Birmingham Personal Injury Lawyer - All Topics - Most Popular

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

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

South Carolina Surprise

Jon Lewis — Mon, 29 Jun 2009 21:36:08 GMT

It was reported this past week that South Carolina Governor, Mark Sanford, has had an affair. The media has treated this as landmark news. What I think would be landmark news is a politician who has not had an affair. Is this surprising? Should we expect anything less?

Why am I writing about this? Because I meet with clients every day who show surprise when the law doesn't go their way. What do I mean?

Let's take arbitration for example. Clients come into the office after being defrauded by a company or had a contractor treat them wrong. After reviewing the contract and seeing the arbitration clause, I tell them that they cannot sue the defendant in court. They have to arbitrate the claim. The reaction, "What?" "Are you kidding me?" "How can they do that?"

Or, what about when I have to explain Alabama's wrongful death law. In Alabama, when someone is killed by the negligence of others, you can only sue the other person or company for punitive damages, not compensatory damages. In other words, we have to argue to the jury that they must punish the defendant, not compensate the victim's family. That becomes VERY difficult when the defendant made a mistake such as running a red light or changing lanes without looking properly.

What is the respective clients' reaction to this? "What?" "Are you kidding me?" "How is that possible?"

What's the moral of the story? Pay attention. Pay attention to your spouse and to politicians, and maybe, you won't be surprised. Pay attention to your legislators and judges. Know what laws they are passing. Lobby your congressmen and let them know that these laws aren't right and need to be changed.

Originally posted at InjuryBoard by Jon Lewis

Tips to Prevent Medical Errors

Jan Boswell — Wed, 11 Nov 2009 09:22:02 GMT

This blog is written in response to the blog, 98,000 Reasons to Care about Patient Safety, by Jane Ayre at InjuryBoard.com. This is the number of Americans who die from medical errors each year. As a nurse, I know that patient safety is a concept that is foremost in the minds of healthcare providers, administration, and regulatory agencies. How can you, the consumer, help prevent medical errors ? In this blog, I will outline tips to help the consumer prevent other medical errors.

1. Be an active part of your healthcare team. Ask questions not just in the hospital but anywhere you receive healthcare. If you don’t understand something, ask for clarification.
2. If you have a choice, choose a hospital at which many patients have had the procedure and surgery you need and have had good results.
3. When choosing a specialist, ask your own physician for a personal recommendation. I have been known to ask my primary doctor: “If this were your wife, who would you send her to for this condition?”
4. Ask all healthcare workers who have direct contact with you whether they have washed their hands. Adequate hand washing is a primary way to prevent infection.
5. Before you leave the doctor’s office or hospital, make sure you understand the treatment plan. This includes understanding about your medications, follow-up care, and when to contact the doctor.
6. Before you leave the hospital, make sure you understand when you can resume regular activities. Make sure your doctor understands your regular activity level. You should know when you can shower, take a tub bath, lift 5 lbs, return to work, etc.
7. If you are having surgery, make sure that you, your doctor, and your surgeon all agree on what exactly will be done. For example, if you are having surgery on your right arm, make sure all involved knows it is the right arm. Make sure the site is marked before surgery.
8. Make sure someone is in charge of your care. This could be your personal physician. You need a point person to direct your care.
9. Make sure that all health care professionals involve in your care has your important health information. I love patients who come in with a written history. It is important that healthcare professional know your allergies, past surgeries, past and current medical conditions, etc.
10. Have a family member or friend designated as your advocate. Ask that person today. Make sure they know your medical history and your preferences in regards to medical care.
11. Before a test or treatment, ask why it is needed and how it can help you. Be informed before you consent.
12. If you have a test, follow-up and get the results.
13. Learn about your condition and treatments. If you use the Internet, use reliable sources. Treatment recommendations based on the latest scientific evidence are available from the National Guidelines Clearinghouse at http://www.guideline.gov. One of my favorites is www.mayoclinic.com.
You can visit my previous blogs on detail ways to prevent medication errors. I have outlined below the top 6 tips:
1. Make sure all healthcare professionals involved in your care know everything you are taking. This includes over-the counter medications, vitamins, herbs, and dietary supplements. Review these with your doctors once a year.
2. Make sure all healthcare professionals involved in your care know about any allergies and adverse reactions you have had to any medications.
3. When you get a new prescription from your doctor, make sure you can read it.
4. Understand your medications. What is it for? How is it to be taken and for how long? What are the side effects? Can I take it with other medications? What should I avoid while taking this medication?
5. Ask the pharmacist if you have any questions about the directions on your medication labels.
6. Ask for written information about the side effects.

Be involved in your care. Ask questions until you understand. Never consent to a test, surgery, or procedure until you are informed. Do not feel like a nuisance, you are standing up for your right to safe medicine that is appropriate for you and your condition. Your diligence could save your life. Share this with your family and friends.

Adapted from Agency for Healthcare Research and Quality

Originally posted at InjuryBoard by Jan Boswell

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

Mis-filled prescriptions can have deadly consequences

Danny Feldman — Wed, 30 Sep 2009 18:09:19 GMT

Every year there literally are hundreds of millions of prescriptions filled. Given the staggerring number of prescriptions that are written and filled, even a miniscule number of errors in filling the prescriptions can result in hundreds of thousands of mis-filled prescriptions. While often the consequences of an error are relatively benign - you miss a few days of getting the prescription that you need, or you experience some negative, but non-life threatening side effects, sometimes the error can result in death or permenent injury.

