Answers to Medical Malpractice, Workers Comp, Long Term Disability Insurance, and Car Accident Questions

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At Donahoe Kearney, we believe it's important to empower through education. 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 as medical malpractice lawyers in D.C., Maryland and Virginia.

Since every person is unique, if you have questions or need information about an injury or death in your family, please contact us to talk it through.We'll talk to you, schedule a free initial meeting and give you all the information we can. Call us today at 202-393-3320.

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  • Could My Child's Developmental Delays Have been Caused by Medical Malpractice?

    Developmental milestones are times when a newborn or child should do certain things - roll over, sit up, walk, form sentences of 2-3 words, etc.  Its not just pediatricians, child neurologists, neuro-psychologists and other experts who use developmental milestones as a tool to help diagnose cerebral palsy and other conditions - most of the time its parents and grandparents who sense something is wrong or that a child has some disability because he is not meeting these milestones on time.

    Medical malpractice, usually some form of injury to a child's brain around the time of birth, sometimes from lack of oxygen, or infection or extreme prematurity, can certainly cause a child to be developmentally delayed.  Sometimes this can be diagnosed shortly after birth, other times, parents may not know the true cause of their child's injury.

    Many times, an injury to the brain means a person cannot control certain muscles, so its important to look at your child's gross motor skills - sitting up, holding her head up, crawling and walking are examples.  If your child has trouble with these or can't do them at the time she should be able to, talk to her doctor about it.  And keep a journal of what your child can do and what she struggles with, plus take pictures or video.  It will help you remember everything and give the best information to your doctor.

    If you think your child is not meeting developmental milestones, it may just be that she is developing at her own pace.  But if you suspect a birth injury or trauma or difficult labor played a part in causing developmental delay, take action to get all the information today. Don't wait or delay - it will take time to assess your child's case, so you need to take action as soon as you can.

    Call us at 202-393-3320.

  • The Office of Workers Compensation Claims Examiner Recommended I Have an Informal Conference. What is That?

    An Informal Conference is a Non-Binding Mediation For Contested Workers Compensation Claims

    In D.C. workers' compensation cases, one of the ways to get an issue decided is through an informal conference.  Just like the name suggests, it's informal, with very few rules.  You don't testify under oath and there is no record or transcript of the testimony. Witnesses are not generally allowed but you can submit medical reports and other documents to the claims examiner. It's more of a mediation than anything else and the decision is not binding.

    Here's what that means - the recommendation that comes out of this conference is not binding on the parties. Either side can reject it and request a formal hearing (which requires testimony under oath, creates a record and can result in a Compensation Order).

    Here at Donabhoe Kearney we usually advise not going to an informal conference if you are out of work due to your injury but the insurance company is Do You Need an Informal Conference for Your Workers' Comp Case?contesting it. They are just going to reject the recommendation and proceed to a formal hearing.  All you've done is delay your benefits by a couple of months to engage in this process and given the insurance company free discovery and more time to build their defenses. With our clients, we always proceed directly to a formal hearing.

    Sometimes an informal conference is necessary: for example if you want to change physicians and the insurance company won't approve the change.  But if you're not getting paid by the insurance company, it's just a waste of time and you'll need to go to a formal hearing so you can get a binding decision from a judge. But don't go it alone. You'll need an experienced workers compensation lawyer like Frank Kearney to win your benefits and keep your medical treatment authorized.

    Get More Free Information Today About Your DC Workers Compensation Claim

    You can learn more about formal heatings and many other critical topics in the signature book on workers' compensation, Protect Your Rights:  The Ultimate Guide to D.C. Workers Compensation. You can order it online or call us at 202-393-3320 and we are happy to send you a free copy.

    If you have questions about whether you should go to informal conference, give us a call at 202-393-3320 to speak with a real person today. We will take down your information for no cost and no obligation. 

  • I was hurt at work in DC. Does my company have to provide light duty?

    Light Duty in DC Workers Comp Cases

    In workers compensation cases in D.C., Maryland and Virginia, it’s up to your company to provide light duty if you can't do your regular job because of your injury but your doctor says you can do some work, or work with restrictions - in other words, it’s the employer's choice to offer light duty work - and some do but others don't.

