Injuryboard Commentary - Alabama

Won Your Workers Compensation Case? Not so Fast

Jon Lewis — Tue, 24 Nov 2009 13:02:11 GMT

What are the insurance companies doing now? They are using "Utilization Review" in order to cut off workers compensation benefits. How does that work?

Well, the Alabama Workers Compensation Act allows for "Utilization Review". That means that the workers compensation insurance carrier can submit your medical records to a third party physician to review and determine if they are related to the injury. If that third party physician says, "No", the workers compensation carrier cuts off the injured employee's benefits.

How does this work in practice? Take my client for example. She had surgery approximately ten (10) years ago. Her workers compensation case was settled, and her medical was left open for future treatment. Typically, that is what happens in workers compensation cases. The person receives medical treatment for the related injuries for the rest of her life.

For ten (10) years, my client has been receiving prescriptions and medical treatment for her injuries. Out of the blue, the insurance carrier sends her records to a foreign doctor in El Paso, Texas who opines that her injuries and medical treatment are not related. So, the insurance carrier, under the "utilization review" provision, cuts off her medical treatment.

Why did they wait ten (10) years? How can this doctor supersede my client's local doctor's opinion when he hasn't even examined her. Shouldn't the "Authorized treating" physician have the final say? The insurance carrier approved her "Authorized Treating" Physician.

This is ridiculous and unfair, but that is how the insurance industry works. Insurance covers everything but the loss. All they want is their money and to hell with everything else - morals, humanity, sympathy, kindness, and generosity. It is all about the bottom line. People talk about "greedy trial attorneys" when they should be talking about "greedy insurance companies".

Originally posted at InjuryBoard by Jon Lewis

Homicides Predict Traffic Deaths

Jon Lewis — Sun, 22 Nov 2009 12:42:37 GMT

Do State Homicide rates predict traffic fatalities? According to a University of Michigan study, they do. The study found that there was a parallel with the number of homicides and the number of traffic deaths. What seems to be the reason for this? Aggression.

The study looked at ten factors and "found that seven of them accounted for 71 percent of the variance in traffic fatality rates." Those seven are "homicide rates, proportion of male drivers, proportion of older drivers, number of alcohol-related liver failures (as a proxy for intoxicated driving), density of physicians, seat-belt use rate, and income." Apparently, the strongest predictor of these seven are homicides because homicides relate to aggression which relates to aggressive driving.

What does this teach us? We need to respect others on the roadways. We can't be in a hurry all of the time. We cannot drive while we are doing several other things: texting, playing with the radio, putting on makeup, using the telephone, changing CD's, and having too much noise and distractions in the car. We need to realize that we share the road with others, and we need to understand that different people have different driving styles just as different people have different psychological makeups.

During this holiday season, think before you act. Take a few miles per hour off your speedometer. Leave a little early for that appointment or meeting so you aren't in a rush. Be more passive on the roadways, and maybe you will save a life.

Originally posted at InjuryBoard by Jon Lewis

SSA Fugitive Felon Program Gone Bad

Stuart McAtee — Thu, 19 Nov 2009 11:07:37 GMT

It appears the "Fugitive Felon" program had some issues and precluded benefits to rightful recipients. A federal judge approved a civil-court settlement requiring the Social Security Administration to repay $500 million to 80,000 recipients whose benefits it suspended after deeming them fugitives.

The supposed fugitives include a disabled widow with a previously suspended driver's license, a quadriplegic man in a nursing home and a Nevada grandmother mistaken for a rapist.

According to an article in the Wall Street Journal, they were among at least 200,000 elderly and disabled people who lost their benefits in recent years under what the agency called the "Fugitive Felon" program. Launched in 1996 and extended to Social Security disability and old-age benefits in 2005, the program aimed to save taxpayers money by barring the payment of Social Security benefits to people "fleeing to avoid prosecution."

But some federal courts in recent years have concluded that most people the agency identified as fleeing felons were neither fleeing nor felons. The problem: Social Security employees relied on an operations manual stating that anyone with a warrant outstanding is a fugitive felon, whether the person is actually fleeing or attempting to avoid being captured.

The Social Security Administration, which neither admitted nor denied wrongdoing as part of the settlement, declined to comment.

The National Senior Citizens Law Center, an advocacy group for the elderly and disabled, sued the Social Security Administration in an Oakland, Calif., federal court last year on behalf of people denied benefits, and asserted that most warrants -- some decades old -- were for minor offenses and most people were unaware they existed.

Let's hope all of the valid recipients are compensated.

Originally posted at InjuryBoard by Stuart McAtee

SSD Questions About Going Back To Work Later In Life And Short Term Disability

Stuart McAtee — Tue, 10 Nov 2009 14:58:13 GMT

From time to time, we receive questions from potential clients about various subjects regarding Social Security. As our nation ages, more elderly workers are re-entering the work force and they sometimes have questions about withholding, Social Security, and taxes. If you are returning to work, after age 65 for instance, your employer must withhold FICA taxes from your paycheck no matter how old you are. Although you may have been retired, you do receive credit for those new earnings according to the Social Security Administration. Each year Social Security automatically credits the new earnings and refigures your monthly benefit. If your new earnings are higher than in any earlier year used to calculate your current benefit, your monthly benefit could increase.

