Category: Workers Compensation

It has come to my attention that Alaska National is sending out medical releases to injured workers asking them to release medical information from 1998 forward.  Further the medical releases are phrased in such a way that the provider will release all medical records from that date.

This is not the law.  Alaska Workers Compensation law is very clear.  The insurance company is entitled to medical information relating only to the injured body part from two years prior to the date of injury in most circumstances.

In the event that the injured body part was injured previously, then the insurance company would be entitled to medical records from two years prior to the first treatment date.

It is imperative that an injured worker respond to the request for medical releases timely.  If the releases are overbroad (see information beyond what the insurance company is entitled to) then the injured worker must file a petition for protective order with the Alaska Workers Compensation Board.  The form is available on the Board's website: http://labor.state.ak.us/wc/pdf_list.htm.  Use form 07-6111.  You must print the form, fill it out, file a copy with the Board and send a copy to the insurance company.

If you fail to execute the forms and return them on time, or instead file a petition for protective order, the insurance company is entitled to cut off all of your benefits, time loss payment and medical benefits included, until the issue is resolved.  Nothing will happen in your case,

For more information, see http://www.keenanpowell.com/faq-wc.html

Contact Keenan Powell through the contact form or call: 258-7663. Toll free: 888-368-5678.

One of insurance companies’ tricks to avoid paying Workers Compensation is to have their doctor state that there was no specific injury at work when the injury that the Employee sustained as a chronic overuse injury which accumulated over a period of time.

Another trick, often seen played at the same time, is for the insurance doctor to say that the pain the Employee is suffering is the result of a pre-existing condition.

The law is clear, and the insurance companies know it, that chronic overuse injuries are compensable under Alaska Workers Compensation law just like an injury from a traumatic event.
Some of the injuries seen develop from chronic overuse include hand nerve injuries, back and neck strains, herniated discs.

The law is equally clear, and the insurance companies know it, that when a work-related injury combines with, aggravates or accelerates a pre-existing condition, then it is still compensable Alaska Workers Compensation law. It is not important that the underlying problem (usually degenerative disc disease) was the result of work, but the pain was caused by working.

If the insurance company has controverted your benefits because it paid a doctor to say you weren’t hurt at work, you need to speak to an attorney.

The Law Office of Keenan Powell provides free consultations regardless of whether or not you have been controverted. To contact Keenan Powell, use the contact form on this page or call 258-7663.

For more information about Workers Compensation, see: http://www.keenanpowell.com/faq-wc.html.

Sometimes in a Workers Compensation case, the insurance company will assign a nurse case manager whose job is to attend the doctor’s visits, consult with the patient and report back to the insurance company.

In theory, that sounds like a good thing.  But in practice, it is not.

I have seen cases where the nurse case manager has told the doctor what the insurance company will and will not pay for and as a result, the doctor has changed his treatment recommendations.  It is a felony for anyone to interfere with the doctor’s recommendations but the nurse case managers get away with it because some doctors think that they have to play ball with the insurance company.  It is particularly a problem when the doctor does not document that his treatment recommendation has changed because of the nurse case manager’s interference.

Another problem that I’ve seen is that the nurse case manager will try to persuade the injured worker that he or she is ready to go back to work sooner than the injured worker should have been.

And, perhaps most importantly, the nurse case manager is working on the supervision of the insurance adjuster.  Every question that she asks you, every thing that she says to you is at the direction of the insurance company for the sole purpose of minimizing the benefits it pays to the injured worker.

And everything you say is reported directly back to the insurance company.

You do not have to accept a nurse case manager.  It is up to the injured worker whether he or she will allow anyone else in to the room during the doctor’s visits.  The insurance company cannot discontinue your benefits because you refused the nurse case manager.

Be warned and be aware.

The Law Office of Keenan Powell provides free consultations regardless of whether or not you have been controverted.   To contact Keenan Powell, use the contact form on this page or call 258-7663.

