Temporary Compensation by Attorney Diana Robles

Temporary Compensation

by Attorney Diana Robles

Snow, Carpio

When you are injured on the job in Arizona, you may be entitled to receive temporary compensation benefits if your doctor indicates you can not work, or can work only in a limited capacity with certain restrictions.  The carrier will review each case to determine if temporary benefits are due.  Arizona law provides that you should be getting 66 2/3% of your average monthly wage.  Average monthly wage can include overtime and/or concurrent employment that you had at the time of your injury.

If your doctor indicates you can not work at all, you should be getting paid every 14 days.  This is called temporary total disability or TTD.  The doctor must address your work status at every visit, as the insurance carrier will want to know whether you are to remain off work.  In most cases, there is no time limit for the TTD benefits you can collect.  There are a few exceptions to this, for example in hernia injuries.

Once a doctor has released you to return to work with restrictions, Arizona law only requires them to pay 66 2/3% of the difference between the wages you are now able to earn and your established average monthly wage.  This compensation is paid every 30 days. This is called temporary partial disability or TPD.  

When your doctor releases you to work with restrictions, you should contact your employer to see if they accommodate those restrictions.  The best thing to do is to put your request to return to work with restrictions in writing.  If your employer can’t accommodate your restrictions, then it is your responsibility to make a good faith effort to find work within your restrictions.  You must apply for a job at other places even if you are still employed with your date of injury employer.  If you get a job you will receive the difference between the wage you earn and the 66 2/3% of the established monthly wage.  If you don’t get a job you would continue to collect the entire 66 2/3% of your average monthly wage from the carrier.

In most instances if you have returned to work your regular hours with restrictions, you will not receive payment from the employer for attending doctor or therapy appointments.  The carrier will review each case to determine if temporary benefits are due, however you would only receive compensation if your earnings were reduced by more than 33 1/3 of your set wage.  

If you or someone you know has been injured at work or has a medical condition that will prevent them from working for 12 months or more, call Snow, Carpio & Weekley toll-free at 855-325-4781 to schedule a free consultation in person at one of our offices around the State or over the phone. You can also find out more about our firm by visiting our website at www.workinjuryaz.com.

DEATH OF INJURED WORKER WHILE CLAIM IS STILL OPEN

DEATH OF INJURED WORKER WHILE CLAIM IS STILL OPEN

by Attorney Chad Snow, Partner

Snow, Carpio & Weekley

We've had several cases lately where our clients have passed away for a variety of reason, some related to their injuries and others unrelated.  The question then becomes – what happens to that claim?  Will the family get any benefits after the death of the injured worker?

Since the only compensation in a workers comp claim is for lost wages, compensation usually terminates with the death of the injured worker – the worker can’t work if he is dead so there are no lost wages.

However, if the death was caused or contributed to by the industrial injury, the survivors of the deceased worker can get ongoing compensation benefits for a percentage of what the worker would have been able to earn but for the injury.

In many cases, the relationship between the industrial injury and the death is not clear.  In these cases, a workers compensation attorney usually takes the case to court to prove medical causation – that the death was at least partially related to the injury or the work.  Surviving spouses, children, and other dependents can get a percentage of the deceased worker’s average monthly wage until age 18 for minors, and until death for surviving unmarried spouses.

You should always consult with a workers’ compensation attorney with any questions about survivors benefits.


If you or someone you know has been injured on the job or has a medical condition that prevents them from working for 12 months or longer, call Snow, Carpio & Weekley on our toll-free number at 855-325-4781 for a free consultation in person or over the phone, or visit our website at www.workinjuryaz.com.

POSITIVE DRUG TEST IN ARIZONA WORKERS COMP CLAIM

POSITIVE DRUG TEST IN ARIZONA WORKERS COMP CLAIM

by Chad Snow, Partner

When I first started practicing 15 years ago, insurance carriers made all injured workers submit to a drug test immediately after the work accident.  A positive result usually resulted in the claim being denied.  

In 2005, a claim went up to the Supreme Court of Arizona alleging that denying claims based on drug test results was unconstitutional as it introduced an element of fault into what is supposed to be a no-fault system (meaning that a claim is compensable no matter who is at fault).  The cases that resulted, Komalestewa and Gramatico, overturned the practice of denying claims based on positive drug or alcohol tests at the time of the injury.  

Many injured workers are still afraid to file a claim for an on-the-job injury because they have used recreational drugs or consumed alcohol prior to their injury.  Although there may be issues with your employer, there are no longer issues of positive drug or alcohol tests in Arizona workers compensation claims.  However, it’s still not a good idea to get high before climbing onto a roof… just a little free legal advice!

If you or somebody you know has been injured on the job or has a medical condition that will keep them from working for 12 months or longer, call our toll-free number at 855-325-4781 to set up a free consultation over the phone or in person at one of our offices across the State of Arizona. You can also find more information about Snow, Carpio & Weekley by visiting our website at www.workinjuryaz.com.

