Answers to Your Questions on Injury and Disability Cases in DC, MD and VA
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At Donahoe Kearney, we know you're in an unfamiliar and unfair system after a serious injury or illness. We've seen too many people get taken advantage of byt the insurance company after a serious injury or illness. So we've published books, guides and reports and answered hundreds of questions that have helped thousands of people just like you.
Here are some of the questions people have when they first contact us about D.C., Maryland and Virginia medical malpractice, serious car accidents, long term disability insurance claims, or workers compensation. We try to provide as much information as we can based on our experience helping people stand up to insurance companies after a serious accident or injury in D.C., Maryland and Virginia.
Since every person is unique, you probably have questions or need specific information about the legal process when there is an injury or death in your family. We make it easy for you, so contact us to talk it through. We'll schedule a free no obligation, secure and confidential zoom call (or regular phone call) and give you all the information we can.
Call us today at 202-393-3320.
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Who Pays for the Damage to My Car After An Accident?
If It Was the Other Driver's Fault, They Should Pay For the Damage
If your car is damaged in a accident caused by another driver in Maryland, D.C. or Virginia, the other driver's insurance company should pay for the damage that the body shop says is necessary to fix your car - after all, it was the other driver's fault.
But what if the other driver's insurance company says it wasn't their driver's fault? They say it was your fault.
There are two basic options. First, you can fight them buy suing their driver for the property damage (the damage to your car) that they caused.
Or, your insurance company can do this for you - if you have the right insurance - they will pay for the damage to your car and then sue the other driver for subrogation to get their money back.
Most people use the second option (again if they have the right insurance) because they need to get their car fixed and working again. You will have to pay your deductible but can later get that back if your insurance company wins the case.
If you have a question about an accident or whether you have the right type of insurance coverage in D.C., Maryland or Virginia, call us at (202) 393 - 3320 and you can set up a telephone appointment to review the insurance with you or answer any questions you may have.
What Are The Signs Of Medical Malpractice in DC, Maryland, and Virginia Hospitals
I Was Seriously Injured in a DC Area Hospital. Do I Have A Medical Malpractice Case?
Medical malpractice in D.C. hospitals is preventable. There are several signs and symptoms we see in our cases against hospitals when patients because of negligent medical care.
If You See Any Of These Signs and Symptoms of Medical Malpractice, You Should Find a Different Hospital
No System for Following Up On Test Results
Every hospital should have what we call Patient Safety Rules; these are established and followed protocols to making sure the systems of the hospital don't fail and leave a patient severely injured. For example, there should be a protocol in place to follow up on all test results, and communicate the test results to the patient or their family. We've seen situations where tests were ordered but never reviewed, and never communicated to the patient. These tragic failures of patient safety rules have resulted in terrible injuries to our clients.
Doctors Not Evaluating the Patient
When you are in the hospital for an issue, the doctor should be performing a differential diagnosis, which will help prevent misdiagnosis. If your condition is properly diagnosed, the doctor should be checking on your and your progress, speaking with other doctors and specialists, and talking with your primary care physician. It's the job of the doctor to evaluate you; this should not be left to inexperienced interns and first-year residents.
Hospitals, Doctors, HMOs Not Telling the Patient About Alternative Diagnoses, Treatment, and Therapies
The doctor and staff should always be discussing different diagnosis, treatment, and therapy options with you so you can make the best decisions for you you and your family. Although the doctors have the expertise, they shouldn't get the only say in how you move forward with your care. They should be providing the options for you, especially when it comes to complex and high-risk medical care, like deciding whether or not to amputate a limb.
Doctors Don't Have All Of The Available Information Because They Aren't Asking Questions, Reviewing Your Medical Records, or Listening To You
Too many doctors are rushed and moving from patient to patient too quickly. Especially emergency room doctors. Your doctor should be taking the time to ask you questions, should be reviewing your medical records, and have a working knowledge of your medical history. It takes time to do all of this but the stakes are so high if it doesn't get done. We've seen catastrophic injuries in a hospital happen far too often because process is rushed.