A number of years ago, I represented a woman who was taking a high blood pressure medication. She got pregnant and immediately, her doctor changed her medication to prevent harm to her fetus because the medication she had been on was known to retard fetal development. For several months into her pregnancy, she took the "new" medication and did fine. However, on one Sunday afternon, she went to the pharmacy and the clerk told her (their story) that two prescriptions for high blood pressure showed up, the old one and the new one and that he showed her the pills and she picked the wrong one (the old one). She took the wrong pill, the one that her doctor had discontinued when he found out she was pregnant. Not surprisingly, she developed troubles with her pregnancy and her son was born with kidneys that functioned at about 15% and which were rapidly failing. He will require a kidney replacement by the time he is 5 and he will face a life time of health related obstacles, including future kidney replacements (since replacement kidneys only have about a 15 year life span), dialysis treatments in between replacements, anti-rejection drugs, a significantly decreased life span etc.

Despite the fact that tragic results can occur from a mis-filled prescription, many pharmacies are very lax in enforcing protocols and redundant checks to ensure that prescriptions are correctly filled. Many times there are low paid and poorly trained workers in the pharmacy that are involved in filling prescriptions. Given the demands on pharmicists to increase volume (and thus profit), it is not surprising that tragic mistakes often are made.

Originally posted at InjuryBoard by Danny Feldman

If I slip or trip and fall can I sue?

Danny Feldman — Tue, 23 Jun 2009 08:31:39 GMT

Every time someone falls down, people make jokes that the injured person will end up "owning the place." What does the law say about a premise owner's potential liability if someone falls on your property?

In Alabama, and a few other states, it depends on the right, or lack thereof, that the person who fell had to be on the property. For example, the duty of a premise owner to someone who is trespassing on their property is very, very low. On the other hand, if someone is a "business invitee" - that is, if someone is on the property to benefit the property owner (like a customer of the store or restaurant) then the premise owner has a higher duty. However, that duty basically is not to be negligent - or in other words, to act as a reasonably safe business owner would act in similar circumstances.

Let's take a look at a couple of examples. Say you visit Wal-Mart or any store for that matter and another customer walking directly in front of tosses the proverbial banana peel. With your next step, you slip on it and break your neck. Can you sue Wal-Mart? Sure. Will you win? Absolutely not. You must show more than the fact that you fell on the store's premises and that you got hurt. You must show that the store was negligent. In the example above - what did the store do that was unreasonable? Not a thing. So, while you may have a claim against the person that tossed the peel (good luck recovering on that, unless the person happens to be Donald Trump or someone else of personal means) you do not have a claim against the store.

Let's vary the facts a bit. The same customer tosses the banana peel 8 hours before you enter the store. A manager sees it 15 minutes later and instructs an employee to clean it up. The employee gets distracted and does not do it. A couple of hours go by and the manager sees the peel again. He means to get on the employee for not picking up the peel, but he too gets distracted. Another couple of hours go by. Several other managers and employees see the peel, but do not remove it. You don't see the peel; slip and fall and break your neck. Negligence? Maybe - it'll depend on what the jury thinks. Was it reasonable for the store to leave the peel on its floor for 8 hours? Does the peel constitute a dangerous or hazardous condition? What about the customer - shouldn't he have seen and avoided the peel?

In my next blog, I'll address in more detail some of these issues and "affirmative defenses" So, the answer to the question is "yes" - if you fall you can sue, however, whether your lawsuit has any reasonable chance of success is another matter entirely.

Originally posted at InjuryBoard by Danny Feldman

I Need Money NOW!!!

Jon Lewis — Fri, 08 Aug 2008 11:15:30 GMT

I don't know about other attorneys, but there is a certain element preying upon those who have been injured and who feel like they need money NOW, and frankly, it's a little sickening. Who are these people? Oasis Legal Finance. J. G. Wentworth. And, the one that just came in our our fax machine: AnyLawsuits. These companies offer money to people with lawsuits, and they are very enticing to our vulnerable clients.

What's wrong with these companies offering such nonrecourse loans? The usurious interest rate that they charge. For example, one of our clients was recently considering getting a loan from one of these companies for $7,500.00. As soon as the loan would be made, the client would owe $9,500.00. If the loan remained outstanding for 1 1/2 years, they would owe $19,000.00 - more than twice the funds received. That should be illegal.

Why? Most of these companies will not loan money to these clients without discussing the case with the attorney and having their own attorney underwriters look at the case. They know when they loan the money that there is a high percentage change that they will get their money back. So, in reality, they are not taking a huge risk in making the loan even though it is nonrecourse financing (nonrecourse means that the person borrowing the money doesn't have to pay it back if they lose their case).

These companies use emotion to entice clients to call them. Many times clients have hit on hard times because of their injuries. It gets harder to pay bills, and these companies realize this and use this to their advantage. They even buy out an individual's structured settlement in order to give them money NOW. These structured settlements are entered into to protect the individual's money. Significant thought goes into such a settlement, and sometimes, when there is a minor involved, a judge has approved the structured settlement at a pro ami hearing (a hearing to approve a settlement on a minor's case).

Until the courts allow lawsuits to proceed against these companies for deceptive trade practices, violations of finance laws, or other wrongful conduct, these companies will continue to "steal" money from these unfortunate individuals. Another solution? Legislators could enact laws to prevent these companies from either loaning money on cases, buying structured settlements, or charging such outrageous interest. Encourage your legislator to do so.

Originally posted at InjuryBoard by Jon Lewis

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

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