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.
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I was hit by a car that ran a red light in D.C. delivering materials for my company. Can I Sue?
I was seriously injured at work when my work truck was hit by a car that ran a red light in D.C. I was delivering materials for my company. I'm getting workers comp benefits and the workers comp insurance company paid for my surgeries. Since the car accident was the other driver's fault, can I sue the other driver?
Yes. This is what we call a "third party case." You actually have two cases with different benefits and/or damages available. The workers compensation insurance company should be paying for your time off work (66 2/3 % of your salary) and for all of your medical treatment - surgeries, hospitalizations, office visits, MRIs, physical therapy, etc. as you need it, even though the accident was caused by another driver.
You also have a case against the other driver (sometimes this is called a third-party case because the other driver isn't your employer or a co-worker) for the harms and losses he caused when he ran the red light and hit you. These harms and losses can be the cost of your medical treatment (both now and in the future), lost income (again, now and in the future), pain, suffering, permanent injury, disfigurement and other things that have been taken from you.
And you can pursue both cases. The catch (there always is one) is that the workers comp insurance company gets paid back what it paid to you or on your behalf for medical treatment (it's a form of subrogation). So you have to do the analysis to find out if the third-party case is ultimately going to make you money.
As injury attorneys, we help you make that decision so we can do what's best for you and your family.
There are a couple of traps to watch out for. For example, check out this question about time limits for filing a 3rd party case in D.C.
Give us a call at 202-393-3320 and we'll set you up with a free informational, no obligation, confidential interview.
Throwback Thursday: 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
What is a Recorded Statement for a Long-Term Disability Company?
After an injury, debilitating illness or a serious car accident, the long term disability insurance company may have an insurance adjuster call or sometimes come to see you in person to get your recorded statement. A recorded statement is essentially a recorded interview and can be used as part of the adjuster’s investigation of your claim for disability insurance benefits.
Should you give the insurance adjuster or investigator a recorded statement?
No - at least not without an experienced lawyer representing you or without knowing your rights.
Remember, insurance adjusters work for the insurance companies and their job is to limit and even deny benefits - they want to reduce the amount of money the insurance company has to pay you. So they WILL use the recorded statement against you if it is inconsistent in any way. You can tell the adjuster the same situation ten times but if there’s something slightly different about how you explain the situation on the tenth time, the adjuster can and will use that against you.
Plus, you may not know the answers to several questions about your medical condition, and those should be addressed to your doctor, but most people want to be helpful in an interview situation, so they guess or do their best to answer questions they really don't know the answer to. Another problem is preparation - how many times have you had a conversation or been asked a question and later wish you had said something or answered differently? We all do that - it's natural that the best answer will come to you after you've had time to consider it, not in the heat of the moment.
This has nothing to do with whether your claim is legitimate and your injury or medical condition prevents you from working - it's about how you best present the evidence, according to the specific language of your long term disability insurance policy, to the disability insurance company. They are the ones making the initial decision on whether you qualify for long term disability benefits and deciding your appeal if your claim is denied or your long term disability benefits are terminated.
We have a process for analyzing and presenting the evidence for you on appeal and part of that evidence would be an interview of you and transcription of your story - and there are reasons why it has to be done right at that stage of your claim - most of all, you don't get a "second chance" to add evidence to your appeal later.
That is why it’s important to either get all of the information you need to help yourself or if your injury or medical condition is serious, have an experienced attorney to guide you through this process. Insurance companies will use any little trick or tactic they can think of to limit, delay and even deny your legitimate claim.
Download the report "Claim Denied - the Ugly Truth About Long-Term Disability" or call us today at (202) 393-3320 to learn about the other different resources we provide to make sure insurance companies don’t force you to make a mistake that hurts you and your family.
And if you received a denial letter from the insurance company - a letter denying or terminating your claim for long term disability benefits - call us today so we can analyze it for you and give you our recommendations on filing your appeal, (this analysis is both confidential and free). But don't wait - if your long term disability policy is governed by ERISA, you only have 180 days to appeal and there is a lot of work to do.
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.
My sister was hurt in a serious car accident. What type of damages or compensation are available?
Compensation for Injuries After a Car Accident in the DMV
Compensation should cover medical treatment, lost wages, bodily injury at the least.