Nobody wants an inexperienced doctor. Yet, teaching hospitals have inexperienced doctors doing the work of seasoned doctors all the time. If you find yourself being treated by an intern, medical student, you can request a change or to speak with the senior physician to make sure you are being treated properly. You can be your own advocate when you are in the hospital.
Doctors Not Consulting The Right Specialists
If your condition doesn't fall into any simple category that an internist deals with, you should be seen by a specialist. Some conditions, like deep vein thrombosis (DVT) do not fall into the "wait and see" category. If you wait too long to get treated, the condition can very easily be fatal.
None Of These Situations Seem To Apply But You Know In Your Gut Something Is Wrong
We tell people: if it looks funny, smells funny, it might be funny. When it doubt, check it out.
What Can You Do About DC Medical Malpractice?
Many of the problems we see with medical care seem to happen over and over at a number of hospitals in the District and throughout the D.C. area. Sometimes its an individual doctor, nurse, intern, resident, technician, etc. that doesn't do the right thing - because he is in a rush, hasn't been trained properly, doesn't understand the severity of the patient's condition or the need to see a specialist, but many times medical mistakes happen because of systems failures in hospitals, HMOs and doctor's offices.
Because we have seen this sort of thing happen far too often, we wrote a report that you can download that will give you more information about how to spot and avoid medical malpractice. This report, 7 Symptoms of Medical Malpractice, can be downloaded here for free.
Want To Speak to An Experienced DC Medical Malpractice Lawyer? Contact Our Negligence Attorneys Today at 202-393-3320
The first thing to do if you suspect you or a loved one have been a victim of medical malpractice is request your medical records. If you wait too long, medical records can get lost, take too long to receive, etc and any lawyer who reviews your case will need to see the medical records. And a conversation with our experienced medical malpractice lawyer can take place for no cost or obligation. If you are dealing with a catastrophic injury we will make sure you speak to a lawyer the very same day - and if we take your case we don't make anything unless we win.
What is the difference between short term and long term disability for someone working in Washington, D.C.?
If you become disabled due to a serious injury or medical condition and are working for a Washington, D.C. employer, you may have both short term disability and long term disability benefits available while you cannot work.
Short Term Disability in Washington, D.C.
If you become disabled working for a company in D.C., your HR Department will probably have you apply for short term disability, or at least give you the information to do so. Short term disability coverage varies because the employer typically has some control over how the policy is set up and the type of coverage it offers.
Usually short term disability policies are administered by an insurance company, like Unum, that also offers long term disability coverage, or a third party administrator, like Matrix, that just handles the claim process.
Either way, short term disability benefits are usually funded by your company, they are just administered by an insurance company or third party administrator. Many policies have an exclusion for work injuries if those are covered under D.C. workers comp law.
A typical short term disability policy will provide 60% of your income for 6 months, or the waiting period for the company's long term disability plan.
You and your doctors will have to complete the insurance company paperwork showing you are disabled and entitled to the benefits. Candidly, it is usually easier to qualify for short term disability benefits since they only last for a short time, and it's the employer's money, not the insurance company's money.
Long Term Disability in Washington, D.C.
Most long term disability insurance policies have a waiting period of 6 months, meaning you have to be disabled for 6 months before benefits start. These insurance policies usually include limitations or exclusions as well. For example, a common limitation we see is a 24 month limitation on benefits when the disability is caused by mental health issues.
Many times, long term disability will pay disability benefits until age 65. Like short term disability, most insurance policies pay 60% of your salary.
Remember, there are several critical things to look for in your long term disability policy - the terms and conditions of the policy will control your claim for benefits under the policy. One of these is how the policy defines disability (it often depends on whether you have to prove you cannot work in your own occupation or any occupation - and how those terms are defined.
In applying for both short term and long term disability in D.C. it is crtical to work with your doctors to educate them on the terms and conditions of your specific policy. It's not enough to just have them fill out some insurance form or write a note that says you can't work. We work with our clients' doctors a lot on this, plus outside physician experts and consultants to make sure the medical treatment and opinions line up with the long term disability insurance policy terms and conditions.
Long term disability policies also usually have a condition that allows the insurance company to reduce the benefits if you are eligible for social security disability benefits, workers compensation benefits or an employer sponsored retirement benefit.