Another question sometimes asked is about short-term disability. What if a worker will only be disabled for a short period of time(for instance Maternity Leave)? Can a person qualify for SSD benefits for short term disability? In a nutshell, no. Social Security pays only for total disability—conditions that render you unable to work and are expected to last for at least a year or end in death. No benefits are payable for partial disability or short-term disability, including benefits while on maternity leave. The disability evaluation process considers any current work activity you are doing, and your medical condition and how it affects your ability to work. For more information, go to www.socialsecurity.gov/pubs/10029.html

Originally posted at InjuryBoard by Stuart McAtee

Loser Pays - A Bad Idea

Danny Feldman — Tue, 10 Nov 2009 07:53:15 GMT

When I was a law student at Vanderbilt, a contracts professor asked a question about whether the "loser" to a lawsuit should be required to pay the "foreseeable costs," ie. the winner's attorney fees. I argued "yes" given that the costs were foreseeable. I was wrong.

This argument, loser pays, really is nothing more than a way for business, insurance companies etc. to shut the doors to the courthouse to the vast majority of Americans who could never be able to afford to pay the tens or thousands of dollars that the other side may incur in attorney fees. Indeed, the reason why contingency fee contracts are regularly employed when representing injured persons is that those persons can't afford to pay their own lawyers an hourly rate. For example, a truck crashes into you, putting you in the hospital for months and causing you to lose your job and health insurance - how in the world will you be able to pay the other side's legal fees if you end up losing the case - and it must be remembered, that even when you are rear-ended, juries can still return a verdict for defendant.

In Alabama, the scale already is tipped very unfairly in favor of defendants. Under ARCP 68 a defendant may file an "Offer of Judgment" which plaintiff has 10 days to accept. If plaintiff does not accept the offer and if at trial, plaintiff does not receive a verdict in excess of the offered amount than plaintiff is on the hook for defendant's costs incurred after the Offer of Judgment was made. In other words, if defendant files an offer of judgment of $10,000 and the jury returns an award of $9,000 for plaintiff, the Court may tax costs (say $5,000) against plaintiff despite the fact that the jury returned a verdict in plaintiff's favor. There is no similar provision in the law that allows plaintiff to make an offer of judgment whereby defendant is on the hook for plaintiff's costs incurred if the jury returns a verdict for plaintiff in excess of what plaintiff offered to settle for. Nor does the rule allow plaintiff to collect costs against defendant if a jury returns a verdict in excess of what defendant offered. How's that for fairness?

As a matter of practice, I would be very surprised if an Alabama judge would enforce Rule 68 as described above, although they could. In addition "costs" do not include attorney fees, but rather are limited to actual costs incurred, like deposition bills, mileage etc. Of course, even costs can run up into the thousands of dollars very quickly, and it is the client that is on the hook for costs. So, you've got to tell your client, not only can you lose, but you also can lose and owe the other side thousands of dollars.

There are several other reasons why "loser pays" is a bad idea - but shutting down the courthouses to the vast majority of Americans is enough.

Originally posted at InjuryBoard by Danny Feldman

What Is This Statement from Social Security and Why Do I Keep Getting It?

Stuart McAtee — Sun, 01 Nov 2009 15:11:53 GMT

Recently, I recieved a Social Security Statement in the mail because my birthday is fast approaching and I meet certain criteria to receive such a statement. If you're age 25 or older, pay Social Security taxes and are not yet receiving monthly benefits, you should get an automatic Social Security Statement in the mail each year about two to three months before your birthday. The statement is a valuable tool to keep track of your annual earnings, as well as to help you plan your financial future. Read Article: www.times-standard.com/lifestyle/ci_13339858

But if your earnings don't meet the threshold for filing a federal tax return, you might not be receiving your annual Social Security Statement. However, you're probably entitled to one.

Everyone who has worked and paid Social Security tax is entitled to receive a statement. So, if you don't get one automatically in the mail, you can request one from Social Security -- and the easiest way to do that is online.

Just visit www.socialsecurity.gov/mystatement and click on the “Need to request a Statement?” banner. You'll need to fill in the following information to make your request:

-- Your name as shown on your Social Security card

-- Your Social Security number

-- Your date of birth

-- Your place of birth

-- Your mother's maiden name (last name only, to help identify you).

You also can provide the following information to make your estimate more accurate:

-- Your last year's earnings and an estimate of your current and future earnings.

-- The age you plan to stop working.(for most this may be difficult)

Once you make your request, Social Security will mail you a statement, which you should receive within two to four weeks. Give it a careful look to make sure your earnings and information are reported correctly, and contact Social Security if you find anything amiss.

After you review your statement, it's a good idea to keep it with your other important papers. And if you'd like to go one step further in your retirement planning, visit the online Retirement Estimator at www.socialsecurity.gov/estimator, where you can get an instant estimate of your future benefits based on your earnings record and plug in various retirement age scenarios. More information is also available at www.socialsecurity.gov.