    Some employers have true light duty jobs available that they can move an injured worker to - and if so, that injured worker would receive his regular salary instead of workers comp benefits for the time he is on light duty.

    Other companies may create a light duty job or have a light duty program. A construction company could have a construction worker with a shoulder injury sit in the trailer, or make sure everyone wears a hard hat. A transit employer could have injured workers watch a parking lot. Again the injured employee would be paid his regular salary instead of workers compensation benefits.

    One thing to keep in mind is that even if you are receiving your standard hourly rate in a light duty job, you may be owed additional workers compensation benefits (called temporary partial disability). This is because your average weekly wage (which includes overtime, bonuses and may include income from a second job) could be more than your standard hourly rate.

    What if your company doesn't have light duty work and can't make up a light duty job for you?

    They have to pay your full workers compensation benefits, also called temporary total disability, or TTD, just as if your doctor said you could not do any work because of the injury.

    One thing to watch out for if you have a Virginia workers compensation case - if you are not under an Award, you must look for light duty work within your restrictions (called marketing your residual capacity) even if you will be released to your regular duty job with your company in a short time.

    Light Duty Restrictions and Vocational Rehabilitation

    And in DC cases, the workers comp insurance company may start vocational rehabilitation - hiring a vocational specialist to look for jobs for you within your restrictions.  If you are in vocational rehabilitation, please call us - we have a lot to tell you about the process (it is sometimes a sham and the insurance company will use it to cut off your benefits, so be careful). 

    The bottom line with light duty is it depends on the employer. But the key to any light duty job is to make sure it is within your doctor's restrictions - you don't want to do anything to risk further injury or delay the recovery from your injury.

    Every employer does something different and every case depends on specific factors. So if you have questions, call us at (202) 393-3320.

  • If You Have Been Affected By Medical Malpractice, You Need Resources.

    If You Have Been Affected By Medical Malpractice, You Need Resources.

    Medical malpractice - mistakes by hospitals, HMOs and doctors when they don't follow the rules to keep patients safe - obviously harms and hurts the patient they injure.

    But medical malpractice has a broad affect on the injured patient's family as well.

    We've represented people who have had a severe brain injury in a hospital and need 24/7 care.  In one case, the father had to quit his job and start a new business so he could be home to help care for his adult daughter.  The family had to convert a first floor room into a hospital room to fit the wheelchair, hospital bed, medical equipment and supplies their daughter needs. Their credit is shot - because Medicaid never pays for everything they need.

    Plus, Medicaid never provides the amount of nursing care to take care of someone who needs around the clock care.  And nurses can quit or not show up, leaving the family in a bind where they can't go to work, can't attend the other kids' activities, or even go out for dinner or a movie.

    We can help get families affected by medical malpractice the resources they need to make their lives better.  You can start today by calling us at (202) 393-3320 to confidentially, discreetly discuss your family's situation.

    And you can order two of our publications for free:  Picking Up the Pieces: A Parent's Guide to Medical Malpractice and Getting Everything Your Special Needs Child Deserves.

    Both are written based on our experience working with families affected by medical malpractice in D.C., Maryland and Virginia.

    Don't wait.  There are time limits for everything.  So get started getting help for your family today.

  • How does PPE affect the safety conditions in my work environment?

    Does PPE Protect You From a Work Injury?

    Personal protective equipment (PPE) is designed to protect workers from getting seriously injured while working. PPEs can be face shields, hard hats or safety glasses. They can also be garments such as gloves, vests, coveralls, earplugs, or devices such as respirators. Even though PPE requirements will vary Personal Protective Equipment on Job Sites in DCdepending on the industry and materials each industry handles, both employers and employees are responsible for using PPEs properly. Employers are required to identify workplace hazards and use PPEs, as well as other methods to reduce hazards. Employers must also train and require workers to use PPEs. Meanwhile, it is the employees’ responsibility to report problems with the equipment to employers.