So review and analyze your long term disability insurance policy!
Need to Apply For Short Term Disability or Long Term Disability in D.C.? Call Us at 202-393-3320!
We'll listen to you and guide you to the next steps. We handle everything for our clients - you won't talk to the insurance company at all, and we will guide you through the entire process. But don't wait, if your claim was denied, the clock is already running.
Will a lawyer sue my company if I get hurt at work?
A lot of people who are hurt at work in Washington, D.C. are worried about losing their job, or having to sue the company they've worked for for many years because they got hurt at work. Here's how it works:
An experienced DC workers comp attorney will file your claim for workers comp benefits, not sue your employer.
When you get hurt at work in Washington, D.C., you are entitled to workers compensation benefits under D.C. law. Workers comp benefits include payment for your lost income while you can't work and payment of all of your medical expenses.
You can't sue your employer for an injury that happened while you were working - that's the law in D.C. So be very careful if any attorney tells you otherwise - it just isn't true. And there are a lot of attorneys out there who claim to be specialists or experts in D.C. workers comp cases, so don't get fooled, especially if you have a serious injury.
We even have a guide of questions to ask any attorney you are thinking about hiring for your D.C. workers comp case and a checklist of what to look for to make sure you get the best lawyer for your D.C. workers comp case.
Our experienced lawyers deal with the workers comp insurance company, not your job
We do this for a lot of reasons. First, all private employers in D.C. are required to have workers compensation insurance, and the insurance company calls the shots - not your employer.
Our attorneys and staff intentionally don't contact your job - everything we do is through the workers comp insurance company. Again, this is very intentional. We want to make sure you preserve your good relationship with your company, and let's face it, most companies freak out when they get a letter or phone calls from a law firm.
Third - while you should keep your job up to date about whether you can return to work after the injury, the details of your medical treatment and workers comp claim are really none of their business.
You need someone to guide you through the complicated workers comp system in D.C. and we can help with that.
After a work injury in D.C., you don't sue your employer, you file a workers comp claim
Our experienced workers comp attorneys make it easy on you after you get hurt at work. We file all of the claim forms and paperwork you need to get workers comp benefits in D.C.
We talk to to the insurance company so you don't have to. We deal with their adjusters, nurses, case managers, claims representatives and law firms so you don't have to. All you have to do is focus on your recovery and rehab and getting better.
But if another company or person causes your injury in DC, you can sue them
If your on the job injury was caused by another person or company, you also have a case against that person or company - and we can help you with that as well. It's important that your lawyer understand how to use both cases to make sure you are fully compensated.
We see this a lot on construction sites, when a construction worker is hurt because another subcontractor or general contractor didn't follow the safety rules, but it can happen to any worker in any type of job - for example, slipping and falling on a wet floor because a cleaning crew didn't put out the warning signs, getting into a car accident traveling from one job location to another or a pedestrian accident going to pick up office supplies.
The key is getting the right attorney and the best information - that's what we do
Call the best D.C. workers comp attorneys for your case today
Call us today at 202-393-3320 and we will listen to what happened and give you a plan to maximize your workers comp case, to make it less stressful on you and your family.
Can I Get Back Benefits If I Lose My Long Term Disability Appeal?
You Need a Long Term Disability Attorney to Focus on Your Appeal
Many executives, physicians and lawyers who are now disabled due to a medical condition and can't work will be denied long term disability benefits under their employer's policy or one they purchased on their own.
And many successful people think, despite their medical condition and disability, that they can win a long term disability appeal on their own.
This is usually a mistake - you don't know what you're getting in to and you really only get one shot at this. If you lose your long term disability appeal you won't get past due disability benefits, ongoing disability benefits or future disability benefits unless you later file a federal lawsuit and have a federal judge reverse the denial of benefits. Problem is, that decision will be based on the administrative record, which is primarily the appeal and supplemental evidence you filed.
Don't Leave Your Long Term Disability Appeal To Chance
Long-term disability insurance can be a lifeline to those who need it most. They are the source of income for those who can't work due to a serious medical condition or accident.
