Answers to Medical Malpractice, Workers Comp, Long Term Disability Insurance, and Car Accident Questions
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 and based on representing many hundreds of people who have been injured in accidents or at work in D.C., Maryland and Virginia.
Here are the basics:
Patients permanently injured by medical malpractice, or the families of patients killed because of medical negligence, when a hospital, HMO or healthcare corporation doesn't follow basic patient safety rules deserve justice - resources to help with the harms and losses due to the injuries or death of their loved one.
Drivers who don't follow the rules of the road, driving recklessly, driving drunk, speeding, and texting should be accountable for the harm they cause when their actions cause a serious car accident or car wreck.
Workers hurt on the job deserve workers compensation benefits for lost wages, medical treatment and permanent injuries. If a worker is killed on the job, his family deserves workers compensation death benefits - to at least help with the financial loss of a loved one.
If you're on a long term disability insurance claim and your claim has been denied, you probably need an attorney to do the appeal. Insurance companies will use every trick in their aresenal to deny or limit your benefits. Don't try to handle an appeal on your own.
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.
- Page 3
Discover the Truth About Vocational Rehabilitation Services
And how will you know?
Some vocational counselors hired by workers compensation insurance companies are just plain dishonest (and there are qualified, ethical counselors as well) who will do anything for their client - and their client is always the insurance company, never you.
Sometimes its not enough that their report casts everything you do in a negative light - while leaving out all of the times the voc counselor canceled meetings at the last minute, showed up late, or didn't have any job leads available. But some will just straight out make stuff up - saying you told them you wouldn't apply for a job when you just asked a question about job requirements, even little things like saying you agreed to meet at a certain time or place. They want to show a pattern of someone who is not trying to find suitable light duty work after an injury so the insurance company can stop your benefits.
How do you know and what can you do about it?
Get as much of it in writing as you can. Use email whenever possible to confirm what was said. Get copies of all of the reports and emails or other documentation the counselor sends to the adjuster (you are entitled to this). Keep your own records of everything - job applications, job descriptions, job leads, etc. - make a copy of everything.
Remember, their goal isn't really to get you back to work - it's to get you off of workers comp. That's a big difference and they accomplish that goal if they can show you weren't cooperating with them - at least to stop or suspend your benefits.
Unfortunately, a lot of the time you don't find out until its too late. Take these steps from the get go to protect yourself.
Need more information? Order one of our free consumer guides today to get a leg up on the insurance company if you are on a workers' compensation claim.
What if someone is paralyzed by medical malpractice?
Medical mistakes like misdiagnosis, not ordering the right treatment, delaying treatment, not ordering a consult with a specialist, system errors and other negligence can cause serious injuries, like paralysis.
We've seen it and helped people who became paralyzed.
If someone is paralyzed due to a medical mistake by a hospital, doctor or HMO, they will need care, treatment and support they never thought they would. Future medical care and treatment, transportation, home modifications or a handicap accessible home, job re-training, access to technology that can help someone adapt - these are just some of the things needed to help.
But the biggest need we see - and what we strive to do for people we help - is get your independence back. And take the stress off of your family members.
Sometimes that is learning to drive a modified car or van to go where you want when you want. Sometimes it is an extra nurse or companion to help you with mobility - getting out and around. Sometimes it is a modifying your home or buying another that is accessible and right for you. Sometimes it is the latest technology to help you do more.
Like every malpractice case, every person we help is different. You are different.
Honestly, we're different too. If we can help you or someone you know get their independence back, call us at 202-393-3320.
How do I know the truth about ERISA long term disability claims in DC?
You would think that insurance would pay when you need it - that your long term disability insurance from your employer would be there for you if you were sick or seriously injured and couldn't work. That doesn't usually happen in ERISA long term disability cases, and here's why:
- Insurance companies exist to make money for their shareholders. They are private companies with a duty to those shareholders, not to you. They are not moved by your illness or financial hardship, so just writing a letter or asking for something you think is fair and reasonable won't get your benefits paid.
- Insurance company forms are not to help you win your appeal or get your benefits reinstated, instead many times they are asking for information they later use to deny or terminate disability benefits. So be careful how you fill out those forms.
- Even though most long term disability policies say you have to apply for social security disability, the insurance company can ignore the social security decision that says you are disabled.
- When they ask you for a list of activities, things you can and can't do, how you spend your typical days and send you a form to write all of that out, they often do that because they have had you under surveillance, secretly videotaping you and that form is then compared to the video
- When you write a detailed, lengthy statement yourself, the disability insurance company can use that as evidence you can work, especially if you had a desk job before your injury or illness.
- Very few lawyers have the training or experience to handle ERISA disability cases. Insurance companies take advantage of "pro se" (do it yourself) claimants and lawyers who don't understand this practice area.
- Put all of your evidence into your appeal - you only get one shot at this, because you will not get a trial under ERISA.