    It is important to know that using a PPE doesn’t eliminate work hazards. It only helps prevent injury due to work hazards. For example, hard hats on a work site are required to help prevent head injuries from falling equipment. Requiring workers to wear hard hats doesn’t eliminate the risk of equipment falling but it can help prevent injuries. So, employers need to implement methods like using PPEs to help reduce risks of serious injuries in a given work environment.

    One way you can protect yourself and your crew is to make sure your work environment is up to standards. This could help prevent life-changing injuries.

    Here are some of the organizations that published guidelines for standards of care for workers, PPE requirements, and more:

    The Occupational Safety and Health Administration (OSHA) is an organization that created standards of care for workers. Besides OSHA’s PPE requirements, the American National Standards Institute, Inc. (ANSI), ASTM International (ASTM), and the National Fire Protection Association (NFPA) also publish standards for the manufacture, testing and use of PPE.

    Do You Know Someone Who Has Had a Serious Work Accident?

    If you know someone with a serious work injury or have questions about workers compensation in D.C., Maryland or Virginia, contact our experienced workers compensation lawyers today and order one of our free guides on workers compensation or the book, Protect Your Rights: The Ultimate Guide to D.C. Workers’ Compensation or by calling (202) 393-3320.

  • What are some of the workers’ compensation benefits available in the District of Columbia?

    If You've Been Injured at Work, Here are Some of the Common Benefits Available in the District of Columbia:

    Temporary Total Disability:

    An injured worker is entitled to temporary total disability benefits if he or she is unable to return to work because of the on-the-job injury. With this benefit, the worker is paid 2/3 of his or her average weekly wage.

    Temporary Partial Disability:

    A worker was injured at work but his doctor says he can return to work only on restricted duty or light duty.  This worker is entitled to temporary partial disability benefits, based on the difference between the pre-injury average weekly wage and the post-injury earnings. For instance, in the District of Columbia, temporary partial disability benefits are 2/3 of the difference between the worker’s average weekly wage and the new income.

    Permanent Partial Disability:

    The difference between this level of disability and the first two is that with the first two, the employee is expected to return to work after recovery and to be able to perform to his or her full capacity. A worker who is permanently impaired from an on-the-job injury is entitled to permanent partial disability.

    It is important to note that these are just the basic definitions. However, it’s much more complex than this because there are many different variables that play into the situation. For example, injuries to the back or neck are compensated by temporary total disability, temporary partial disability, or permanent partial disability, based upon wage loss. Another factor that is taken into account is the nature of the injured worker’s job.

    Workers’ compensation cases are extremely complex and time consuming. Once you’re injured on the job, make sure you have all the information and have all the help you can get. One simple mistake can cost you thousands of dollars each week. Call us today at (202)393-3320 to speak to us about your work-related injury so we can work together to make sure you’re receiving all the benefits that are available for you. This will help you stop worrying about the finances and start focusing on getting better.

    Have Your Workers Comp Benefits Been Denied? Contact our Workers Compensation Lawyers Today

    If you're worried about getting benefits after a work injury, you're not alone. Our experienced workers comp lawyers can get you started on the right path to protect yourself and your family. Contact us today at 202-393-3320.

  • My long term disability claim from my job working in D.C. was denied. Where do I file my long term disability appeal?

    If your long term disability benefits were denied, you have the right to appeal.

    If you were working for a private employer in Washington, D.C. and applied for long term disability benefits under a long term disability insurance policy, you have the right to appeal that decision.

    If long term disability benefits were provided as an employee benefit from your company, the disability plan will be covered by a federal law, the Employee Retirement Income Security Act (ERISA) and there are certain rights and responsibilities ERISA gives claimants (claimant is the term for the person who is disabled and is making a claim for long term disability).

    Your first appeal is to the insurance company that just denied your long term disability claim.

    There are several basic rights under ERISA.  First, you should request a complete copy of the claims file - everything that the insurance company considered in it's decision to deny your claim for benefits.

    Second - you only have 180 days from the date you received the letter denying your benefits to appeal your case.  

    So request that claim file (or have an experienced DC long term disability attorney request it for you) immediately so you can begin to analyze the insurance company decision and the legal and medical basis for that decision denying your benefits.