However, if you don't have sufficient legal help or not enough information for your case, you'll be likely to lose your appeal. That comes with the greatest risk of not getting your benefits at all. Court cases are a scary thing to go through alone or with a lawyer that can't do you justice. That's where we step in. We understand you need your benefits as a means of being able to live and we are ready to help you stand up to the insurance company.Our Experienced Long Term Disability Lawyers Can Get You The Maximum Benefits Without Wasting Your Appeal
At Donahoe Kearney, our experienced long term disability lawyers win insurance benefits for people who need them. Our lawyers have years of trial experience and handling medical evidence. However, be prepared to share with our lawyers documents such as policies, denial letters, or any other insurance information. Medical evidence is just as important because it shows proof of inury. Items such as MRIs and test results count as medical evidence. Appeals can only happen once and doing it with the right choice of legal help and substantial amounts of evidence can strengthen the appeal. You don't have to feel like your appeal wasn't worth it. You will have someone properly representing you.
Contact Our Experienced Long Term Disability Lawyers Today To Get Started
Are you looking for the long-term disability benefits that you need? You need an attorney that will properly represent you in your long-term disability case. We will help you get the maximum of what you need and make you feel like the appeal was worth it. Call us at (202)-393-3320 today. Don't forget to consult our free legal guides and books for additional information on what we do and any other questions you may have.
Do I Need A Work Injury Lawyer If I'm Getting Paid Workers Comp Benefits in DC?
What Can A DC Workers Comp Lawyer Do For You If You're Receiving Benefits?
A DC workers comp lawyer can help you if you're already getting paid workers comp benefits. Getting workers comp benefits from the insurance company after a serious injury at work is only the first step. Many workers comp insurance companies will start paying workers comp benefits and medical treatment at first, but they can deny your claim at any time for virtually any reason.
The DC Workers Comp Insurance Company Stopped My Benefits. Can They Really Do That?
In DC, Your workers comp insurance company can stop paying your benefits at any time.Unlike in some states, there is nothing that requires the workers comp insurance company to pay your benefits after you get hurt at work and file your claim for workers compensation. You have to continually prove you are entitled to those benefits. This means ongoing evidence that you can't return to work due to your injuries (meniscus tear, rotator cuff tear, herniated disc,) or that you have physical limitations or restrictions that prevent you from doing your regular job and your company doesn't have light duty work available (a lot of construction companies and hospitals don't have the ability to provide light duty work).
You have to continually work with your doctor and other medical specialists to make sure you have the right medical evidence.
The Workers Comp Insurance Company May Stop Paying You After They Send You To Their Doctor.
Insurance companies have several "go to" insurance company doctors they use over and over. These doctors charge $750 to $1,000 to see you for about 5 minutes and say there is nothing wrong with you...it's called an Independent Medical Exam or IME - and it is anything but independent.
You need a strategy for your IME exam, you can't just go in there and wing it. You need someone who knows the doctor and how to handle the exam to give you the best shot at continuing on benefits and getting the medical treatment you need. Our experienced DC workers compensation attorneys can guide you through the process and make sure the insurance doctor doesn't take advantage of you.
The Insurance Nurse Will Try To Bully You Into Going Back To Work Before You're Fully Healed
The workers comp insurance may assign a nurse to try to get your doctor to say you can go back to work before you're ready. Can you handle a nurse case manager who is pressuring your doctor to send you back to work or limit the medical treatment? She has probably done this thousands of times for the insurance company.
If she is sucessful, your benefits will stop. Do you know how you will get your benefits re-instated?
And just FYI - we don't allow nurse case managers on our workers comp cases. So our clients never talk to nurse case managers or insurance adjusters.
The Right DC Workers Comp Attorney Will Help You Stand Up To The Insurance Company
Most people are terrified of losing income after an injury keeps them out of work. We provide financial stability and medical treatment while you can’t work so you can pay your bills and recover. Our DC workers comp attorney guides you through the complicated DC workers comp law, rules, regulations and process, so you can stand up to the insurance company.
And there is no fee unless we win or settle your case - there is no fee to keep you on benefits - to keep your weekly benefits going.
Don't wait until your benefits are stopped. Get the help you need now.
And don't rely on the insurance company to tell you all the benefits you could be receiving. They don't have to and they won't help you.