For more information about Workers Compensation, see:  http://www.keenanpowell.com/faq-wc.html.

mailto:keenan@keenanpowell.com.

http://usnews.nbcnews.com/_news/2013/08/08/19917073-yarnell-hill-firefighters-kin-say-theyre-being-cheated-out-of-benefits?

Employer’s game playing to avoid paying benefits is the reason why I fight on the behalf of Employees.

In Alaska, employees are entitled to workers compensation benefits whether or not the employer wants to pay them, whether or not the employer carriers workers compensation insurance, whether or not the employer characterizes the employee as an independent contractor and whether or not the employer files a Report of Injury.

As long as an individual is an employee, as defined by the Workers Compensation law, that person is entitled to benefits.

And the beauty of the system is that the employer can be forced to pay penalties to the employee for denying benefits and if the insurance company is involved in bad faith denials, it can be reported to the Division of Insurance by the Workers Compensation Board.

Bottom line: the last person you should trust when you’re hurt at work is your employer.  Call an experienced Workers Compensation attorney and find out what your rights are.

The Law Office of Keenan Powell provides free consultations regardless of whether or not you have been controverted.   To contact Keenan Powell, use the contact form on this page or call 258-7663.

For more information about Workers Compensation, see:  http://www.keenanpowell.com/faq-wc.html.

"An employee may not be required to pay a fee or charge for medical treatment or services provided under this chapter."  AS 23.30.097(f).

An employee never has to pay for his medical treatment for a Workers Compensation Claim.  AS 23.30.097(f).  If you were made to pay for any of your treatment then you need to submit the proof of the charge and payment to the insurance company for reimbursement.  Be sure that you keep a copy for your own files of the proof of payment and the date upon which you sent it to the insurance company for reimbursement.  There are two ways to prove that you submitted the payment:

1. You can hand carry the payment to the insurance company and ask the receptionist to sign and date your copy of the document, or

2. You can mail it priority mail.  You will be given a tracking number by USPS.  After the mail is delivered, go to the USPS website and print off the proof of delivery.

The reason that is important to keep proof of your submission is that you are entitled to a 25% penalty if the insurance company is late reimbursing you.  For more information: http://keenanpowell.com/faq-wc.html.

If the insurance company controverts you and refuses to pay the medical bills, you are not required to pay the bills.  AS 23.30.097(f).  However the doctors are not required to treat you if they are not paid under most circumstances, so you probably won’t receive treatment.

If you have health insurance or are eligible for Medicaid or Medicare, the providers can bill those entities while you are sorting out the Workers Compensation case.

If you do not want to file a claim for payment of medical benefits, then the providers are entitled to file a claim directly.

Call:  Keenan Powell 258-7663.  E-mail:  keenan@keenanpowell.com.

Workers Compensation is a whole new world and if you’ve never dealt with it before, you might feel like you just fell into the Land of Oz.

Many Employees that I meet think that they have been dealing with the Workers Compensation Board when actually they have been talking to an adjuster for an insurance company. So when the adjuster tells them something like"Workers Compensation will not pay for that surgery", the Employee believes that it’s the law that is preventing them from getting the surgery whereas the truth is that it’s an insurance company trying to increase it’s profits by denying the Employee’s benefits.

So who is "Workers Compensation"?  The Division of Workers Compensation is a part of the State of Alaska’s Department of Labor.  http://labor.state.ak.us/wc/home.htm.   It has a director in Juneau and offices in Anchorage, Fairbanks and Juneau.   In each of the offices, there hearing officers who manage the files.  In the Anchorage office, there are legal technicians who are available to talk to injured Employees.  If a case goes to a hearing, it will be decided by Board members of which there are three: a hearing officer who is an employee of the Division, and two members of the public appointed by the governor.  One of the members is from labor and one is from management.   These are the people who decide what an Employee’s rights are.

There is usually an insurance company involved in your case because all employers in the State of Alaska are required to carry workers compensation insurance unless they are approved as self-insured employers.  If they are self-insured, they will hire an adjusting firm to handle the files.  The adjuster does not work for the State.  The five largest insurers in Alaska are: Alaska National, State of Alaska, Liberty Northwest, Commerce & Industry, and Liberty Insurance.  http://labor.state.ak.us/wc/forms/2011AR.pdf.