    An appeal after a denial of long term disability benefits is a lot more than filling out a form.

    Many people make a critical mistake that can't be fixed later.

    Instead of approaching the appeal and denial of benefits like an experienced long term disability lawyer, they just fill out a simple form or write a letter indicating they don't agree with the decision - just like the denial letter says they have a right to do!

    Sometimes they will send in a few more recent medical records about their disabling condition.

    But they won't schedule additional medical testing, or a Functional Capacity Examination, or a vocational rehabilitation specialist evaluation.  They won't interview co-workers, conduct medical literature searches, perform opposition research on the physician who reviewed their medical records, review specific policy provisions with their doctor to generate highly specific, individual reports from the doctor.

    There are 2 basic reasons why someone who is disabled should not file their own appeal.

    1. There is no way to understand ERISA law and procedure unless you have been in this field - you didn't ask for this and have never been through this before - how could you know whether you are making a mistake that ends your disability benefits forever?
    2. You have a disabling medical condition or injury that you need to focus on.  You don't have the stamina, endurance or time to take on this kind of legal work.

     Take it from an experienced long term disability attorney - you only get one shot at your appeal.

    That's because if your appeal is denied by the insurance company, your next step is to file a lawsuit against them in federal court (since ERISA is a federal law).  

    So your case will be decided by a federal judge - there is no right to a jury trial under ERISA.  And the judge will consider the administrative record of your appeal - all of the information, evidence and medical records you used to support the appeal will be part of that administrative record.

    What do you think your chances of winning are if all you did was fill out a form or send in some medical records?

    Call our experienced long term disability lawyers today at (202) 393 - 3320 to discuss your long term disability claim in DC.  We offer a number of cost effective ways to help you get the disability benefits you and your family deserve.

                

     

  • Do you offer video appointments for car accident cases?

    Experienced car accident lawyers in DC can help you with video meetings.

    An accident that wasn't your fault in DC or on the Beltway in Maryland or Virginia can have serious consequences.  A lot of the accidents we see cause serious injuries requiring surgery, hospitalization and extensive rehab.

    And our philosophy is simple - we want you to focus on getting better, getting the medical treatment and therapy you need.  We eliminate the stress of dealing with the insurance company on your case - so you don't have to worry about getting taken advantage of or making a mistake that hurts your case.

    Our DC accident attorneys deal with insurance companies so you don't have to.

    Our accident lawyers have a process we've developed over 25 years to make sure you are taken care of - just check out some of our reviews.

    Whether you were just visiting when the accident happened or you live nearby, our lawyers can help you without you ever needing to come to our office.  We are fully equipped to meet with you by video conference, sign all the paperwork digitally and get started helping you with your car accident case today.

    We've already helped several clients who were injured and hospitalized during the coronavirus, so couldn't have visitors at the hospital, and it was too risky to meet with them personally in their homes - since they were in a potentially compromised condition after being in the hospital.

    One of the keys to a successful accident case is getting started right away.

    With any serious injury case in DC, there is a lot to do right away.  You need to determine and coordinate all of the insurance coverage - health insurance, the other driver's insurance, your car accident coverage, any other insurance policies or benefits that may apply, like long term disability or workers comp (if the accident happened when you were working or in a work vehicle), investigate the scene of the accident, assess all of the damage to the cars, interview witnesses and first responders, and coordinate all of the medical care you need.

    So don't wait - if you've been hurt in an accident, call us today at (202) 393 - 3320 for a video appointment so we can help take away the stress of dealing with the insurance company while you focus on getting better.

  • Can I work if I'm getting long term disability benefits?

    Work and Long Term Disability Benefits

    We fight insurance companies on behalf of people every day.  If you were denied long term disability benefits for your injury or medical condition, you know how difficult that process is.  Many long term disability insurance companies deny tons of people because they know that some people won't appeal at all.

    It's an unfair strategy, but it works.

    So once you are back getting benefits, is it OK to work?

    Probably not.  Here's why:

    Insurance companies will use any activity related to work, including volunteer work (for people who work with us, we have an entire interview and assessment process that analyzes and explains this for your specific situation) as a basis to deny or terminate your long term disability benefits - many times before you are fully recovered or ready to return to work full time.