Our DC Workers Comp Lawyer Literally Wrote The Book on DC Workers Comp
Call us today at 202-393-3320 for a confidential, free assessment of your case. But don't wait - even if the insurance company is paying you now, their team of lawyers, adjusters, nurses, doctors, investigators and case managers are behind the scenes, working against you to limit or stop the workers comp benefits you and your family rely on.
We make it easy on you - call us today at 202-393-3320.
Can I Win My Long Term Disability Appeal If I Don't Have a Definitive Diagnosis?
What Is A Definitive Diagnosis And How Can I Get One?
We've heard this story - your story - time and time again. You've been injured or diagnosed with a serious illness. You are worried that your injury or illness will prevent you from working. You head to your doctor and he confirms your worst fear - you are not going back to work. You have a long term disability insurance plan sponsored by your employer. So you call human resources and get the claim forms. You fill out all the paperwork and send in your medical records, first for short term disability and later for long term disability.
Everything seems smooth. You're approved for short term disability and your long term disability application goes off without a hitch.
However, what nobody told you is that the insurance company makes the decision on whether or not you receive any benefits. And they deny your your claim, stating that you don't have a definitive diagnosis. This is the first time you've heard that phrase - how can you corrrect the error?
A definitinve diagnosis is a test that produces concrete results that will tell you whether or not you have a certain condition or diagnosis, such as MRI's, blood tests, biopsies, etc. Definitive diagnoses are clear-cut confirmations that you have a certain medical condition. But not all medical issues have a way to measure by definitive diagnosis.
I Don't Have A Definitive Diagnosis. What Comes Next?
If you have any type of chronic pain conditon, mental health issue, gastrointestinal issue, etc. you probably don't have a definitive diagnosis. Your diagnoses has come over time and a results of many tests and studies, which are more like indicators than diagnoses. But your long term disability carrier is telling you that if you can't get definitive support for your injury or illness, you can't get long term disability benefits.
You may try to contact the insurance company and correct the error, thinking maybe they made a mistake and they just need more information or records. You may try to argue and spin your wheels. The insurance company knows this and that's why they have only given you 180 days to appeal their decision. They are counting on you wasting time, trying to get them to change their decision. They are counting on you not calling an experienced long term disability lawyer who will tell you that denial was their plan from the very start.
If your long term disability claim has been denied, contact our experienced long term disability lawyers today at 202-393-3320 to get started on your appeal. Don't delay - you only have 180 days to appeal their decision. Don't waste it trying to handle the appeal on your own. We make it easy to get started - call 220-393-3320.
Can I Win My Appeal Without A Definitive Diagnosis?
Yes it is possible to win your appeal without a definitive diagnosis as long as you have an experienced long term disability lawyer like Frank Kearney someone representing you. Without a long term disability lawyer, your fight for benefits against the insurance company can be an impossible battle. The odds are highly stacked against you and the law that governs your policy heavily favors the insurance company and allows them wide discretion to deny claims.
But just because you don't have a firm diagnosis doesn't mean that you shouldn't get the benefits you are entitled to. But on your own, it's virtually impossible to win an appeal. Fighting back with an appeal is a lot more than filling out a form or sending an email. That's why you need the help of a long term disability attorney like Frank Kearney. His approach combines his experience in workers comp, medical malpractice and insurance litigation in order to write a persuasive appeal on your behalf. This appeal will include testimony, medical evidence, etc as a legal brief that gets submitted to the judge.
What Can An Experienced Long-Term Disability Lawyer Do For Me?
We have seen numerous cases where people have not been able to go back to work and being denied benefits because of the unfair discretion allowed to the insurance company. After being denied, our clients come to us and we win them back benefits as well as ongoing benefits while they are unable to work. We are able to do this becauase we know exactly how to beat the insurance company at it's own game.
Contact Our Experienced Long Term Disability Lawyers Now
Are you ready to fight for what you need? Are you ready to take a stand against the companies that did you wrong? Don't be intimated by the insurance company. Donahow Kearney fights for you to make sure that you get what you need. We understand that the system works against people who need it most. Don't let it happen to you. Don't fight the battle alone. Call us at (202)-393-3320 today. We make it easy to get started.