Can I still get benefits if I am an undocumented worker?

Can I still get benefits if I am an undocumented worker?

by Attorney Diana Robles

Absolutely!  Immigration status of a worker is not a factor for Workers’ Compensation benefits in Arizona.  In fact, Arizona laws expressly cover undocumented workers in its workers compensation statutes.  The Arizona Workers Compensation Act defines covered employees as “every person in the service of an employer … including aliens and minors legally or illegally permitted to work for hire …” A.R.S. 23-901(6)(b).  There is no reduction of benefits for not being a legal resident.

The Arizona workers compensation system is a no fault system, which entitles the injured worker to necessary medical treatment, in addition to 66 2/3 of their average monthly wage, when they can’t work because of their injury.  It is very important to report the injury to the employer promptly when you are injured.

If you or somebody you know is injured on the job or facing a disability that will keep them out of work for 12 months or more, call Snow, Carpio & Weekley toll-free number at 855-325-4781 to schedule a free consultation in one of our office located around the state. Or, we are happy to schedule a consult over the phone if you are unable to come into an office in person. You may also visit our website at www.workinjuryaz.com.

How do I pay my SSD Attorney?.

                                                                                     

How do I pay my SSD attorney?

Most every Social Security attorney charges the same way, which is by contingency fee agreement.  A contingency fee agreement means that your attorney does not get paid unless they win your case.  Up to the hearing level, most Social Security attorneys will charge 25% of your past-due benefits or $6,000, whichever is less. If you are approved for benefits, Social Security will generally directly withhold your attorney’s fee and pay your attorney directly



If you or someone you know has been injured on the job or has a disabling condition and will be out of work for 12 months or more, call our toll-free number at 855-325-4781 to set up a free consultation. You may also check out our website at www.workinjuryaz.com

What is an over payment and what can I do?

by Allyson Snow, Associate Attorney

SSD Practice @ Snow, Carpio & Weekley

An over payment occurs when Social Security improperly paid a recipient benefits they were not entitled to for some reason or another.  Unfortunately, it usually takes Social Security months or years to catch their mistake.  A recipient will get a letter in the mail that they owe Social Security a certain amount of money back.  Obviously, receipt of such a letter can cause great distress.

I classify over payments into two categories.  The first category is where Social Security has made a mistake about the over payment and the recipient is actually entitled to that money.  These types of cases are rare.

More often than not, even if Social Security is at fault and has paid benefits they shouldn't have, the recipient will be required to pay back the money. Most Social Security attorneys do not handle over payment cases because they are difficult to win.  Additionally, Social Security will find it hard to believe that one has the money to pay an attorney to fight the over payment, but they don’t have the money to pay Social Security back.  In these cases, I find that Social Security will normally work out very favorable re-payment terms.  The best thing to do is to be proactive and work out a re-payment plan with Social Security that fits within your budget, rather than having Social Security withhold part of your benefits to repay the over payment. 

If you would like to speak with somebody regarding a Social Security or Worker's Compensation matter, please call 855-325-4781 for a free consultation in person or over the phone. You may also find out more about our firm by visiting our website at www.workinjuryaz.com

Letter from the Industrial Commission of Arizona, dated 03/06/15 Regarding Medical Care

The following letter has been put out to the Arizona Community regarding medical care.

If you have any questions regarding medical care, an injured worker's right to choose their own doctors or any other questions related to Workers' Compensation or Social Security Disability, please call out office at 855-325-4781 or visit our website at www.workinjuryaz.com.

The attorneys and staff at Snow, Carpio & Weekley are dedicated to serving the needs of injured workers and disabled members of our community and State.

What happens if I miss an IME set up by the insurance carrier?

What happens if I miss an IME set up by the insurance carrier?

By Diana Robles, Associate Attorney

Arizona law provides that the insurance carrier can periodically set up an independent medical examination (IME) for you, at a time and place reasonably convenient, by a doctor of its choosing, so long as they give you 14 days advance notice of the appointment. If you miss an IME appointment the carrier can suspend your medical and temporary compensation benefits. In addition, many times the carrier will ask for sanctions to be assessed against you. They often ask that you reimburse the cost of the IME or that they be allowed to take a credit against future compensation owed.  

An IME can cost several thousand dollars.  If you have missed an IME appointment and receive a Notice of Claim Status requesting reimbursement or a future credit against temporary compensation, you only have 90 days from the issuance of the Notice to protest it.  Our firm will argue that these exorbitant costs should not be assessed to the claimant. 

However, it is very important to make it to these appointments and let the carrier know if there is a good reason why you can't attend the appointment. Of course, emergencies occur and if something happens which prevents you from attending the IME you may need to show proof that there was an emergency which prevented you from being at the IME.  More importantly, is the fact that the carrier may accept the opinion of its consulting doctor and base change in your claim status, or the closure of your claim, on that doctor’s opinion.  