- It's not enough for your doctor to indicate just that you are disabled for you to get benefits - the doctor needs to know how that is defined by your policy, and back it up with support and medical evidence. Working with your doctors to get this right is critical.
- The appeal process after your claim is denied is biased in favor of the disability insurance company - you have to know this, understand it and deal with it in your appeal.
- Many federal judges have written that you are not on a level playing field with the insurance company in ERISA disability cases.
- Your employer really can't help (and they usually don't understand the policy either, or why the insurance company won't just pay you (because they know you have a legitimate injury or illness and can't work). But it's really up to the insurance company.
If your ERISA long term disability insurance claim has been denied, you only have 180 days to gather the evidence, medical opinions, records, statements, draft and file your appeal, and most policies only allow one appeal. Don't go it alone - your income is at stake. The insurance company has lawyers working for them around the clock, so don't try to handle this, as your first case ever, on your own. Call us at 202-393-3320 and you'll speak with someone who can get you started getting the information and help you need to make the best decision for you and your family.
If I'm in an accident that was the other driver's fault, should I use my health insurance to pay for the medical treatment and bills I have from the accident?
If you are injured in a car accident in Maryland, Virginia or D.C. you can use your health insurance to pay for medical treatment from the accident. Its really a question of whether your health insurance company has a lien or right to be paid back from a settlement with the other driver's insurance company.
In D.C. and Maryland, most health plans require repayment of what they have paid for medical treatment if someone gets a settlement or verdict from the other driver's insurance company.
In Virginia, most health plans cannot recover their payments from a settlement (this is also called subrogation) because of Virginia's anti-subrogation statute.
Typically, most health insurance plans pay less than the actual charges, so it is usually better for someone injured in an automobile accident to use their health insurance rather than agree with the doctor or hospital to pay the medical bills out of any settlement because the health care providers will be entitled to the full amount from the settlement and if the case doesn't settle, is lost or not pursued, you are still on the hook for the medical bills.
The analysis also depends on whether you were injured in an accident in D.C. Maryland and Virginia, where you live, where you work (if that's where you get your health insurance), other car insurance you may have, etc.
If you have questions about what to do after a D.C., Maryland or Virginia accident, just call us at (202) 393-3320 and we'll talk it through.
As the parent of a disabled child, do you feel overwhelmed?
If you're caring for a child with special needs, developmental or physical disabilities, you know that there is a lot of information to go through about resources, benefits, activities, education, treatment - you name it. Many of the parents we have helped have told us how stressful and draining this can be.
So we developed a guide based on our experience and research, to at least get you started. A list of resources in the Washington, D.C. area designed to help you find the right activities, enrichment and opportunities for your child.
As you know, one size does not fit all when it comes to kids. But this is a starting point - to get people thinking and talking about what is available to help their child with disabilities and their family.
Getting Everything Your Special Needs Child Deserves: A Parent's Guide to Resources is a free gift to parents. You can order it through our website or by calling (202) 393 - 3320. But don't wait. If you know a family or child who can use resources, get it to them today.
Why Are ERISA Long Term Disability Insurance Claims so Difficult?
We hear all the time from people who are on ERISA disability claims that they are frustrated, they don't understand why their claim has been denied, and they really need the money they assumed would come when they filed a claim. After years of helping clients with their disability cases, I am sometimes asked, "are there easy disability claims?"
It is logical to believe that if your doctor, employer, and the Social Security Administration recognize that you are disabled, then your disability insurance company must agree that you are entitled to disability benefits.
Unfortunately, this is NOT the case.
Once upon a time, disability insurance companies offered policies that actually helped the people who paid their policy premiums. They provided clear explanations and definitions, and required the insurance company to pay benefits within 30 days of approval. Sounds exactly like how it should be, doesn't it?
We don't see policies like this anymore. Most disability insurance policies are designed to help the insurance company reject disability claims and provide as little coverage as possible. It's a big problem, but under the current law (ERISA) it's easy to get away with this type of practice.
These thin, ambiguous policies ensure that there is never an "easy" disability insurance claim. That is why a federal judge said, "claimants not able or aware enough to hire legal counsel before the administrative process is complete, likely enter into judicial review facing a loaded deck."
Now if a judge thinks that these claim are difficult, you may want to think twice about handling your own ERISA long term disability insurance case.
If you have been denied disability benefits by your individual or group disability insurance policy, such as AFLAC, Guardian, or Unum, Donahoe Kearney will review your denial letter for free. Call 202-393-3320 and we will help you move forward.
Give us a call today at 202-393-3320 to figure out your next steps, and if we can help you. But don't wait. You only have 180 days to appeal a denied long term disability insurance claim.
What is substandard medical care?