¿Qué Sucede Si Mi Empresa No Tiene Trabajos Livianos Para Mí?
¿Qué Son Tareas Livianas Cuando Está En Compensación De Trabajadores En DC, Maryland o Virginia?
Antes de volver al trabajo, el médico puede ponerlo en tareas livianas. Básicamente, le da restricciones que dicen que puede realizar algunas actividades, pero no todo lo que requiere su trabajo. Por lo general, su médico le dirá que no puede levantar más de 20 libras después de una lesión en la espalda, o que no puede trabajar por encima de la cabeza después de una cirugía del manguito rotador desgarrado o que no puede subir escaleras después de una cirugía de rodilla. Si tiene algún tipo de restricción debido a su lesión laboral que le impide realizar su trabajo habitual y su empresa le ofrece trabajar dentro de esas restricciones, eso es un trabajo ligero.
¿Sabía que a veces el trabajo liviano puede ayudarlo a recuperarse más rápidamente y regresar al trabajo en menos tiempo? Vea cómo las tareas ligeras pueden ayudarlo aquí.
¿Qué Es El Trabajo Liviano?
Recuerde, trabajo liviano significa que está en el trabajo realizando algunas tareas (no todas las tareas de su trabajo) y se le paga en consecuencia. Además, recuerde, si está ganando menos dinero del que ganaba en el momento en que se lesionó (y eso es por semana, no solo su tarifa por hora), debería recibir cheques de compensación para trabajadores para compensar la diferencia mientras realiza tareas livianas.
La Forma Sencilla De Calcularlo Es La Siguiente:
Si le pagan lo mismo por semana (con horas extras y bonificaciones calculadas para su salario semanal), volverá a recibir un cheque de pago de su empresa y no obtendrá más beneficios de compensación para trabajadores.
Así Es Como Funciona:
Si está ganando menos dinero con tareas livianas porque trabaja menos horas o no puede hacer horas extra como solía hacerlo, sus beneficios de compensación para trabajadores serían 2/3 de la diferencia entre su salario en el momento en que se lesionó y el nuevo trabajo ligero. Estos beneficios se denominan beneficios por discapacidad parcial temporal.
Las tareas livianas no le impiden obtener sus beneficios por discapacidad, pero si le ofrecen un trabajo liviano dentro de sus restricciones y lo rechaza, la compañía de seguros de compensación para trabajadores puede detener o reducir sus beneficios. (Y debes apostar que lo harán).
Pero ¿Qué Debe Hacer Si Su Empleador No Ofrece Trabajo Ligero?
Si su empresa no ofrece trabajo liviano, debe continuar pagando su tarifa completa de compensación para trabajadores.
Muchas empresas de construcción no realizan tareas ligeras en el comercio. Por lo tanto, aunque un médico puede decirle que puede regresar a algún trabajo con restricciones, hasta que esté autorizado para regresar a sus funciones completas, sus beneficios de compensación para trabajadores deben continuar al ritmo completo. Por lo tanto, es muy importante obtener una nota o una hoja de discapacidad de su médico que indique cualquier restricción o limitación que tenga debido a la lesión laboral.
¿El Cheque De Compensación Laboral Llega Tarde?
Haga clic aquí para ver qué hacer. Sabemos que el hecho de que el cheque de compensación para trabajadores esté atrasado no significa que pueda pagar sus facturas con retraso, así que asegúrese de comunicarse de inmediato con un abogado experimentado en compensación para trabajadores si sus cheques se retrasan.
¡Póngase En Contacto Con Nuestros Abogados Con Experiencia En Compensación Laboral Hoy Mismo!
Probablemente se encuentre bajo mucho estrés debido a la incertidumbre, la mayoría de las personas lo están, porque ¿cómo puede saber qué o cuánto debería recibir, ¿cómo obtener la mejor atención médica para sus lesiones o qué tipo de beneficios puede conseguir en el futuro? No te preocupes, te ayudamos con todo eso, así que llámanos al 202-393-3320 y hablarás con una persona real que quiera escuchar tu historia. Nos tomamos el tiempo para responder preguntas sobre lesiones laborales en D.C., Maryland y Virginia cada semana y nos encantaría saber de usted.