Damages or compensation for your sister's injuries depends on the harms she suffered. Basically, she can be compensated for what she has lost - medical expenses caused by the negligent driver, lost income and time off of work (lost wages), medical devices and medical durable goods (like a wheelchair) her injuries require. She may also be compensated for the pain, distress, permanent injury, and disfigurement the accident caused.
The amount of compensation or damages depends on the extent of the injuries. Severe injuries often require extensive medical treatment and costs, future medical care and treatment and result in significant lost income. If that is the case, the compensation required to make up for these harms, caused by the negligent driver, can be substantial.
There is a lot to factor in - and you need to investigate the other driver's insurance information or other sources of insurance to make sure there is enough coverage to pay for the serious injuries - surgery, hospitalizations and rehab costs add up in a hurry, especially if you can't work because of your injuries.
Do you have questions about what you can recover after being in a serious auto accident? Don't wait to give us a call at 202-393-3320. You will speak to a real person today who wants to hear your story. And there's no cost or obligation to you - it's completely confidential, no obligation and of course, absolutely no pressure.
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I'm not getting better - can I switch doctors?
THE SHORT ANSWER IS...IT DEPENDS.
After being injured in D.C. on my job, I started medical treatment with an orthopedic surgeon for my back injury and the workers compensation insurance company approved my doctor. They have been paying the medical bills. But now the doctor doesn't seem to be helping my back injury, which is not getting any better and could be a herniated disk. Can I change my treating doctor if I was hurt at work in D.C.?
The insurance company tried to "assign" me a doctor. Can they do that?
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. But 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 would like more aggressive treatment than your treating orthopedic surgeon is recommending, 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 orthopedic doctor.
Finally, if your doctor refers you to another orthopedic surgeon or other specialist, that treatment will be covered.
Does that help? 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? Don't you worry --we 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.
How Can I Get From Short-Term Disability To Long-Term Disability Smoothly?
Going From Short Term Disability to Long Term Disability
Most people don't realize that short term and long term disability are totally different - different policies, administration, time limits, types of injuries and medical conditions, just to name a few. So even if both types of policies are provided by your employer, you may have very different benefits and claims policies available.
A lot of short term disability policies cover you if you can't work for anywhere from a few months to 2 years. They typically have a short waiting period, about 14 days, and require a less intensive application policy and review. Many times, these applications are granted quickly. They may have exclusions - for example, they may exclude injuries that happen at work.
So does getting approved for short term disability mean you will be automatically approved for long term disability? You would think that but it's not the case. Many times the short term disability is really the employer's money rather than the insurance company's money - the disability insurance company just administers the policy.
Long term disability can cover you for many years if an injury or medical condition prevents you from working in your occupation, or after a period of time, any occupation, and typically these policies cover you until age 65. Like short term disability, there are usually exclusions, often for mental illness, for example, and the application and review process is more rigorous. These policies often require you to apply for social security disability (and take a credit if you're approved and getting social security disability).
Keep in mind - all long term disability insurance policies are written to favor the disability company, and the federal law that governs disability claims (ERISA) is much more favorable for disability insurance companies than it is for employees with legitimate, serious injuries or medical conditions that prevent them from working.
And the key is - if you've received a letter from the disability insurance company denying or terminating your claim for benefits, call us so we can arrange to review the denial letter (in confidence and free of charge) and give you our analysis of what to do to put your appeal in the best light. But under ERISA, you only have 180 days and that's not a lot of time for the amount of work involved.
Call us today at (202) 393 - 3320 to get started.
What Role Does My Doctor Play in My Long-Term Disability Claim?
I've been on long-term disability for a full year and they are just now telling me I don't have proper documentation of my injury and medical treatment. What am I supposed to do?
Yes, we are very familiar with this type of situation. Many times, people on disability just go along getting treatment and hoping to recover and go back to work. All the while, nobody tells them that the insurance company is looking for very specific medical records, will require certain times of tests, and will nitpick over language: all to find ways to deny your claim.
It doesn't seem fair, does it? Of course, it's not but you do still have power. You can discover the truth about ERISA long-term disability insurance and set yourself on the right path.
Most people have short-term disability claims first, and they never intend on going on long-term disability. They hope to recover and go back to work; and so their sights are set, as they should be, on recovery instead of preparing themselves for a successful long-term disability claim.