Originally posted at InjuryBoard by Stuart McAtee

Alabama Court Clarifies Burden Of Proof For Interference With Business Relations

Michael Roberts — Fri, 30 Oct 2009 13:53:44 GMT

A recent decision in the Alabama Supreme Court has clarified the requirements for filing and proving a claim for intentional interference with business relations. Since at least 1986, Alabama courts have recognized this claim as a distinct tort, but arguments have been asserted based on a lack of understanding or clarity about the specific requirements or elements for such cases. The requirements as typically described include the existence of a contract or business relation; defendant’s knowledge of that contract or business relation; intentional interference with that contract or business relation; damage or losses to the plaintiff as a result of this interference. In this recent case, one company “put pressure” on landowners to sell to that company, notwithstanding the fact that the owners had signed a “letter of intent” to sell to the plaintiff company. The Supreme Court rejected the interfering company’s arguments that the plaintiff company had the burden of proof in showing the “absence of justification” for the interference. The court held that “justification” is an affirmative defense for which the interfering company, the defendant, had the burden of proof. (For further discussion of the tort of interference with business relations, see Chapter 26, Alabama Tort Law (Lexis Law Publishing).

Originally posted at InjuryBoard by Michael Roberts

SSA Announces No Payment Increase for 2010

Stuart McAtee — Thu, 15 Oct 2009 11:57:32 GMT

As I have blogged about before, President Obama released extra payments earlier this year to millions of disabled Americans. For 2010, the outlook doesn't look good for a cost of living increase based on the Social Security Administration's denial of increased benefits for the upcoming calendar year. CNN is reporting no increase will occur: money.cnn.com/2009/10/14/news/economy/obama_seniors_payment/index.htm

It marks the first time that Social Security benefits have not been increased year over year since the cost-of-living adjustment was put into effect in 1975. To help counterbalance that, President Obama is calling on Congress to send another $250 relief payment to 57 million seniors and other Americans to stem the economic strain.

Congress approved $250 emergency payments as part of the $787 billion economic recovery act that lawmakers passed in February.

"Even as we seek to bring about recovery, we must act on behalf of those hardest hit by this recession," Obama said in a statement Wednesday. "That is why I am announcing my support for an additional $250 in emergency recovery assistance to seniors, veterans, and people with disabilities to help them make it through these difficult times."

As with the first $250 emergency payment, the second one would be exempt from income tax, a senior administration official said in a call with reporters.

If approved by Congress, the payments would be sent out in 2010, most likely in the first half. "It wouldn't be late in 2010," the administration official said. The measure would cost $13 billion over 10 years, according to White House estimates. The $250 is roughly equal to a 2% increase in benefits for the average Social Security beneficiary.

Let's hope President Obama's efforts to help those in need will pay off.

Originally posted at InjuryBoard by Stuart McAtee

I've Been Denied For SSD, Now What?

Stuart McAtee — Thu, 24 Sep 2009 10:59:38 GMT

In our Social Security Disbility(SSD) Practice, we see clients who have been turned down for their initial application for SSD and simply give up or keep re-applying for their benefits. If your social security disability claim was denied, should you just apply again? No.

A person(claimant) should not submit another social security disability application after he/she does not initially receive approval for benefits. Many people who wish to have their case reviewed again mistakenly apply again. The appropriate next step is to file an appeal. Having your case reconsidered will be your first step in the appeals process. A claimant must file the appeal to have his case reconsidered within 60 days of receiving notification that his initial claim was not approved. You will then appeal for a hearing, after your claim is reconsidered and denied. Having your case heard before an administrative judge offers one last chance to plead your case and allows the judge to comprehensively review your file and all supporting items. If you simply keep filing a new claim that goes through the initial review process, your case never gets to be heard by a judge. Not appealing adds tremendous and unnecessary time as you await a decision that is likely to not be in your favor, given that your claim was already denied at the initial review process stage. You will be back where you started. Appealing gives your case the best chance of approval.

If you have been denied, please give us a call within sixty(60) days to have us look at appealing your denial.

Originally posted at InjuryBoard by Stuart McAtee

Alabama Lawyers Offering Discounts to Military Personnel

Jason Knowles — Mon, 21 Sep 2009 14:31:18 GMT

The Alabama State Bar is offering legal services at a reduced rate to military personnel. The Bar Association’s Lawyer Referral Service helps connect military members with legal services in Alabama at a reduced price, which is a great idea. Currently, the service only applies to members of the Alabama National Guard and the Alabama State Defense Force, but in October 2009, the service will expand to all military members. When a military member calls the State Bar’s Lawyer Referral Service, he or she will be directed to a lawyer who is willing to offer a 25% discount to service members. If a participating lawyer isn’t in the service member’s area, he or she will be referred to the nearest participating lawyer. The State Bar Association reports that it gets lots of calls from military members looking for help, particularly with will and estate planning and child-custody cases. For more information, visit the Alabama State Bar’s website at http://www.alabar.org/lrs/. This is a great service and hopefully other states are, or soon will be, offering similar services to America’s finest.

Originally posted at InjuryBoard by Jason Knowles