Answers to Medical Malpractice, Workers Comp, Long Term Disability Insurance, and Car Accident Questions
The Best Way To Reach Us Is Call 202-393-3320. You Can Also Send Us An Email Through This Form
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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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.
Will it hurt my DC workers' compensation case to look for another job or take another job after my injury heals?
Will it hurt my DC workers' compensation case to look for another job or take another job after my injury heals?
Not at all. The way it works is your weekly workers compensation benefits should continue until you are released by your doctor to return to your regular job or you return to another job making more money than you were when you got hurt.
If you have a permanent injury to an arm, leg, hand, foot, etc. (sometimes called a scheduled loss or permanent partial disability based on the schedule) you can get those benefits after you reach maximum medical improvement whether you are working for the same employer or not.
Future medical treatment and ultimately settlement will not be affected by a job change, either.
When should I contact a D.C. medical malpractice attorney about a medical malpractice case?
The best medical malpractice attorneys are both selective in the cases they choose and busy. For example, we want to help people with certain types of medical malpractice cases such as cerebral palsy, injuries to children and babies, and wrongful death cases for adults. These are people who are worried about the future of their loved ones and family – how to take care of them. Those are the kind of people we serve.
So as soon as you are suspicious that a patient has been critically injured or has died due to medical malpractice by a hospital, HMO or doctor in D.C., Maryland or Virginia, you should call us and talk it through with an experienced medical malpractice lawyer. Starting the process of investigating and preparing a medical malpractice case earlier always helps the family - it is less stressful and time consuming and you don't have to worry about whether something was missed because you waited too long.
And with medical malpractice cases, the longer you wait, the harder it is to get an experienced medical malpractice lawyer to even talk to you about your case. The best lawyers won't take cases when the statute of limitations is near because there may not be enough time to really help someone. That's our policy.
Please give yourself and your family enough time to thoroughly investigate any medical malpractice issue. You can call us at (202) 393 - 3320 to set up a time to speak with you to see if we can help.
How do top D.C. medical malpractice lawyers decide whether to take a medical malpractice case?
Top medical malpractice lawyers in D.C., Maryland and Virginia (and probably everywhere else) are selective in deciding whether they can take a medical malpractice case. In our D.C. medical malpractice law firm, we decide whether to take a medical malpractice case after a thorough screening process. And we only agree to represent clients where the medical malpractice caused significant injuries such as paralysis or cerebral palsy, or death. The reason for that is simple. As medical malpractice lawyers for patients and families, we feel we can help people the most in those types of medical malpractice cases, and those patients and families usually need our help the most.
The process of investigating a medical malpractice case in D.C. starts with just a phone call. If you'd like us to investigate a medical malpractice case for you or your family, call us today at (202) 393-3320. We'll talk it through with you and hopefully get you some answers.
But don't delay - there are time limits to medical malpractice cases and if someone calls us too close to the statute of limitations (the deadline to file a medical malpractice case) we won't be able to help.
How Can I Get My Difficult Insurance Adjuster To Cooperate?
Workers Compensation Companies Employ Adjusters, Nurse Case Managers, Attorneys, Vocational Specialists and More to Fight Your Claim
If you're on workers compensation, you have probably already figured out it's not a fair fight. Your workers comp adjuster has handled hundreds, if not thousands, of workers compensation claims in D.C., Maryland and Virginia. Their job is to limit the amount the insurance company pays for medical treatment, testing, medications, therapy, benefits, etc. You name it, she will try to reduce it.
Remember, the adjuster works for the insurance company - not you and your family. In fact, your employer may have very little say in the matter of how you're treated, and often can't help you (other times they're upset because you got hurt on their job and may not even care).
Plus, these insurance adjusters handle hundreds of cases at a time and they really don't have time for you. They don't want to be bothered and you may notice that days and weeks have gone by while you are waiting to hear back from them on important issues like your paycheck and medical treatment authorizations. You might even be waiting to hear back on authorization for surgery - and your condition is getting worse while you wait for them.
You Need an Advocate on Your Side to Balance the Scales
Unless you have the experience and knowledge to deal with them, plus the time to devote to calling, writing, and faxing everything to get things done, it's never going to be fair.
With a minor injury that may not matter, but if you need significant medical treatment and will be out of work for an extended period of time because of your injury, you don't want to rely on the adjuster to do right by you. You will definitely need an attorney to advocate for your and your family.
Contact our Experienced Workers Compensation Lawyers Today
Call us today at (202) 393 - 3320 to discuss your options and we'll send you one of our free books, guides and reports that will give you the information you need now to take care of yourself and your family.
I Hurt My Shoulder at Work and My Doctor Thinks It's a Torn Rotator Cuff. What Do I Do?
3 Ways to Avoid Messing Up Your Case After Rotator Cuff Tear
A torn rotator cuff (tears of the the tendons in one or more of the major muscles of the shoulder) is a painful, often disabling injury. Many times it requires surgery, especially if an MRI confirms a tear and physical therapy or injections haven't helped. If you are a heavy duty worker, you might be dealing with a permanent injury that will keep you from going back to work.
How do you protect yourself if this serious injury happens at work?
There are three essential things that you need to do when you're hurt at work in order to protect your legal case, your income, and your livelihood. First, tell your employer it happened on the job. We call this giving notice, and it should be done as soon as possible after the injury.
Second, be wary of doctors referred by the insurance company. The insurance company will be watching their bottom line, not advocating for your care. If the insurance company referred you a doctor ask yourself: is he going to order expensive tests, like an MRI, that the insurance company will have to pay for? Is he going to believe you when you say how much it hurts? Is he thorough and does he seem objective? You should not let the insurance companies' doctor manage your treatment.