Remember, it is your responsibility to understand all notices. If you disagree, you must file your request for hearing with the ICA within 90 days from the date of the Notice of Claim Status or the Notice becomes final.

If you or somebody you know is injured on the job or suffering from a disabling condition, you can call 855-325-4785 for a free consultation. Consultations are free and can be done either in person or over the phone. You may also visit our website at www.workinjuryaz.com for more information about our firm.

I am on light duty, does my employer have to pay me to go to my medical appointments?

by Diana Robles, Associate Attorney

In most instances if you have returned to work on light duty, you will not receive payment from the employer for attending doctor or therapy appointments.  The carrier will review each case to determine if temporary benefits are due.  However, once a doctor has released you to return to work with restrictions, Arizona law only requires them to pay 66 2/3% of the difference between the wages you are now able to earn and your established average monthly wage.  This compensation is paid once a month. So if you have returned to working your regular hours and you are only missing a few hours a week for appointments, it is unlikely that you would get compensation for time missed for appointments.  You would only receive compensation if your earnings were reduced by more than 33 1/3 of your set wage.

If you or anybody you know has a work injury or disability, call Snow, Carpio & Weekley at 855-325-4781 for a free consultation. You can also visit our website at www.workinjuryaz.com.

Can I Get a Loan on my Workers’ Compensation Benefits?

By Brian Weekley, Partner 

Snow, Carpio & Weekley

The simple answer is no.

By law, workers’ compensation benefits in the State of Arizona are not subject to lien. That means that a lender, such as  national advertiser Oasis Finance, is unable to legally secure all or part  of your future workers’ compensation benefits in order to pay its loan.  Without that security, no loan can be completed. The same logic applies to liens for medical services and products. These liens are unenforceable and, therefore, I highly recommend against their use.

I been asked many times in the past few years by clients to sign such a lien. I have always refused, exactly for this reason. I cannot sign a lien that is waive-able by the debtor. 

As an aside, the terms of these loans are usually very oppressive, with sky high interest rates and penalties. 

Similarly, your attorney is prohibited by law from lending you money. 

I realize that a workers’ compensation claim creates a lot of financial pressure on claimants, since , if they are being paid correctly, they are only receiving 2/3 of their normal monthly income. The amount of benefits paid is also subject to a ceiling known as the "maximum average monthly wage." There may be other, and better, options to increase a claimant’s benefits. these options do not include loans, advances, or other onerous products. 

For more information on this topic or if you have any other questions about Workers' Compensation or Social Security Disability, please call 855-325-4781 to schedule a free consultation in person or over the phone. You may also find more information about our firm at www.workinjuryaz.com.

Nurse Case Managers

NURSE CASE MANAGERS

by Chad Snow, Attorney and Managing Partner

One of the insurance company’s best tools in reducing their costs (and your benefits) is by hiring a “Nurse Case Manager” to work on your case.  These are usually R.N.’s who try to act like they are your advocate, but are really just an agent of the insurance company.  They will arrange for you to see doctors who are usually extremely insurance-oriented, schedule your appointments, and then attend the appointment with the injured worker.   At the appointment, they can then pressure the doctor into limiting the amount of medical care that the injured worker receives and into releasing him or her to work as soon as possible – even if the injured worker doesn't feel ready to return.  Generally, our firm does not allow nurse case managers on our files.  One of the benefits of having a Workers Compensation Attorney is that any agent of the insurance company (NCM’s) is not allowed to have contact with you as it violates the attorney-client privilege.  In some special cases we do allow them to work with our clients and they can be very helpful.  For example, in catastrophic injury cases where the injured worker is unable to make appointments or follow up on their own medical care or in cases where multiple specialists are involved.  I don’t mean to sound overly negative about nurse case managers, and there are some that are very conscientious and great at what they do – but we’ve had too many bad experiences with them over the years to not be at least a little skeptical.  If you have questions about a Nurse Case Manager in your case, you should contact one of our attorneys to see if it is hurting your case.  

The ramifications of receiving medical care in rural communities

Special Considerations for Workers’ Compensation Cases in Rural Arizona

The ramifications of receiving medical care in rural communities

By Attorney Brian Weekley, Partner

Snow, Carpio & Weekley, PLC

Snow, Carpio & Weekley handles cases all over the State of Arizona. We have full time offices in Phoenix and Tucson. We also have dedicated office space in Yuma and Flagstaff. We are able to use offices virtually all over the State of Arizona. Because of this statewide presence, we have lots of experience with cases from the state’s smaller communities. there are several peculiarities about these cases that are worth noting.

First, smaller communities do not have the depth or diversity of medical care offered in a larger city.  Your town may have an orthopedic surgeon, but it is unlikely that that surgeon will be subspecialty trained in foot and ankle, upper extremity  or other subspecialties.  