    What if you're receiving long term disability benefits and want to return to work?

    First, you'll need to thoroughly review your long term disability insurance policy.

    Most long term disability policies have 2 terms and conditions you should be familiar with: "own occupation" and "any occupation."  During the "own occupation" time period, you qualify for benefits if you cannot perform the primary duties of your own job.  But after a period of time (your specific policy will indicate this) you qualify for benefits only if you can't work in "any occupation."

    There are a few other terms and conditions in your long term disability policy to identify and analyze:

    • How Total Disability and Partial Disability are defined
    • Offsets for "other income" which allow the insurance company to reduce your benefits
    • Vocational rehabilitation programs and incentives to work

    Working with your doctor is critical to your long term disability claim.

    You need to constantly educate your doctors on this process - they are busy and don't have the time or expertise to analyze the specific terms, definitions, conditions and law that apply to your long term disability benefits.

    If you think you can return to some type of work, discuss it with your doctor and have him examine you first.

    • Have your doctor thoroughly document any physical restrictions or limitations
    • If your doctor agrees you can try to return to work, have the doctor write a detailed report that documents the exam findings, restrictions and limitations you have and indicate that you are approved to attempt to try to return to work for a trial period.  If the trial period works, that is great, otherwise you can use it as evidence that you cannot work. 

    Be honest with the long term disability insurance company.

    It's important to provide the insurance company with the medical records that document you can return to work for a trial period and disclose any income you receive.

    And be upfront with your employer about your physical limitations and restrictions as well.

    We hope these tips help with a healthy, long term transition back to work - one that puts you in control.

    Questions about your long term disability plan?

    Before taking action, call to schedule a flat fee strategy session with us.  We'll review and analyze your policy and medical records and explain how the different terms, conditions and clauses impact your eligibility for benefits, and help you with a game plan so you can make the best decisions for you and your family.

    Call us today at (202) 393 - 3320 to get started.

  • I was denied long term disability benefits from my job in DC. How do I write an appeal?

    Appealing your long term disability denial is a complicated process.

    There are several steps you need to take after you receive a denial letter from your long term disability benefits insurance company, and you need to act quickly.  Under ERISA (the federal law that governs most long term disability insurance policies) you only have 180 days to file your appeal.

    Here are some of the initial steps to get ready to write your appeal.

    Remember - appealing your long term disability denial (to the same insurance company that denied or terminated your benefits) is a lot more involved than filling out a form or writing a letter.  A lot of work and analysis will need to be accomplished before you draft the actual appeal.

    After analyzing the claim file you've requested from the insurance company (we typically request 18 - 20 categories of documents and information, and claims files can be many hundreds or thousands of pages depending on the nature of your medical condition, the length of time on benefits and other factors), under most long term disability insurance policies, you need to gather and generate evidence that proves the insurance company denial was unreasonable.

    That can mean working with medical and vocational specialists, getting additional diagnostic testing for support, undergoing a Functional Capacity Evaluation, getting statements from co-workers addressing your job duties, educating your physicians on the specific terms and definitions of your policy and integrating all of that new information into your appeal.

    And you need to draft the appeal as if a federal judge were reading it, because under ERISA, if your appeal is denied, you must file your case in federal court, and the only information the judge will use to decide your claim is the administrative record - most of which is your appeal.

    That's a lot of pressure on anyone, much less someone with a serious medical condition - and you only get one shot at the appeal. 

    A long term disability attorney in DC can help.

    In our DC disability practice, we have an entire process for helping people appeal their long term disability denials.  We want you to focus on getting better - your medical treatment and rehab.  

    We request your complete claims file to get started, analyze your claim, make recommendations, and communicate with you to keep you updated every step of the way. 

    You didn't ask to get sick.  Let us help protect you from losing everything you've worked hard for.

    Call our DC long term disability attorney today at (202) 393 - 3320 to get started. 

    Don't wait - if you received a letter denying or terminating your benefits, you want to get started right away - we'll evaluate the insurance company's denial without charge and give you our recommendations on what to do next.