Answers to Medical Malpractice, Workers Comp, Long Term Disability Insurance, and Car Accident Questions
Get The Help You Need Now
Contact us directly 202-393-3320
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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I was working for a company in D.C. and became disabled. Why did my ERISA Long Term Disability Insurance Claim Get Denied?
Here at Donahoe Kearney, we believe that the clients should be informed about what's really in their ERISA long term disability insurance policy, and how they are vulnerable to having their claims denied if they ever need to file for long term disability after a serious injury or medical condition keeps them from working.
If your insurance was offered through your employer, it probably falls under The Employee Retirement Income Security Act of 1974 (ERISA), which is a federal law that governs long-term disability policies and other employee benefits.
Every case is different and because of all of the different types of medical conditions, illnesses and injuries we are at risk for, every situation is unique. But there are enough similarities in every ERISA employer-sponsored disability insurance policy, so we try to help people understand the difficulties with these cases, how to approach them and what they need to do if they ever need to file a claim under their long term disability policy.
First, you should know that the law allows the disability insuraance company a lot of discretion in deciding who qualifies (according to them) for benefits under an ERISA log term disability policy. Here are a few things we see in these policies:
• The insurance company has the “discretion” to determine your benefits - whether you qualify under the terms, conditions and definitions of the policy, how they decide that and what evidence they use. "Discretion" is one of those words, at least in the legal field, that means just about any reason you can think of to deny benefits is "reasonable."
• Manipulating your job description: what are the material and essential tasks of your job, and can you do these? If your job requires 19 things, do you prove your case and get paid benefits only if you can’t perform “each and every” important duty of your job?
• If you have a mental illness, anxiety or depression that causes or contributes to your inability to work, disability benefits are often limited to 24 months under the terms of these policies.
• The insurance company requires you to prove you cannot work through "objective medical evidence" but not all legitimate medical conditions that prevent you from working can be proved in this fashion. Objective medical evidence was typically considered test results - an MRI to diagnose a herniated disc in your back, an x-ray to diagnose a compound fracture, that kind of thing. Unfortunately, some doctors and insurance companies have taken this to mean that you need this "objective" evidence for everything and that medical conditions like fibromyalgia, chronic fatigue, chronic pain or any illness where the symptoms are reported by the patient and can't be verified by a test result are somehow suspect.
• A part time work clause: if the disability policy doesn't define part time work, usually by the number of hours or income earned, they could use this to deny your benefits because a doctor says you can work a few hours per week (and doctors make these mistakes all the time - maybe someone does have the physical capacity to work 2 hours per day with an hour break in between - what kind of job is that? It doesn't exist. But that's not the doctor's problem. He's just the doctor, not an employment counselor...)
None of these disability insurance terms are required by law, but let's face it, disability insurance companies know that if they control the terms and definitions (and employers who provide these policies don't realize or care) they can save millions of dollars by denying or terminating benefits on legitimate disability claims.
Just remember - insurance claims examiners and adjusters are trained to find ways to limit benefits. That's how insurance companies make money.
If you filed a claim for long term disability and your benefits have been denied or terminated, get a copy and see if these terms and conditions are in play. They make these cases difficult for people who can't work through no fault of their own.
But now that you know this, here's the most important tip
Don't let the insurance company just deny your benefits without a fight! You can still win your case if your policy carries these clauses, but you will need help from an experienced attorney who is knowledgeable about ERISA disability claims.
Give our office a call at 202-393-3320. We want to hear your story, and we're very sorry that your claim has been denied unjustly. Even if you don't need to hire an attorney, we will educate you about your situation and point you in the right direction. But don't wait - these cases have strict time limits to take action, so do it today.
What If I Am on Workman's Comp, but I Get Another Work Offer?
What Are the Rules About Working When I'm on Workers Compensation in DC?
We always advise people to be careful about working while you are on workers compensation. You may be able to get some partial benefits if you go back to work at a lesser role or less pay. Or, if you are on light duty at the same position.
But, if you are totally disabled and collecting workers compensation (usually called temporary total disability or TTD), you cannot work at a different job and get paid for that. Anyone working and concealing it from the insurance company is committing fraud - remember, the system exists to pay legitimate injured workers, not people who claim they can't work when they are working. And if you do decide to commit fraud you will be found out because the insurance company will most likely put surveillance on you if they suspect something. It's never pays to commit fraud against the workers compensation carrier.
If you can work light duty work or in some reduced capacity, you should. You will still get workman's comp benefits but these will be based on partial disability, and the calculation goes like this: If your normal weekly paycheck (weekly wage) was $1,000.00 and your light duty wages are $700, you would get $200 in temporary partial disability benefits ($1000 - $700 = $300 x 2/3 = $200). Many times, the light duty wages will vary so these benefits have to be adjusted every week. Our staff collects the data, calculates the benefits and follows up with the insurance company to make sure you get all of the benefits you should.