Also, most small town physicians are not fluent in the language of industrial medicine. This is the language that will be applicable throughout the life of your case. Are you stationary? Is there ratable permanent impairment? Do you need supportive medical care? What diagnostic testing is necessary? Is your injury or need for treatment related to your industrial injury? What is the nature of your industrial injury?

In order for you to have as strong a case as possible, your physician must be able to articulate and communicate his or her opinions on these and many other subjects. They must communicate in written reports and also, if necessary, through oral testimony at a hearing at the Industrial Commission of Arizona.  This is exactly why IME physicians ( Independent Medical Examiners) have an advantage over local practitioners. They know the questions and answers. They understand what the Judge is looking for. They know how to build a case with medical evidence. They communicate with their defense attorneys. The sum of these efforts is a smoothly presented case…often against the injured worker.

There are many excellent specialists in our larger urban areas who are fair and willing to “ go to bat” for injured workers. They will provide the same level of testimony as their defense counterparts. This gives parity, or levels the playing field, for injured workers.

There are some very good physicians in rural areas of Arizona. However, a stronger case can usually be made if the injured worker is willing to travel to a seasoned veteran of our industrial medical system. In most cases, the worker is able to choose his or her own physician. The exception is if the worker is employed by a self insured employer. In that case, the employer can direct care.

If you or somebody you know has been injured on the job or is disabled, call our toll-free number at 855-325-4781 for a free consultation in either of our 4 offices or over the phone. You may also get more information on our website at www.workinjuryaz.com.

What if I am a 1099 Contractor and I get injured?

Can I still recover under workers compensation if I work as an independent contractor?

by Nick Wearne, Associate Attorney

Snow, Carpio & Weekley

In Arizona, independent contractors are not entitled to workers’ compensation benefits. Workers’ compensation benefits are reserved for employees.  However, determining whether someone is an independent contractor vs. an employee is not as easy or as clear as it may seem.

Just because you are labeled as an independent contractor does not necessarily mean you are one for workers’ compensation purposes.  In Arizona, there two tests that the court applies in order to determine if a worker is an independent contractor or an employee: 1) The Control Test, and 2) The Nature of Work Test.  Sometimes the court will apply one over the other, other times they will mix the two together.

The Control Test:

When applying the ‘Control Test’ the court looks at a variety of factors in order to determine who had the right to control the worker.  If the factors tend to show that a company controlled a worker then he/she is an employee regardless of how the company labels him/her.  The factors the court looks at include duration of employment, the method of payment, the right to hire and fire, who furnishes equipment, whether the work was performed in the regular course of the employers business, and the extent to which the employer could exercise control over the details of the work.

The Nature of Work Test:

When applying the ‘Nature of Work Test’ the court looks at whether the work the worker was hired to do is a well-defined activity which is ancillary to the central concern of the business or whether the delegated task is in fact the basic employment activity.  For example  in one Arizona case a cab driver was determined to be an employee even though the cab company tried to portray him as otherwise because cab driving was at the core of the cab business.  Without cab drivers the company would have no cab services to provide.

If you or someone you know has been injured on the job or is facing a long-term disability condition, call Snow, Carpio & Weekley for a free consultation in any of our Arizona offices at 855-325-4781. You may also visit our website at www.workinjuryaz.com

Why do I have to look for work while I am on Light Duty and still injured?

Why do I have to look for work while I am on Light Duty and still injured?

by Nick Wearne, Associate Attorney

Snow, Carpio & Weekley, P.L.L.C.

If you are injured at work and the insurance company accepts your claim you will begin to receive active medical care.  Active medical care is treatment designed to get you better.  Active treatment may include anything from major surgery to physical therapy.  Obviously your ability to work during your treatment will vary depending on your treatment and the requirements of your job.  After a major surgery you will probably be unable to work at all.  But several weeks later, while your receive physical therapy, you may be able to do some light duty work.

In Arizona, it is expected that you will work once the doctor has released you to light duty.  If you do not have a job, it is expected that you will look for one.  While very few companies if any will be willing to hire you for light duty work, it is expected that you will at least look for such work.  We advise all of our clients to reach out to their employer once they are released to light duty asking for work.  We advise clients to do this in writing and to keep a copy of the email or letter.  If the company refuses to give you light duty work we advise our clients to go out and apply for 2-3 jobs a week and to keep a log of such job applications.

Why do you have to do this?

The reasoning behind this expectation that you will at least look for work is that by working you will mitigate your damages.  To mitigate means to lessen or to make less severe.  When you are injured at work you are entitled to a percentage of your wages for time lost from work.  If you happen to find light duty work you mitigate or lessen what the company owes you in lost wages.

Does my work have to let me work while I am on Light Duty?

Unfortunately, the answer is no.  While you are legally obligated to make yourself available to do light duty work, the company is not legally obligated to let you work. Again, we recommend informing your employer that you are available for light duty work in writing and making a copy of the letter.