It is important to remember that when you are talking to someone from the insurance company, they do not speak for the Board.  They represent the insurance company who pays their salary and their job is to save the insurance company money.   The adjusters have orders from the supervisors on how to handle claims, they have very little discretion.  So there is no point in arguing with them.

If you have any questions regarding your case, you can go to the Workers Compensation office and talk to a legal technician and you can consult with an attorney.   The Law Office of Keenan Powell provides free consultations regardless of whether or not you have been controverted.   To contact Keenan Powell, use the contact form on this page or call 258-7663.

For more information about Workers Compensation, see:  http://www.keenanpowell.com/faq-wc.html.

mailto:keenan@keenanpowell.com.

When the employer is determined to be "medically stable", then he or she is entitled to a Permanent Partial Impairment (PPI) rating.

"Medically stable" means that there is no objective measurable improvement.  Medical stability is presumed in the absence of objectively measurable improvement for a period of 45 days however that presumption can be rebutted.

The PPI rating is determined by a physician who is specifically trained to conduct PPI ratings.  He examines the Employee and reviews medical records and then makes his determination based upon the American Medical Association Guidelines to the Evaluation of Permanent Impairment.

When the physician assesses a certain PPI rating, he will state that the Employee has a per centage of whole body disability.  The whole body figure used in Alaska in $177,000.  Thus if the physician says that the Employee has a 10% PPI rating, then the Employee should be paid 10% of $177,000 or $17,700.

There is a lot of room for disagreement in this process.   Frequently the insurance company will hire an doctor to perform an Employer Medical Evaluation (EME) and that doctor concludes that the Employee is medically stable but the treating physician say that he isn’t, that he needs more treatment to improve.

Another area of disagreement is when the Employee became medically table.  Sometimes the EME will conclude that the Employee was medically stable months before the evaluation but the treating physician assesses a different date.  The reason that is a problem is that if the Employee was drawing Temporary Total Disability during the period time after which the EME said that he is medically stable, the insurance company is going to want that money back.

The obvious area of disagreement is the PPI rating itself.  The EME will often conclude that the rating is very low, claiming that there is pre-existing degenerative changes and/or that the Employee was malingaring (faking) the extent of his disability.

When these disagreements come up, the Employee is entitled to a Second Independent Medical Evaluation (SIME).  A SIME is an evaluation by physician chosen by the Board.  The insurance company pays for the SIME and if the Employee needs to travel to the doctor, the insurance company is required to pay for the travel as well as time missed from work.

For more information, see http://www.keenanpowell.com/faq-wc.html

Contact Keenan Powell through the contact form or call: 258-7663.  Toll free: 888-368-5678.

In Workers Compensation cases, the first question most attorneys ask when a prospective client calls is: "Have you been controverted?"

A controversion can be formal or informal.  If the insurance company is obeying the law, it will send you a Controversion Notice explaining why it is no longer paying your benefits.  The back side of the form sets out what your rights and obligations are if you wish to pursue a Claim before the Board.  That information is very important, so read it.  If you don’t understand it, you can go to the Board’s office and ask to speak to a legal tech.  Or you can call an attorney.

 Controversion Notice

An informal controversion is when the insurance company resists payment of benefits.  For instance, the insurance company may refuse to preauthorize your surgery.  Because it refuses to preauthorize your surgery, the doctor won’t perform the operation.  Suddenly you’re stuck not being able to get the surgery that you need and you can’t go back to work because your injury isn’t fixed.  Even if the insurance company is paying you temporary total disability or temporary partial disability, it’s not enough to live on.  And you fall farther and farther behind.

 Even if the insurance company has not formally controverted you, you are still entitled to file a Claim to recover your benefits and you can still find an attorney to help you, because once the insurance company has controverted you, or resisted payment of your benefits, and you are successful in obtaining benefits through the services of your attorney, the insurance company will have to pay your attorneys fees.

 See http://www.keenanpowell.com/faq-wc.html for more information.