured or not, will certainly affect the workers compensation market.

 

The effect will fall on the companies that will have to employ veterans, though those who will employ veterans with service-related injuries will still enjoy the support of the Veterans Administration (VA). The VA’s coverage ensures that veterans with service-related injuries are continuously addressed even when the veterans turn to private employment.

 

That saying, the issues are still many. First, how will a private work injury be treated when there is a pre-existing service-related injury? While it could easily be treated as any other work injury superimposing a pre-existing work injury (from a previous employer), it is reasonable to expect that the veteran would prefer to seek assistance from the VA as it is where he or she is getting service-related injury treatments. In such a case, the question of reimbursement for the work injury to the federal government looms.

The Affordable Care Act

The much awaited implementation of The Patient Protection and Affordable Care Act of 2010 (‘Affordable Care Act’ or ACA) finally started this January 2014. The ACA will definitely have an impact on workers compensation costs as medical expenses have been shown to take up a huge chunk of the market.

 

The predictions with regard to ACA favor the businesses as it has aspects that are expected to reduce workers compensation costs. First, the removal of lifetime caps on medical insurance coverage (typically pegged at $1 million) will change the way workers apportion the costs between their health insurance and the workers compensation carrier.

 

Second, the mandatory coverage of employees with pre-existing conditions such as hypertension or diabetes would shift treatment costs to the insurer. An illustration: A hypertensive worker who suffers a fall and would need hypertensive treatment prior to orthopedic surgery would normally turn to the workers’ compensation carrier for treatment of both hypertension and orthopedic injuries. Under the ACA, it is the health insurer who is liable.

 

The ACA is generally favorable to both employees and employers. After all, a healthier workforce will ultimately yield to a lower workers’ compensation cost.

 

Return to litigation from mediation of workers’ compensation claims

The shift has reversed. Ten years ago, the trend has been towards mediation. Today, given the way mediation has not favored them, businesses have started to demand their cases to be litigated instead. From settlement of dubious injuries to paving the way for some unwritten worker benefits, mediation has proved to be a dangerous way of doing things. This reversal will definitely affect the number of workers compensation claims in the future.

The Difference between Workers Compensation and Social Security Disability

Denver Workers Compensation and Disability Lawyers Explain The Difference between Workers Compensation and Social Security Disability

Thanks to established labor policy, compensation systems have been set up for when an employee or a worker suffers a bad injury at work such as a fall or a blast. In the state of Colorado, there are two types of compensation which an injured worker may avail: the Social Security Disability from the Social Security Administration or the Permanent Total Disability under the Colorado Workers’ Compensation Law. Don’t know which one you can avail? Below is a simplified guide which compares and contrasts the difference between the two compensation options.

 

Qualifications

The qualifications for availing either the Social Security Disability or Permanent Total Disability vary.

Anyone who has been a member in good standing (meaning, all fees have been religiously paid) in the social security system for at least five years preceding an injury may avail of Social Security Disability. This option is more comprehensive in scope and considers all major prescriptions like hypertension, diabetes, etc., as well as injuries, whether work-related or not, in assessing your case.

 

On the other hand, the Permanent Total Disability option may only be availed of when returning to work is made absolutely impossible by the work-related injury. It is more restrictive in the sense that pre-existing conditions like hypertension etc. are not covered and should not be the main injury that prevents resumption to work.

Age as a factor of eligibility is also one of the stark differences between the two compensation systems. Social Security Disability uses a grid system, starting at age 45 and ending at age 65 in increments of five years. In simple terms, the older applicants are more likely to qualify under the SS Disability system. This is not the same with Workers’ Compensation. Permanent Total Disability will only look at one thing: whether an injured worker is fit to work. Any work, at that. This includes casual jobs with minimum wage salary.

 

Application and processing

Another difference lies in the presentation and processing of claims. Social Security Disability cases are filed with the Social Security Administration. This is a national office and the merits of claims are processed by a federal SSA judge in comparison with other national cases.

 

Meanwhile, Permanent Total Disability under the Colorado Workers’ Compensation Law is a state-administered institution and it would be best to consult a Colorado lawyer when filing a claim in order to prepare its merits. As discussed above, the most primary criterion for qualifying under Permanent Total Disability is capacity to work in general. The claim will be heard by a judge who will consider the findings of doctors and vocational specialists. This is where a Colorado disability lawyer comes in hand. When the claim is heard and the judge decides that you don’t qualify, a competent lawyer can still argue on your behalf for some compensation to cover your medical bills and loss of earnings, or make you qualify for some other compensation more fitting like a Permanent Partial Disability.

 

As it stands now, the process can be overwhelming with all its complexities. Depending on the preparation of the claim, an injured worker may qualify for both Social Security Disability and Workers’ Compensation, either of the two, or none at all. It is most recommended to consult a competent and experienced legal counsel.

Denver Workers Compensation Lawyer
Still confused? Kaplan Morrell, Denver disabiilty attorneys and Denvr workers compensation attorneys are here to help you understand further these two concepts. For many years, we have been helping workers claim what is due to them from their employers and/or other concerned parties.