If you or somebody you know has been injured on the job or is disabled and unable to work, call Snow, Carpio & Weekley for a free consultation. We service the entire State of Arizona and can be reached at 855-325-4781. You may also visit our website at www.workinjuryaz.com

When should I apply for Social Security Disability?

   

When should I apply for Social Security Disability?

by Allyson Snow, Associate Attorney

Snow, Carpio & Weekley, PLC

Under Social Security’s rules, one has to have a condition that has lasted/is expected to last one year OR result in death.  Technically, there is no perfect answer to this question.  One can apply the day their symptoms force them to stop working or earning below the amount Social Security considers Substantial Gainful Activity ($1090 gross income per month in 2015). 

If one has been out of work for a year, it is important to apply immediately. For SSDI candidates Social Security will only pay past-due benefits back one year, even if they find you became disabled and unable to work prior to that time.  In those cases, a delay in filing your application can cost you past-due benefits that you could be entitled to. It is important to consult with an attorney early in your case. 

If you have further questions about this or other SSD matters, you can call our firm at 855-325-4781 for a free consultation or visit us on the web at www.workinjuryaz.com.

What is the difference between SSDI and SSI?

 What is the difference between SSDI  and SSI?

by Allyson Snow

Associate Attorney

Snow, Carpio & Weekley

SSDI and SSI are the two major programs administrated by the Social Security Administration. Medically, the requirements for qualifying are the same. However, the eligibility requirements for both are different.

SSDI stands for “Social Security Disability Insurance.” Essentially, when you work, you pay federal income taxes.  If work is sustained long enough and is recent enough, these taxes will insure you should you become disabled and unable to work. 

SSI stands for “Supplemental Security Income.” SSI is the fallback for those who do not have enough work history, or their work history is too remote, to qualify for SSDI.  SSI is a needs-based program and there are income and asset limitations for one to qualify.

There are several differences between the two programs including the monthly benefit amount, the health insurance that one will qualify for if approved, and offset potential due to earnings and other income resources.  It is important to consult with an attorney early in your case.

If you would like more information on filing for Social Security benefits, you can call our offices toll-free at 855-325-4781 for a free consultation with Attorney Snow. You can also read more about our firm on our website at www.workinjuryaz.com.

SCW Gives Back - Community Outreach Focusing on Workers' Legal Rights

Attorney Alex Carpio spoke at two separate events over the weekend in Yuma County as part of a Community Outreach Focusing on Workers' Legal Rights. He spoke Friday in Yuma and then on Sunday in San Luis. 
Snow, Carpio & Weekley is dedicated to serving those in the communities we work in. Through outreach programs such these, we are able to take part in helping those individuals who might not otherwise receive legal assistance.
Thank you Alex for representing SCW! You did a fantastic job!

Can I Sue My Employer?

Can I Sue My Employer?

by Nick Wearne

Associate Attorney

In Arizona, you are generally unable to sue your employer for an injury that has occurred on the job, regardless of how it occurred.  The law in Arizona forces employers to get workers compensation insurance but, it also bars personal injury lawsuits against them, even if the company was careless or negligent.  So while you may not be able to sue your employer, the trade off is you are guaranteed workers compensation coverage for injuries that occur at work, even if they were your fault.

If injured at work you are entitled to medical coverage and a percentage of your lost wages for time off work.  While you are not allowed to sue your employer, if you are improperly denied these workers compensation benefits, you can protest the denial in front of a judge.  If you win, the company must pay you the benefits designated by the judge back to the date of injury.

If you were injured at work and you feel someone other than your employer was responsible for the injury, you may sue that person in court without a problem.  For example, if a piece of equipment malfunctions or if you drive a company car and are injured by a negligent driver, you may sue the responsible party in court.  If you receive workers compensation benefits while you are suing, the workers compensation insurance company may be entitled to reimbursement from whatever money you receive.

If you have questions you need answered, call Snow, Carpio & Weekley, PLC at 602-532-0700 for a free consultation or got our website at www.workinjuryaz.com to find out more about our firm.

Yuma

Snow, Carpio & Weekley is very proud to announce 

that our new Yuma office will be open on February 1, 2015! 

The Yuma office contact information is:
152 South 1st Avenue 
Yuma, AZ 85364
928-783-7000

We look forward to serving the injured workers of Yuma County with the same high level of legal representation and customer service as our other Arizona offices!

Attorney Nick Wearne

Attorney Brian Weekley Speaks about a Recent Case

Neck Injuries

Neck Injuries

by Chad Snow, Partner

Snow, Carpio & Weekley, PLC

Some of the most common and most debilitating injuries sustained on the job are injuries to the discs and vertebrae of the neck, also known as the cervical vertebrae.  These usually happen as a result of falls or sudden deceleration accidents.  

