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Denial of Workers’ Compensation Medical Benefits Can Be Legally Challenged

Posted on Thursday, February 16, 2017
Blog, Workers' Compensation

Your ability to receive medical benefits under Florida workers’ compensation is dependent on strict guidelines–guidelines that can, nevertheless, be challenged in court. According to the Florida Division of Workers’ Compensation, your employer may have to provide you with medical treatment, but it is your responsibility to quickly report any on-the-job illness, or injury. And, the doctor who aids you at the scene of the workplace mishap may not be the doctor who continues your treatment under your employer’s insurance plan. Likewise, be sure to advise hospital emergency-room personnel–if they are your “first responders”– to forward your records to your employer, and/or your insurance carrier.

Florida Workers’ Compensation laws declare, also, that you can only receive initial, ongoing and “specialist” medical care for a (supposed) on-the-job injury if insurance-company physicians declare this “medically necessary.” However, the term “medically necessary” is subject to interpretation, and you can, therefore, present a legal challenge whenever the carrier denies medical help you feel is crucial.

The types of medical care usually offered by workers’ compensation for physical-health problems–doctor’s visits, hospitalization, therapy, exams/tests and prescription medications–also apply to “mental and nervous injuries,” as described by Florida Statute 440.093. In order for “mental/nervous” treatments to be covered, though, your mental “stressors” must be directly attributable–by at least 50%–to the “compensable physical injury” that occurred while you were working. This 50% is used in comparison with any other possible causes of your mental-health issues. And, the term “directly attributable” is another that can be viewed differently by you, and by your insurance company.

Your “mental and nervous injuries,” therefore, must be proven by clear and convincing medical evidence, and this evidence can only be provided by a licensed psychiatrist–not a psychologist–who can give your condition a unequivocal diagnosis by employing the criteria now extant in the DSM-IV, the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association.

Asserts Florida laws: A mental injury that results from stress, fright or excitement are not an “accidental injury,” even if it was, you believe, engendered from an on-the-job incident. Workers’ Compensation, in other words, must see a trauma to your physical body in order to permit your employer’s insurance to help you to heal. –Can this “nervous injury” interpretation be legally challenged? Yes!

But can the insurance company claim, in a situation such as this, that your “mental challenges” existed prior to your current employment? Yes!

Some physically injured employees have, conversely, been accused of mental malingering, when in fact; the trauma they experienced was real–just not easily diagnosable.

This overview of actual, nameable and feasible workplace injuries–which may be denied by Florida Workers’ Compensation–should convince any employee with questions to seek legal help.

Discuss Safe Driving With Your Teen to Help Avoid Injury

Posted on Thursday, July 30, 2015
Auto Accident Injuries, Blog, Lawyer Advice

According to a recent article published in U.S. News and World Report, car accidents are the number one cause of death among teens, and this problem gets worse during the summer. Luckily, if you are a parent of a teen, there are a variety of things you can do to help your teen drive safer and reduce the chances of your child being involved in a car accident, which could result in personal injury or even death.

First, model the behaviors you expect. This means turning off your cellphone, silencing it, or putting it out of reach while you are driving. If your teen sees you using a phone while driving, even if you have told your teen not to use his or her phone while driving, you have shown that driving while using a cellphone is acceptable behavior.

Another behavior you should model is seatbelt use. Teens are the least likely to use their seatbelt even though seatbelt are known to reduce the risk of crash-related injuries and deaths by roughly half. You may not be in the vehicle every time your teen drives, but you can demonstrate the importance of a seatbelt when you are in the vehicle.

Second, establish rules for your teen’s driving. Many parents establish rules about radio usage or the number of passengers the teen can have while driving. Not only is it important to establish these rules, but also it is important to tell your teen why these rules are important. Let your teen know that as he or she becomes a more experienced driver and as responsible driving skills have been demonstrated, the rules will become less strict.

Finally, consider signing The New Driver Deal with your teen. This contract or agreement puts forth expectations for your teen’s driving and helps the teen to see when greater driving responsibility will be awarded. It also makes parents responsible for helping their teen become better drivers. If teens and parents know the rules and respect the rules, the likelihood of a car accident can be reduced.

Assessing Truck Accident Liability – Part Two

Posted on Wednesday, July 8, 2015
Blog, Truck Accident Injuries

There are many possible reasons for accidents that involve commercial trucks. Here are other areas that experienced investigators explore when determining where the responsibility lies for a truck accident:

Company Misconduct

Trucking companies are responsible for timely inspections and proper maintenance. Occasionally, company personnel may demand that a driver meet an unreasonable delivery deadline. In some such cases, it is possible to assert that the pressure the driver felt contributed to an accident.

Improper Loading

Trucking companies are also responsible for the proper loading of semi tractor-trailers. In the aftermath of some truck accidents, it is possible to claim that negligent overloading or unbalanced loading caused a crash, in whole or in part.

Faulty Service or Parts

Finally, third parties may incur liability in truck accidents. For example, the manufacturer of a failed truck part that leads to a crash may incur liability. In other cases, it is possible to hold maintenance providers liable for crashes. For example, a company that performs defective brake service is sometimes found guilty of negligent conduct. In certain cases, defective computer systems are to blame, so those that developed and/or installed such systems may incur liability as well.

Sometimes, investigators employed by one company attempt to shift the blame for the accident to another business involved in the ownership or operation of the rig. Strong representation helps injured victims to deal with such tactics.

If you or a loved one suffers an injury in a commercial truck accident, it is possible to review the matter with an attorney. Our firm offers such a consultation without charge or obligation. To ask your questions, or to learn more, please contact us.

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