Most people who have been seriously injured at work are very anxious to get back to work, but don't go back before your doctor releases you to go back. Going back on light duty or at a different role is one way to make sure you are healthy before returning to heavy duty. We have found that our clients who have been able to do light duty or a modified role will continued to get paid by the insurance company to help make up the difference in their earning power, and often times they get to maintain that positive relationship with their employer that many workers worry about when they are not working.
Are You Unsure About What to Do Next After a Serious Injury? Get the Help You Need Now
If you were seriously injured at work, especially if you need surgery, you probably need an attorney to help you take care of your family and protect yourself from the insurance company. Give us a call today at 203-393-3320 and we will get your started on your road to success in workman's comp.
I Was in an Accident That Wasn't My Fault. Will The Other Driver's Insurance Company Pay My Hospital Bills?
After a Serious Accident in the DMV, the Other Driver's Insurance Doesn't Pay Your Medical Bills As You Go - Here's What to do About That.
We get this question a lot. A lot of people think the other driver's insurance company will take care of their medical bills - the hospitalization, surgery, rehab, specialists you need after getting hurt in a big accident in DC, Maryland or Virginia. But it doesn't work this way. The other driver's insurance won't pay those medical bills directly.
Instead - here's what you need to do.
First, if you have health insurance, use it.
Depending on where you live and what health insurance you have, you may have to pay back what your health insurance paid out of any settlement - that's ok for a couple of important reasons. First, your health insurance doesn't pay the full amount of the charges, so you only have to pay back what the health insurance paid, not what the hospital or doctor actually charged. Second, you only have to pay it back if you win or settle your case against the other driver's insurance company - they are not entitled to anything if you lose the case or never receive a settlement.
Second, understand how the system works.
Educate yourself on the insurance claims process - what kind of damages are allowed and how will you prove things like medical expenses, future medical needs and expenses, pain, future lost income and the other types of damages you may be entitled to as a result of the accident.
Third, keep records of everything.
In any case against the other driver's insurance company, if you can prove the other driver was at fault and that you were injured, you may be able to get a settlement, but this comes at the end of the process, usually after your injuries have healed or you don't need any more medical treatment from the accident. You need to have everything ready so you can make your best case to the insurance company.
If you don't have health insurance, part of your settlement will go to pay your medical expenses.
Contact Our Experienced Car Accident Lawyers Today.
We help people with serious injuries every day in DC, Maryland and Virginia. Call us at (202) 393 - 3320 to order one of our free consumer guides, books or reports and tell us your story to see if we can help you and your family.
My child has shoulder dystocia from birth. Could his condition have been caused by medical malpractice?
Shoulder Dystocia and Medical Malpractice at a DC Hospital
Shoulder dystocia can sometimes occur at birth when the obstetrician or other hospital providers do not follow the rules of good patient care, or the hospital doctor, interns or residents do not recognize this complication and treat it as an obstetrical emergency. There are also certain risk factors, such as maternal diabetes or a fetus suspected of weighing more than 4,000 grams that make a baby more susceptible to shoulder dystocia during delivery. The hospital staff should test and be looking for these well known risk factors.
Umbilical cord compression due to the baby getting "stuck" during delivery can also lead to a lack of oxygen for the baby, increased acidosis and ultimately brain damage for the baby if the lack of oxygen to the brain is prolonged. That's why the condition needs to be recognized and evaluated by experience hospital staff, so that actions can be taken to prevent or limit harm to the baby or mother.
Shoulder dystocia usually refers to when one of the baby's shoulders is caught behind the mother's pelvic bone after the baby's head is delivered. This can lead to brachial plexis palsy, a permanent nerve injury that leaves the child unable to use that arm, or with extensive damage that prevents him from doing things normal kids do.
If your child has a permanent injury after birth or during his time in the neonatal intensive care unit, or NICU, call us today for a confidential, free consultation. We may be able to help your family get him the resources you need to provide for your child's future medical care, therapy, rehab, occupational therapy, vocational training and other things that can help him manage and cope with the effects of the injury.
The sooner you get started, the better - all parents want to help their child if they can, and so do we!
Just call us today at (202) 393 - 3320 or click here to order a copy of our free guide to medical malpractice so we can help get you answers today.
How long will a medical malpractice case in D.C. take?
As my D.C. medical malpractice lawyer you recently filed my son's medical malpractice case against a Washington, D.C. hospital. How long will a medical malpractice case in D.C. take?