Treatment for neck injuries is usually done by an orthopedic spine surgeon or neurosurgeon, if surgery is needed – or a physiatrist (also known as Physical Medicine and Rehabilitation) specialist for non-surgical treatment.  Treatment of neck injuries can include physical therapy, epidural and facet injections, or surgery.  

Although many people successfully recover from a permanent neck injury, many are left with permanent restrictions, mainly on heavy lifting or prolonged periods of overhead work, which can place additional stressors on the neck.  For purposes of Arizona workers compensation claims, neck injuries, when permanent, are classified as unscheduled and can result in permanent partial disability if the injury precludes a return to regular work.  

If you have a neck injury or any other type of work injury and would like a free consultation, call the Snow, Carpio & Weekley at 855-325-4781.

Heart Injuries and Heart Attacks

Heart Injuries and Heart Attacks

by Nick Wearne, Associate Attorney

Snow, Carpio & Weekley, PLC

Some work related injuries have special laws that govern whether they are compensable and how much benefit can be received.  One such law is Arizona Revised Statute 23-1043.01.  This section tells us what is required for a heart related injury to be covered under workers compensation. 

Generally speaking, a heart related injury is not covered under workers compensation.  However, the statute says a heart related injury is covered when some injury, stress, or exertion related to the employment was a ‘substantial contributing cause’ of the heart injury.  Whether a work related stress or exertion is a ‘substantial contributing cause’ is a determination that must be made by an administrative law judge on a case by case basis.

While it is hard to know ahead of time how a judge will rule on a heart attack case, we can look at past cases for guidance.  In one Arizona case, Skyview Cooling v. Industrial Commission, a heart attack was considered compensable where the main cause of the worker’s heart attack was the workers underlying heart disease but, a work related exertion precipitated the attack.  The worker in this case was walking through thick mud while doing farm work in Yuma Arizona when he experienced a heart attack.  The worker’s doctors agreed that the main cause of the heart injury was a blocked artery in the workers heart but, one of the doctors testified that the exertion from walking through the mud, and the exertion of having to pull his legs out when he got stuck, contributed to the heart attack and caused the attack to happen when it did.  The heart injury in this case was considered compensable under workers compensation.

If you have a job that requires stress/exertion, have experienced a heart attack while at work, and a claim was never filed or has been denied, call an experienced workers’ compensation attorney.  Do not assume that just because you had heart disease or were somehow predisposed to a heart attack that you do not deserve coverage.  At Snow Carpio and Weekley we will fight to get your past medical expenses covered, we will fight to get you lost wages while you recover, and will fight to get you the best cardiac care possible. 

Hernias

Hernias

by Attorney Nick Wearne

Some work related injuries have special laws that govern whether they are compensable and how much benefit can be received.  One such law is Arizona Revised Statutes Section 23-143.  This section tells us what is required for a hernia to be covered under workers compensation.  A hernia is defined as a condition in which part of an abdominal organ protrudes through the abdominal muscles that are supposed to contain it.  Hernias are placed in two different categories according to the law: 1) Real Traumatic Hernias, and; 2) All other hernias.

A Real Traumatic hernia is an injury caused by a cut, puncture, or tear to the stomach or groin area that cuts through the skin and causes an exposure or protrusion of abdominal organs.  These types of hernia injuries can be life threatening and we do not see them very often.

Hernias more often occur when a person is lifting, twisting, or moving while handling something heavy.  There is no puncture of the skin but organs break through the abdominal wall causing a bulge beneath the skin.  These types of hernias, regardless of how they occur, are considered to have existed since birth or to have formed over many years and are not compensable under workers compensation, unless you can prove 4 things:

1)      The cause of the hernia was a sudden effort or severe strain related to your employment

One of the hardest things about hernia cases is that when our clients go to the doctor immediately after they will often tell the doctor about all the groin pain they have ever had in the past.  The doctor will usually make note of this in the medical record.  Even though such groin pain is almost always unrelated to the hernia and caused by sore muscles or gas, the insurance company uses the medical record to suggest that the hernia was of a gradual onset and not caused by a sudden event.  Such cases become much more difficult to win.

2)      The decent or popping out of the hernia occurs immediately

The hernia bulge has to have occurred at the same time or immediately after the sudden effort or strain.  The hernia bulge consists of organs protruding through your abdominal wall and occasionally can be pushed back into the abdomen or will go away when you lie down. Because they have pushed the bulge back in, sometimes clients will tell the doctor they have no hernia bulge or protrusion.  Before long these clients will strain and the hernia will protrude once again through their injured abdominal wall.  Such cases become more difficult to win because insurance companies suggest that the bulge did not occur till long after the original strain. 

3)      You experienced severe pain during the incident

a.       At the time of the strain or effort you must have experienced severe pain. When you go to the doctor following a hernia, it is not the time to try and prove you have a high pain tolerance.  Be truthful with your doctor regarding the pain you experienced at the time of the event.