Substandard Medical Care is another term for medical malpractice - and that can include hospital or office systems that fail, a doctor not following up on test results or ordering a consultation with a specialist, not working up a potential diagnosis, giving the wrong medication or wrong dosage - almost any medical problem that is preventable.
Some people call this medical negligence, or a violation of the standard of care or standards of practice - and these terms usually refer to the same thing - a situation where a doctor, nurse or hospital doesn't follow established safety rules for their patient.
Sometimes, there is no harm from this, like when another doctor or nurse catches a mistake and re-writes an order, so the patient never gets the wrong medication. But patients can be seriously injured or killed due to mistakes that can be avoided.
Want to learn more? Take a few minutes to order one of our free, no obligation guides - they are full of common examples of medical mistakes that we see over and over again. Or just call our office and we'll send it to you.
At the point where you're looking for a D.C. medical malpractice lawyer because you suspect a medical mistake?
Download our FREE Medical Malpractice Lawyer Evaluation Form. Make sure anyone you hire for such an important case can past the test. And remember, hospitals, doctors' insurance companies know the lawyers who specialize in medical malpractice and those who don't.
Can My Husband Get Workers' Comp Benefits for Two Different Jobs?
My husband works two jobs. He was hurt at work in D.C. on his first job and now can't do the second job either because of his injury. Can he get workers comp benefits for both jobs?
Say he worked construction in D.C. and fractured his ankle on the job. He can't go back to work as a construction worker because he can't lift or carry much and can't walk around the jobsite, but he was also working every weekend at a garage fixing cars and he can't do that job either because of his fractured ankle.
If he's making $900.00 per week as a construction worker and $300.00 as a mechanic, his average weekly wage should be $1,200.00, so his workers comp benefits would be $800.00.
Maryland and Virginia are different - Maryland workers compensation doesn't generally allow wages to be stacked and Virginia requires the second job be in the same "trade, business or occupation" as the first.
But in Washington, DC there are not the same limits to what they call "wage stacking" -- so don't forget to include your wages from both jobs when you file your husband's claim.
Do you have more questions about DC Workers' Comp? Give us a call today and order our free comprehensive book all about DC workers' compensation.
What do the best medical malpractice lawyers look for in a medical malpractice case?
Whether a patient is injured by a hospital, HMO or doctor in D.C., Maryland or Virginia, as experienced medical malpractice lawyers, we look for certain factors to help us evaluate a case and determine whether we are the best lawyers for you.
First, we can only take cases involving very serious injuries or medical conditions - paralysis, cerebral palsy, brain damage, blindness, death, etc. - injuries or conditions which forever change a patient's life or a family.
The reason for this is that medical malpractice cases in our court system (at least in Washington D.C., Maryland and Virginia) are complex, time consuming and expensive to prove. We want to make sure our case can make a difference in a patient's life. And we never want to put a patient who has been harmed by the medical system, through the legal system unless we can help make up for the harms and losses caused by the hospital, doctor or HMO.
And that's sometimes hard, because it means we can't help everyone with a legitimate malpractice case.
Second, are you someone we can work with - we view a medical malpractice case as a relationship, working together with a patient and his or her family to try to get everything they need to make their lives better. So we want trust to develop over time and be able to work toward a common goal.
Third, of course is the actual investigation of the case, learning what really happened, studying the medical literature, reviewing the medical records with experts and consultants.
There is more to it than that, of course, but our medical malpractice cases and trials have taught us this is where to start. And if you're thinking you have a medical malpractice case, don't wait (there are time limits). Call us today at (202) 393-3320 to see if we are the right medical malpractice lawyers for you and your family.
Can filing your D.C. workers compensation case in Maryland or Virginia cost you hundreds of dollars per week?
Can filing your D.C. workers compensation case in Maryland or Virginia cost you hundreds of dollars per week?
Absolutely it can.
Filing your workers compensation case in the wrong state can cost you hundreds of dollars - every single week!
You see, all states (or at least Washington, D.C., Maryland and Virginia) have maximum compensation rates. That means that if you are a high wage earner, a union worker, professional, athlete, or have been working a lot of overtime before your injury, you could be at that maximum compensation rate and not get 66 2/3% of your average weekly wage.
Here's the thing insurance companies don't want you to know...
The maximum rate in D.C. is much higher than Maryland or Virginia. So your benefits will be much higher. And here's the catch - if you accept benefits in another state, you can't come back and get them in D.C. for the same injury. So you can't even get the difference between the maximum compensation rates.
Unfair? It sure is.
Here's what you have to do. Don't sign any forms the insurance adjuster, safety man, your boss, or anyone else gives you until you talk to us or read this book Protect Your Rights: The Ultimate Guide to D.C. Workers Compensation.
Your co-workers, family and friends may all have advice and mean well, but don't make the mistake that will cost you and your family hundreds of dollars per week.
Get the information and help you need by calling us at (202) 393-3320.