Next, get to a specialist. This is not an injury that can be managed or treated by a family physician and maybe not even by a general orthopedic surgeon. Make sure you choose the best doctor to be your long term provider to deal with this injury. You could be looking at months or even years of rehabilitation and/or rotator cuff repair surgery, so you want to make sure you choose the best physician from the outset. If you don't, it can be very difficult to get the physician approved later on.
Finally, file your workers' compensation claim in the right jurisdiction. If you were injured in Washington DC and you work in Washington DC, you should file your case in DC. Don't let the insurance adjuster tell you to file in the wrong state. They often tell injured workers they need to file in a state where they live, which is total BS. They know that Virginia and Maryland both pay less for workers comp injuries, and they want to cheapen your claim.
If You Have a Torn Rotator Cuff, There's A Chance You Won't Be Able to Go Back To Work Full Duty.
Many people who tear their rotator cuff end up having a permanent impairment. If you have a permanent injury you cannot handle the claim on your own. You may need to learn a new skill set and change positions; which will cost money and time. You'll need to be covered by a settlement while you are busy making changes in your life; whether that be learning a new trade and skill set, or going back to school.
With A Torn Rotator Cuff You Will Need Ongoing Legal Help to Protect Yourself and Your Family. You Need An Experienced Accident Lawyer For That.
These are the things you should consider, but remember, there is a lot more to it. Making a mistake can cost you a lot of money in lost wages and a lot of time and treatment when it comes to your injury. In most cases, you should not go it alone. You may need an advocate to fight for your rights.
Before you make any serious and difficult decisions, read the free book offered by our offices and written just for workers hurt on the job in the D.C. area: Protect Your Rights: The Ultimate Guide to D.C. Workers Compensation. It's free to injured workers and their families in D.C., Maryland and Virginia. So order your free copy today - call us at 202-393-3320. And if you need help now, contact our experienced staff at 202-393-3320 and we will help you take the next right steps today.
What if your company does not have light duty and cannot create light duty work?
What Happens If Your Employer Doesn't Have Light Duty After A Serious Work Accident
The answer is simple. They have to pay your full workers compensation benefits, also called temporary total disability, or TTD. It's just as if your doctor said you could not do any work because of the injury. Unless and until they provide light duty work, you should be on full workers compensation benefits. If your employer does happen to have light duty, but the normal pay rate for the position you're doing on light duty is less than what you make on full duty, then the workers compensation insurance company still need to make up 2/3 of the difference. The point is that while you are unable to do your regular job, you should still be making 2/3 of your salary/hourly rate (tax free) for as long as you can't do your regular job.
At some point, you may be asked to start vocational rehabilitation or work hardening, or both. But that doesn't usually happen until you are down the line long enough to gauge whether or not you have a permanent injury e.g. whether or not you'll be able to go back to work regular duty.
There are lots of questions that come up in the workers compensation process - don't try to go it alone. Give us a call - we are happy to help you and give you lots of free materials that will equip you for the road ahead.
Give us a call today at 202-393-3320 and order one of our free consumer guides today.
Why Do I Need An Experienced ERISA Attorney for my Denied Claim?
If your insurance policy comes through your employer, and your claim has been denied, your case falls under the federal ERISA code (The Employee Retirement Income Security Act of 1974). Ironically, this act was passed to protect the cash in your pension fund, but over time it has been used to protect insurance companies more than employees. And for some reason it covers employer-sponsored disability insurance plans in addition to dealing with pensions.
Ninety-nine percent of all disability insurance plans offered to employees are governed by ERISA. Under ERISA, you have the right to file suit in federal court if your claim for benefits is denied.
But, unlike almost any other legal proceeding, one side goes into court with all of the “good cards.” That side is the insurance company.
The most important card held by the insurance companies is something called a “reservation of discretion.” The reservation of discretion is something that the courts have given to the insurance companies – free! Here is what this “special card” means:
If your claim for benefits is denied, you will lose your lawsuit against the insurance company, even if you are right and it is wrong, if there is any evidence that supports the insurance company’s decision.
In any other legal proceeding, you can win if you have more than 50 percent of the evidence in your favor. Under ERISA, however, the claimant can have 85 percent of the evidence, and the insurance company can have 15 percent of the evidence, and if the insurance policy contains a “reservation of discretion,” they win!
If your claim has been denied, you'll need an experienced attorney to review your denial letter. We will review your denial letter for free. Contact my legal team at 202-393-3320 to take advantage of this incredible offer.
How Do I Know If a Work Hardening Program is the Next Right Step for My Case?
What is Work Hardening and How Do I Know If I Need It After a Serious Injury at Work
Work hardening is a little like physical therapy. The idea is to simulate work activity to see if you can do it and transition back to work.
That sounds great but in practice, some work hardening facilities don't know your real job duties (they just get a job classification from a generic list), and some think they are assessing psychological factors like "pain or illness behavior" or "symptom magnification".
These are insurance buzz words for "you are faking or malingering" - and the people making these "findings" are only physical therapists - they can help you stretch, use proper body mechanics and give tips on overcoming soreness but they're not doctors.
The key is to always be on guard - these facilities get almost all of their patients from workers comp insurance companies and sometimes "evidence" that someone is somehow not giving full effort (according to a physical therapist) is more valuable to them than getting you back to work.
Contact Us If You're Looking For a Place to Do Work Hardening
We do have a fantastic physical and occupational therapy group that we work with that gets referrals from attorneys, insurance companies, family members - everywhere! So you don't have worry that they are biased, or that they won't do a great job with you. Give us a call today and we would be happy to share that information with you. 202-393-3320.