4)      The pain and hernia bulge were of such severity that you reported them to your supervisor

a.       You must report you hernia to a supervisor immediately.  If you do not report it immediately your cases becomes difficult, if not impossible, to win.  Do not try and tough it out as this could be detrimental to both your health and your case.

If you have experienced a hernia at work, and feel you may be entitled to compensation, you need to hire an experienced workers compensation attorney to help you get the benefits you need. Contact our offices toll-free at 855-325-4781. You can also visit us online at www.workinjuryaz.com to read more about our firm and attorneys.

The Big Picture - A Workers' Compensation Case Flow Overview

Blog by 

Nick Wearne

Associate Attorney

Snow, Carpio & Weekley, PLC

Many of our blog posts are focused in on specific workers’ compensation issues. However, one of the first things we like to do when clients come in is walk them through the natural progression of a case so they get the big picture. A typical workers compensation case proceeds as follows.

Step 1: 
An Injury Occurs at Work The workers’ compensation system is a no fault system. That means that if you are injured you are entitled to compensation regardless of whose fault it was. However, the injury must occur while you are on the job. Work breaks, lunches, or any other activity that occurs on the job site is usually considered ‘on the job.’ Driving to and from work unfortunately is not.

Step 2: 
Forthwith Reporting Once an injury has occurred the law says you must forthwith report the injury to your employer. While the precise definition of the word forthwith is unclear, it essentially means immediately.
In professions where it is common for a worker to become sore from the days work, and injury symptoms originally presented as soreness, it is ok to wait a few days. But, when in doubt, report immediately!

Step 3: 
Active Care Once an injury has occurred you should go to the doctor and will begin to receive active care. Active care is medical treatment designed to help you get better.
If you have been injured do not wait to go to the doctor, as this may hurt your case. If your employer does not send you, schedule an appointment yourself or report at the emergency room. While going through active care your functioning capacity should begin to improve.

Step 4: 
Forms 101, 102, and 407 Within 10 days of your injury your employer should file a document referred to as Form 101 with the Arizona Industrial Commission. Likewise your doctor should file a Form 102, reporting the injury to the Industrial Commission.
 If your employer and your doctor have not filed these forms, you can report the accident yourself by filling out Form 407 and sending it to the Arizona Industrial Commission.

Step 5: 
The Insurance Carrier Accepts or Denies Your Claim Once the appropriate forms have been filed, the information gets sent to your employer’s insurance carrier. The insurance carrier then accepts or denies the claim. If a claim is wrongfully denied we can request a court hearing and will protest the decision.
At times we have clients come in telling us that their employer does not have an insurance carrier so they never filed a claim. All employers are required by law to carry workmans’ compensation insurance and their carrier is kept on file with the Arizona Industrial Commission.

Step 6:
Average Monthly Wage is Determined Once a claim has been accepted, the insurance carrier sends information to the Industrial Commission explaining what they think your average monthly wage was at the time of the accident.
Normally you’re the carrier will send in the amount you earned in the last 30 days. The Industrial Commission reads through the information sent over by the insurance carrier and they make their own determination. If for some reason you feel the average monthly wage determination is incorrect we protest the amount by scheduling a hearing and by collecting information showing the amount was incorrect.
Common reasons for protesting an average monthly wage determination is that the worker had more than one job, the worker took some vacation time in the month before they were injured, etc. It is extremely important to be sure your average monthly wage is correct because the benefits you receive will be based on this amount.

Step 7: 
Temporarily Totally Disabled (TTD) or Temporarily Partially Disabled (TPD) Remember, at this time you are in active care, care designed to help you get better. During your active medical care you are also entitled to lost wages. The amount you receive in lost wages will vary depending on if you are TTD or TPD. Temporarily Totally Disabled means the doctor has said you cannot work at all. Our clients are often TTD after they come out of a serious surgery or if they have had broken bones.
When a person is TTD they are entitled to 66.67% of their average monthly wage split up into two payments a month, no questions asked.
Temporarily Partially Disabled means the doctor has put you on light duty. Our clients may be designated as TPD when they are going through physical therapy and rehabilitation. During this time you must ask their employer if they have light work for you to do. If you have been fired, you must look for light duty jobs. If you find a job doing light duty, or if your employer gives you a job doing light duty, you are entitled to 66.67% of the difference between what you would have made without the injury and what you now make.
If you cannot find work you are entitled to 66.67% of your average monthly wage, payable once a month. You are entitled to these benefits from the date of your injury, but often times you will not receive them till you average monthly wage has been determined. Fortunately, benefits are retroactive, and the company will give you back pay for all the payments they missed.

Step 8: 
Maximum Medical Improvement At some point in your treatment you will become medically stationary. This means you will have improved as much as the doctors think you are going to improve. Hopefully this means you are a 100% better.