A medical malpractice case in D.C., filed against a hospital in D.C. Superior Court, usually takes approximately 1 1/2 to 2 years to get to trial.
There are a lot of reasons why D.C. medical malpractice cases take that long to go to trial. Sometimes medical malpractice cases require taking 30 or 40 depositions of doctors, specialists, nurses, and expert witnesses and these healthcare workers may be practicing medicine all over the country. Many times, the trial will last several weeks so the hospital's lawyer or the judge may not have enough time, due to other trial commitments, to hold the trial any sooner.
And occasionally medical malpractice trials are continued (delayed), if a new judge takes over the case but is not available for the trial date, or a key witness is ill, etc.
Its a long process but remember any medical malpractice case we file has already been thoroughly investigated, expert witnesses in various medical specialties have agreed to testify at trial, and much of the case is ready to go, so we can minimize delay whenever possible.
Do you have questions about medical malpractice? Call us today for an informational interview at 202-393-3320. You won't have to sign anything or agree to anything in advance - we mostly do these interviews so we can get to know you, and you can get to know us and what we do.
Watch the videos on this page to discover the truth about case acceptance at Donahoe Kearney and to learn more about serious conditions like cerebral palsy.
Can I Handle My Long Term Insurance Disability Appeal Alone?
Why do I need an attorney to do my long term disability appeal?
You're an intelligent person, a professional. The process seems fairly straightforward: all you have to do is get your medical records together, show all of your doctor's recommendations, and the appealed claim will go through, right? Isn't it pretty simple to prove that you are disabled?
Wrong. Knowing more about what a disability claim attorney can do for you will help guide your decision-making process when facing an ERISA Long Term Disability claim appeal. Please consider the following items carefully if you are faced with filing an appeal of a claim the long term disability insurance company has denied.
There are many different types of attorneys.
You definitely don't want a general practitioner, who dabbles in all types of law, to handle your long term disability insurance claim appeal. If your long term disability claim has been denied, you will need an experienced attorney like Frank Kearney who understands the ins and outs of how insurance companies operate. Frank Kearney has been representing people against insurance companies for 25 years and even has some experience working in insurance defense when he was first out of law school. He understands insurance companies. That's exactly the type of attorney you need for a long term disabiilty appeal.
Our team can help make your ERISA Long-Term Disability claim smoother. All we do is represent people with serious injuries or medical conditions against insurance companies (including medical malpractice, workers compensation, major car accidents, in addition to long term disability). This specialized experience is one of the greatest benefits of having an attorney work on your ERISA long term disability insurance case if your claim has been denied.
Having an attorney with experience can make the difference between winning or losing your appeal.
The experience an attorney can bring when appealing your case is invaluable. We've successfully navigated the complexities and industry tricks involved with the insurance industry in all of our practice areas. Specialized knowledge like this will make all the difference if your disability claim is denied. We understand challenges that you will face with producing objective medical evidence, dealing with surveillance, social media review, etc. Having someone who can navigate and administrate the entire process is something everyone appealing a disability denial needs.
Hiring an attorney when making a disability claim is a right that is exercised by people with a legitimate injury or disease who can't work and are doing their best to heal.
People sometimes aren’t sure if hiring an attorney is right for them. If you are legitimately injured or ill and out of work, you have every right to consider what types of actions are in your best interest to get you well and provide for yourself and your family. The premiums are paid every month, and the insurance company exists, in theory, to support you when the policy is needed - when you can no longer work.
You owe it to yourself to get more information on the process of appealing a denial or termination of long term disability benefits, or to learn more about the process before going in to it. Call us today at (202) 393 - 3320 to get started.
And if you've received a denial letter from your disability insurance company, do it today - you only have 180 days to file your appeal and there is a lot of work to do (your claim file alone could be hundreds and hundreds of pages).
As medical malpractice attorneys, how do you help children with disabilities and special needs?
We give every family we work with a copy of Getting Everything Your Special Needs Child Deserves: A Parent's Guide to Resources, a resource guide we published so parents can find out what resources are available for their child. We developed this because we found many parents didn't have the time to investigate all of the resources that could help - special camps, respite care, therapies, etc.
As part of our investigation of every case we accept for a disabled child, we have a physician or qualified rehabilitation nurse prepare a comprehensive report outlining the services the child will need to maximize his abilities. Many times, we will have the child and family evaluated by specialists to help determine the child's specific physical, emotional, and educational needs as well.
We've also published Picking Up the Pieces After Medical Malpractice: A Parent's Guide to help families struggling with medical malpractice in D.C., Maryland and Virginia make the best decisions for their family.