¿Qué Tiene De Diferente Recibir Tratamiento Médico En La Compensación Laboral?
¿Por Qué Necesita Obtener Una Nota Laboral De Un Médico Después De Una Lesión Laboral Grave? Respuesta Corta: Es Su Boleto A Los Beneficios.
Escuchamos todo el tiempo a trabajadores lesionados en DC que no entienden las diferencias entre simplemente recibir tratamiento médico por una lesión y recibir tratamiento médico por una lesión de compensación laboral. Si se lesionó en el trabajo y está recibiendo beneficios, debe recibir notas de trabajo mensuales como su "boleto" para continuar recibiendo beneficios monetarios y tratamiento médico.
Entonces, ¿Cómo Funciona El Tratamiento Médico Después De Una Lesión Laboral Grave En Washington DC?
En primer lugar, el tratamiento en la compensación de trabajadores requiere autorizaciones, mucha más autorización de la que se requeriría con un seguro de salud normal. La compañía de compensación de trabajadores solo quiere levantar obstáculos y ralentizar el progreso con la esperanza de que los trabajadores lesionados se sientan frustrados y detengan el tratamiento. O use su seguro personal en lugar del seguro de compensación laboral. Y los trabajadores lesionados lo grabarán de ambos lados. Debido a que el seguro de compensación para trabajadores es tan molesto, muchos consultorios médicos simplemente no continuarán con el tratamiento médico hasta que tengan la "autorización" (promesa de pago) de la compañía de seguros. Entonces, cuando el ajustador de seguros requiere autorización por su parte, y el consultorio del médico no avanza sin una promesa de pago, es muy difícil para los trabajadores lesionados en DC obtener el tratamiento que necesitan después de un accidente laboral.
Este es el tipo de asuntos con el que tratamos todo el tiempo con el seguro de compensación de trabajadores, y sabemos cómo rechazar a los ajustadores y enfermeras encargadas de casos para que nuestros clientes puedan obtener el tratamiento médico que necesitan cuando lo necesitan.
El Tratamiento Médico Después De Una Lesión Laboral Grave También Puede Requerir Tiempo Adicional Y Papeleo En El Consultorio Del Médico
Al programar un tratamiento médico, debe estar preparado para medidas administrativas, evaluaciones y trámites adicionales con los que quizás no tenga que lidiar cuando utilice un seguro médico regular. Debe darse tiempo adicional antes de una primera cita con un nuevo proveedor para este tipo de tareas. Y llame con anticipación para asegurarse de que la oficina haya recibido las autorizaciones del ajustador de compensación de trabajadores para asegurarse de que no maneje a su cita solo para que lo envíen de regreso a casa.
Necesita Obtener Una Nota De Trabajo o Una Nota De Discapacidad Cada Vez Que Visite A Su Médico Tratante
Una nota de discapacidad, o nota de trabajo, es el boleto para obtener beneficios en la compensación de trabajadores de DC. Cuando vea a su médico tratante (no a un fisioterapeuta ni a un terapeuta ocupacional), deberá obtener una nota de discapacidad siempre que vaya. Esta nota de discapacidad dice si puede o no regresar al trabajo (o regresar al trabajo con restricciones). Si no tiene trabajo, no obtendrá beneficios sin enviar esta nota a un ajustador después de cada cita con el médico. Y es mejor que tenga en cuenta que si llega tarde con la nota de trabajo o, peor aún, no la recibe, el ajustador de seguros detendrá sus beneficios.
No Salga De La Oficina Sin La Nota En La Mano
Se vuelve mucho más difícil conseguir la nota de trabajo una vez que sale de la oficina. La gente de recepción está ocupada, los empleados de registros tienen cientos de archivos frente a ellos. Solo tienes que conseguirlo cuando estés allí. Y no se olvide de mirar su comprobante antes de salir del consultorio y asegúrese de que diga lo que les dijo el médico. Los consultorios médicos a veces cometen errores administrativos, por lo que siempre querrá asegurarse de que el papeleo coincida con lo que discutió con su médico.