Here are some quick tips we can give you to get started.
1. Ask your doctor if he or she is familiar with "Objective Medical Evidence." These are the types of evidence-based tests that are famously cited by insurance agents looking to deny your claim. Use these type of diagnostics whenever possible to document your illness or injury.
2. Index your own copies of your monthly progress notes and disability slips. Don't ever leave your doctor's office without an updated disability slip, and follow up with your doctor's front desk to get copies of your progress notes a few days after your appointment.
3. If your progress notes don't fully describe your treatment and connect it to the injury you are claiming on disability (and they should be), ask for edits from your doctor. Your doctor can do this (and should).
4. Don't do anything at all, publicly or privately, that is outside of your doctor's restrictions. If surveillance is taking place courtesy of your insurance company, you can get kicked off your claim.
5. Stay away from social media; don't post anything related to your doctor's appointments or treatment, and keep all of your social media settings on private.
Want more? Securing a consultation with attorney Frank Kearney can keep you from making the kinds of toxic mistakes that will set you up to have your claim denied. Call us today at 202-393-3320 to get started on your road to success.
What Do Long-Term Disability, Workers' Compensation, and Serious Car Accidents Have in Common?
All insurance companies have one thing in common; they want to minimize their number of claims and pay out as few claims as possible. It would be a ridiculous business model if they didn't.
All business seek to maximize their profits, but it shouldn't be at the expense of making good on the promises you make to good people paying their premiums.
There is no exception for ERISA long-Term disability, workers' compensation and serious car accident claims in Washington, DC, Maryland, and Virginia.
Here are a five things that these types of claims all have in common.
1. The insurance companies are always protecting their bottom line, and usually not looking out for your interest;
2. Generally, insurance adjusters are trained to find ways to limit your claim;
3. You can be scheduled for an independent medical exam in all types of claims (though it's far more common in long-term disability and workers' compensation).
4. You can settle your case at the end of the medical treatment for a lump-sum.
5. Donahoe Kearney, LLP can help you maximize your benefits and settlement value on all of them.
Should I Avoid Posting on Social Media if I Have a Disability Case?
Should I Avoid Posting on Social Media if I Have a Disability Case?
The Answer Is a Resounding YES.
Consider this scenario. A new client comes on board with an experienced ERISA attorney like Donahoe Kearney. The attorney does initial research on his case file, which includes reports that the client has received from the insurance company.
What do they see? A lengthy investigative report completed by the aces at the insurance company. It starts with screen shots of him wake-boarding in Cancun. How did the insurance company find these pictures? They didn't have to work very hard for it.
They just searched his name and the town where he lives, and there it was, in all its glory, on his public Facebook page.
So much for his long-term disability claim!
Social Media scouting is just one of the tricks of the insurance company. The insurance company will also do surveillance - by phone and video.
The insurance company chatted up his neighbors, called him directly and and made "discreet inquiries" to fish out whether he was running a business on the side or had any type of "side hustle."
They even hung out on his block, trying to catch him on video doing something that they can use to say he can go back to work.
What most people don't know (but any insurance attorney worth their salt will tell you) files are often filled with surveillance video that insurance companies have gotten from unsuspecting claimants.
Many times you might hear the claimant (client) expresses outrage:
"How dare they sit on my street and video me. It's an invasion of privacy for them to follow me to my doctor's office."
Here's our reply: "Don't lie to the insurance company. What were you thinking?"
You don't HAVE to kill your disability claim with social media. Here are some tips to help you out.
Cheaters always get caught. Be honest and straightforward when talking to the insurance company about what you can and can't do.
The insurance company probably knows when your next doctors appointment is. Be aware of that fact- they will likely be videotaping your trip. Don't stop at Home Depot on your way.
Be smart about Facebook and Instagram. Don't post stupid stuff to Facebook (if you think it might be inappropriate, it probably is). Update your social media privacy settings.
An experienced long-term disability lawyer will be your best investment with an ERISA claim, but they cannot work miracles. They cannot make "discovered" social media disappear. There's a lot an experienced firm can do to improve your chances of winning but changing the reality of a video or photo or Facebook comment isn't one of them.
If you have questions about your ERISA disability claim, or have received a denial letter from your employer’s insurance company, give us a call at 202-393-3320.