So it's a lot more than most people realize - but that's how we work. So you can focus on what's best for your child.
Call us today at 202-393-3320 to see if we can help your family.
How much does a medical malpractice attorney cost?
Frank Kearney was a guest on a local TV show speaking about our firm’s work with families of special needs children and our approach to medical malpractice cases. He explains how medical malpractice cases work, from how a case is investigated to the benefits of a successful case, and everything in between.
Above is a clip of Mr. Kearney explaining the cost of hiring an experienced medical malpractice attorney. Many people don’t realize that it doesn’t cost any more to hire an experienced, Board certified attorney with a track record of successful medical malpractice cases than it does to hire a lawyer right out of law school.
Frank Kearney, Esq:
Most of the families that we work with can’t afford the services of a lawyer billing on an hourly rate and there are very different reasons for that. As a civil justice attorney, what I do, my law firm and I, we work on a contingent fee, which means it’s a percentage of any total verdict or award after the case is finished. And these cases can go on for several years and many times do.
We also front all the costs and expenses associated with the case. For example, when there’s been a violation of a patient safety rule by a HMO or a hospital, it takes a very thorough investigation. We need experts, physicians, primarily in all different specialties to review the case, to review the chart, to work with you. Obviously all those things cost money before you even file a case or when you’re still investigating it. So we don’t require our families to front those cost in the beginning because again, if you have a special needs child or if you’re dealing with a death in the family due to a medical error, you know, that’s a 24/7 occupation. You can’t be worried about your lawyer calling you up saying, ‘Oh you need to pay me this much this month, or this much next week, I need this or I need that.’
It’s just not the best way to help families—we don’t think.
If you missed it, here’s a YouTube link to watch Mr. Kearney’s full interview: http://www.youtube.com/watch?v=GFfeRnK8zWk&feature=youtu.be
When should I hire a workers compensation lawyer for my workers comp injury?
As I say in my book, Protect Your Rights: The Ultimate Guide to D.C. Workers Compensation, Don't wait.
The insurance company already has a team of lawyers, adjusters, nurses, case managers and investigators working against you from the moment you got hurt at work - sometimes before you even get to the hospital.
You need to be prepared for what is coming.
If you have a serious injury and you will be out of work or need surgery, you need to act now to protect yourself and your family for the long term consequences of the injuries. Even though you may be getting benefits, there is no guarantee those will continue, and you may not even be getting paid at the correct rate. The insurance company will never tell you everything you are entitled to in the future, or whether you can get benefits if your injury is permanent.
I literally wrote the book on workers compensation because one young couple got totally screwed by the insurance company - and by the time they came to me, it was too late.
There was nothing I could do.
I tell people a little bit about their story when I send them a copy of the book.
You'll see why a hard working union man, Mike (that's not his real name - I'm protecting his privacy) with a serious, legit injury that would end his career, was legally getting paid $20,000 less per year by his workers comp insurance company, because he made a common mistake he had no idea he was making at the time.
So don't delay in getting the best workers compensation lawyer for your case. As I say in my book, the insurance company's duty is to its shareholders - not you! No matter how nice they are or how smoothly everything went at first, there comes a time when that all changes.
In fact, I just spoke to a nurse I couldn't help because her injury lifting a patient happened so long ago. If she had called shortly after the injury, she would be much better off today, getting the medical treatment and income benefits she should have been getting.
Get the information you need to help yourself and your family by calling 202-393-3320. Any discussion we have will be free, confidential, no obligation and above all else, no pressure. But you'll walk away knowing a lot more about the workers comp system and how to protect yourself and your family.
The insurance company or your employer won't do it for you.
Can I Switch Doctors After a Work Injury?
You Have the Right To Choose Your Own Treating Physician After an Injury at Work in DC
First of all, every worker hurt on the job in D.C. has the right to choose their own physician. The workers' comp insurance company can't just send you to some doctor or clinic, even though they might try. However, you do have to be careful. Once you have made the choice of a treating physician, it may be difficult to change doctors (or at least difficult to do so quickly). If you have already been treated several times by the insurance doctor or a different doctor and would like to make a change, you can request a hearing with the Office of Workers Compensation to get the change in physician approved, but this can take several months. If the workers comp insurance company agrees to the requested change, you can begin treatment with the new doctor. If not, you will have to win the hearing in order to change your doctor.
In summary, if you were hurt in DC you do get to choose your treating physician, even if your work "assigns" you a doctor. In Maryland you also are permitted to choose your own doctor. In Virginia, you can choose from a panel of three physicians.
Have More Questions? Our Experienced Workers Compensation Lawyers Have Answers.
Give us a call at 202-393-3320 today and you will speak to a real person who wants to hear your story.