Referencias, Recetas y Notas De Progreso
Cuando recibe referencias, deben coincidir exactamente con el tipo de tratamiento. Por ejemplo, si la referencia dice "fisioterapia" y usted desea recibir "terapia acuática", deberá obtener una orden específicamente para terapia acuática. También debe verificar sus recetas para verificar la consistencia de la dosis. Quiere asegurarse de tener suficiente para su próxima visita.
Debe asegurarse de tener todas las notas de las visitas al consultorio de su médico tratante y los informes de cualquier cirugía y tratamiento especial. Le recomendamos que guarde una copia de todos sus propios registros, pero para nuestros clientes ordenamos y mantenemos un registro de todos los registros asociados con su tratamiento y buscamos autorizaciones en su nombre.
Estos registros, especialmente de su médico tratante, son el rastro del papeleo que usamos para mostrar la continuidad de la atención y la continuación del tratamiento, por lo que también querrá asegurarse de que las notas de su visita reflejen todo lo que habló con su médico. A veces, los consultorios médicos dejan inadvertidamente en notas de visita cosas que no corresponden con las órdenes del médico, como "el reclamante puede volver a trabajar", cuando el médico en realidad lo dejó sin trabajo por otro mes. Estos errores no son fatales, solo necesita llamar al médico y pedirle que corrija las notas de la visita. A veces, su ajustador querrá ver los informes de sus visitas, por lo que debe asegurarse de que sean precisos.
Comience Con La Representación Legal Adecuada Para Una Lesión Laboral Grave En DC 202-393-3320
Y si tiene más preguntas, no dude en llamarnos al 202-393-3320. Hoy hablará con una persona real que puede ayudarlo a comenzar.
How Do I Appeal Long Term Disability in DC?
After being denied long term disability benefits in DC, your appeal is critical.
If you received a letter from your long term disability benefits insurance company denying or terminating your benefits, click here.
We will review the insurance company denial letter and give you a specific 5 point plan for the appeal at no charge and with no obligation. It's both free and confidential. We implement these plans, and greatly expand on them for our own clients.
The insurance company letter denying your benefits should be specific.
The long term disability insurance company has to tell you why they denied or terminated your benefits. Sometimes this is because they had a "peer review" - a doctor somewhere far away who has never seen you but has reviewed your medical records and says you can go back to work. Maybe they quote the terms and definitions of your insurance policy, saying things like "you are no longer disabled under the policy" or you "do not fit the definition of disabled." Maybe they have vocational evidence that shows you can be working at another job or surveillance evidence that they say shows you do not have the restrictions your doctors have put in place.
Regardless of the reason, here are 6 steps you should take immediately after you receive that letter.
Mark your calendar - you probably only have 180 days to appeal
Most private long term disability insurance policies provided by your job or purchased on your own are governed by a federal law (ERISA) and have a 180 day time limit to file an appeal - if the appeal is denied you can then file your case in federal court, where a federal judge will scrutinize your appeal.
Even if your policy is not governed by ERISA, it probably has a 180 day time limit. Don't wait on any of this - this is not much time given the amount of work you need to do for your appeal. If you don't file in time, you may be out.
Request a copy of your policy
You need to see the terms and definitions as they are set out in the ilong term disability insurance policy - that is what the insurance company is using to evaluate your claim.
Request a copy of your complete claim file
The insurance company has to give this to you, but be careful how you phrase your request. The claims files we request for our clients have 28 categories of information we ask for.
Request a complete copy of your medical records
You'll need this from every doctor or hospital you've been to for medical treatment for your injuries or condition that prevents you from working.
Talk to your doctor about your disability claim
Your doctor's input and analysis could be critical and he or she will not know how the insurance policy defines disability, light duty, even your occupation. So you need to schedule time to explain all of this to your doctor. We talk to treating physicians, specialists and consultants for our clients.
Send us a copy of the letter that denied your long term disability benefits
We'll analyze it for you and give you a 5 point plan for your appeal. There is no risk or obligation with this offer and it doesn't mean we will agree to work with you, but we hope it will get you started in the right direction if you decide to research, draft and file your own appeal.
Ready to work with an experienced long term disability attorney?
We make it easy for you. Just call us at (202) 393-3320 to get started.