Unfortunately, for most clients, it means that they have plateaued at some percentage and rather than treating you to get better, the doctors merely try and keep you stable. This type of medical care is called supportive care and usually includes things like occasional physical therapy, pain medications, epidural injections, etc.
Often times the insurance carrier will schedule an independent medical examination during your active care. For this appointment they will send you to a different doctor hoping that he/she will say you have reached maximum improvement. The insurance company has the right to do this and you must attend these examinations. We will often protest maximum medical improvement designations and will schedule a court hearing to try and keep you in active care.

Step 9: 
Post Injury Benefits Once you’ve reached Medical Stability and are receiving supportive care, your benefits change. You will always be entitled to your supportive medical care. However, the lost wages you will receive from that point on depend on whether your injury is scheduled or unscheduled.
An injury is scheduled if it is listed in A.R.S. 23-1044. Scheduled injuries include injuries to a finger, a hand, an arm, a foot, a leg, ears, an eye, and facial scars. For scheduled injuries the amount of compensation has already been set by statute. However, the amounts set by statute are for total loss. A total loss injury is one where the injured body part is severed or is left completely dysfunctional. If you have not experienced a total loss but instead, a loss in function, then you will receive some percentage of the amount laid out in the statute.
Any injuries not listed in A.R.S. 23-1044 are unscheduled injuries. If you have two or more scheduled injuries, they too become unscheduled injuries. When you have a unscheduled injury your compensation will be based on your loss in earning capacity. Someone at the Industrial Commission will look at your injury restrictions as well as your education and will determine what your earning capacity is. If we do not agree with the Industrial Commission’s determination we will protest it and hire a labor market expert to testify in a court hearing about what your lost earning capacity should really be.
Once your loss in earning capacity has been determined you will receive 55% of that amount, payable monthly, for the rest of your life. If it is determined you have experienced a total loss in earning capacity, or in other words that you can make no money, then you will receive 66.67% of your average monthly wage, paid monthly, for the rest of your life.

Step 10: 
Reopening a case While receiving your post injury benefits, you will be receiving supportive care only. Some clients receive supportive care for the rest of their life and never need more than that. Other clients experience complications with their injuries and they require further active care such as a second surgery or further testing. If active care becomes necessary, we can petition the Industrial Commission to reopen the case. If we are successful in reopening the case you will repeat steps 7-9.

Attorney Nick Wearn is an Associate Attorney at Snow, Carpio & Weekley, PLC. For more information on work injuries or how our firm can assist you, please call us at 855-325-4781 toll free. We are happy to speak with you and set you up for a free consultation in any of our Arizona offices. You can also read more on our website at www.workinjuryaz.com.

Surveillance

Surveillance

by Attorney Nick Wearne

Associate at Snow, Carpio & Weekley, PLC

On occasion our clients notice that they are being followed and videotaped by an investigator.  We refer to this as surveillance.  These investigators are hired by your employer’s insurance carrier to monitor and record you.  Contrary to what you may believe, it is completely legal for your employer’s insurance company to videotape you. 

Why do they do it?

Despite warnings, there are some injured workers who will continue to engage in activities inconsistent with doctor recommendations.  Insurance carriers often spend a few hundred dollars to hire an investigator to videotape you with the hope that they will catch you doing this.  If the investigator obtains footage of you disobeying your doctor’s recommendations it can destroy your credibility with the insurance carrier, with your treating physician, and with the judge assigned to your case.  Many physicians may even change work recommendations if the footage shows you working outside of your restrictions with little or no pain. Surveillance can be a powerful tool for the insurance company.

Moral of the Story

The moral of the story is never do anything above and beyond the work restrictions the doctor has advised.  At times you may be tempted to tough it out or to test your limits, but doing more than has been advised could be detrimental not only to your case but also to your health.

Settlement of Workers Compensation Claim

Settlement of Workers Compensation Claim

Many times, it is in the interest of both the injured worker and the insurance carrier to settle either part or all of a claim.  All settlements must involve a bona fide dispute between the parties and must be approved by a Judge of the Industrial Commission of Arizona.  Settlement of a claim prior to the claim being accepted are called “compensability settlements” and are the only settlements that can include future active medical care.  Other issues that can be settled include entitlement to temporary compensation, supportive care, and Loss of Earning Capacity.  For accepted claims, future active medical care can never be settled.  Because there are numerous factors which determine what a claim is worth, and because insurance companies are for-profit businesses trying to pay as little as possible,  it is always a good idea to consult an attorney prior to settling a claim.  

Attorney Chad Snow is the Founding Partner of Snow, Carpio & Weekley, PLC. For a free consultation, please call our Phoenix office at 602-532-0700 or our Tucson office at 520-647-9000. For outlining areas, please call 855-325-4781 and speak with April to set up a telephonic consultation. For more information about Snow, Carpio & Weekley, please visit our website at www.workinjuryaz.com