Advice from the Mannix Group
1. VISIT YOUR DOCTOR AT LEAST EVERY FOUR TO SIX WEEKS.
If you are either out of work because of your disability or are working at less pay (referred to as reduced earnings) because of your disability, a doctor’s visit every six weeks is required by law and necessary for you to be eligible for weekly compensation checks . The Workers’ Compensation Law requires up-to-date medical reports every four to six weeks stating your disability and/or your work restrictions from your injuries. Failure to comply can result in suspension of your checks.
2. TELL YOUR DOCTOR TO INDICATE YOUR DEGREE OF DISABILITY IN EACH REPORT.
If your doctor believes you are totally disabled, then it needs to be stated in the report submitted to the Workers’ Compensation Board and insurance carrier. If your doctor feels you have a partial disability, then the doctor must indicate what work restrictions you have, if any (i.e., as in bending, lifting, standing, squatting, pulling, pushing, even limits of hours worked per day, etc….). Your weekly payments depend on the content of these medical reports.
3. PLEASE TELL YOUR DOCTOR TO FORWARD A COPY OF ALL MEDICAL REPORTS TO OUR OFFICE FOR EACH VISIT.
Your continued entitlement to compensation benefits will be based upon the medical evidence received by the Workers’ Compensation Board and insurance carrier. Without these reports there is no evidence for a Judge to start or continue a compensation award.
4. IF YOU HAVE A PARTIAL DISABILITY, YOU
MUST LOOK FOR WORK.
If your doctor gives you restrictions, regardless of whether your employer will take you back or not, you have an obligation under the law to look for work within those restrictions. As soon as your doctor gives you restrictions, you should contact your employer and find out if they can accommodate you. If not, you should apply for unemployment and also look for work. If you fail to look for work, the Board can suspend your benefits. This is called withdrawal from the labor market. Obviously, it is very important for you to look for work actively by completing at least five (5) applications per week for jobs that meet your restrictions. Maintain a written record of your job search with the name of each employer contacted, who you spoke with, and the date that you contacted them. Keep a record of want ad, Internet, and job fair activities for reference. Keep in mind, if you have work restrictions, unemployment benefits may be available. You may receive unemployment benefits in addition to your compensation benefits, with certain limitations. When you are partially disabled, you are asked at all hearings to detail your work search efforts. Make sure you are prepared.
ACCES-VR is an agency that assists people in your situation. The name stands for Adult Career and Continuing Education Services – Vocational Rehabilitation. The phone number is (585) 238-2900. These professionals can help you develop a new career path if your injuries prevent return to your existing job. School and retraining may be available. Starting your own business may also be an option. ACCES-VR sometimes can provide financial assistance in your pursuits.
6. NOTIFY THE INSURANCE COMPANY AND US IMMEDIATELY WHEN YOU PERFORM ANY WORK, WORK-LIKE ACTIVITY OR VOLUNTEERING.
You must understand, the Workers’ Compensation Law requires claimants to notify the insurance company immediately upon performing any work or work-like activity, whether for pay or not, or on-the-books or off. Even if you receive a meal or something of value in exchange for your services, you must notify the insurance company immediately. If you fail to notify the insurance company about your activities and you continue to receive checks while you were out of work, you have committed Workers’ Compensation fraud. This statute (114-A) was enacted in 1996. It allows Workers’ Compensation fraud cases to be easier to prove. Immediately notifying the insurance company is critical. Failure to do so can result in you owing the carrier money and even criminal prosecution!
7. PROVIDE THIS OFFICE WITH COPIES OF YOUR PAY STUBS AFTER RETURNING TO WORK. ALSO SEND US YOUR W-2’s AND TAX RETURNS WHEN AVAILABLE.
If you return to work at less pay, you may be entitled to reduced earnings benefits. If you are forced to work less hours, for less money, or both, the carrier may still owe you benefit checks. A medical report from your doctor stating a partial disability is usually all that is needed. To calculate whether you are entitled to reduced earnings, we need your pay stubs, return-to-work date and W-2’s, when available.
8. IF YOU ARE TOTALLY DISABLED FROM ALL WORK FOR AT LEAST ONE YEAR, YOU MAY BE ENTITLED TO SOCIAL SECURITY DISABILITY OR SUPPLEMENTAL SECURITY INCOME.
We are not qualified to help you with this but can refer you to someone who can. Call us for additional information.
9. SOME MEDICAL PROCEDURES REQUIRE THE APPROVAL OF THE INSURANCE CARRIER.
Any test, surgery or other procedure costing $1,000 (e.g., MRI, nerve test, physical therapy, etc.,) or more must be pre-approved. A carrier has 30 days to respond to a written request. We don’t want you to wait that long. Call our office when your doctor tells you he/she is requesting testing. We may be able to speed up the process.
10. REMEMBER OUR FEES COME OUT OF ANY AWARD PAYABLE TO YOU.
We provide a written overview of our fees in the packet we send. If you have any questions about fees in the future, please let us know. We pride ourselves in being the most reasonable and flexible firm in the business.
The above tips are for reference and developed from our enormous wealth of knowledge and experience in Workers’ Compensation Law. These are just small pieces of advice and do not replace regular phone calls, office meetings and pre/post hearing discussions. If you have any questions regarding any aspect of your case, please do not hesitate in contacting this office.