medical stuffMany times I've met with clients whose cases were damaged because they didn't take the right steps months before and their response is always, "I didn't know.  Nobody told me."

If that excuse makes you feel better, that's good but 9 times out of 10, it won't save your case.

So if you're injured at work, you need to meet with an experienced workers compensation attorney as soon as possible to find out what your rights are and what you need to be looking out for down the road.

Keenan Powell has practiced Workers Compensation law in the State of Alaska for more than 30 years and has dedicated her practice to Workers Compensation representing injured Alaskans.

All consultations are free.  If you want to set up a meeting, use the contact form on www.keenanpowell.com or call:  907 258 7663.

 

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Beware.  Be very aware if the insurance company is calling you in to talk about a settlement.  Remember firstly, the insurance company is about making profits.  It isn't interested in helping you.  And the adjuster just wants the file off his or her desk.  He or she doesn't care about what your needs are.

Secondly, you should be particularly worried if the insurance company controverted you and then wants to settle the claim. They're trying to get you into the office before you have time to talk to an attorney.

Thirdly, Workers Compensation settlements are practically impossible to undo.  You will have to live with the results for the rest of your life.

So before you sign a settlement, talk to a Workers Compensation attorney.

Keenan Powell has practiced Workers Compensation law in the State of Alaska for more than 30 years and has dedicated her practice to Workers Compensation representing injured Alaskans.

All consultations are free.  If you want to set up a meeting, use the contact form on www.keenanpowell.com or call:  907 258 7663.

medical stuffIn a series of stunning decisions from the Alaska Supreme Court and the Alaska Workers Compensation Board, it was ruled that when an insurance company stalls authorization of an injured worker's surgery, the insurance company has violated the law.

These are the dirty tricks that the insurance companies will use to stall an injured worker's needed surgery:

1.  They will claim they have no duty to preauthorize surgery.  Not true.  There is a duty to provide prompt medical treatment and to preauthorize needed surgery.  In Bockus v First Student/ Sedwick CMS AWCB Decision No 14-00400 (3/24/14), the Board ruled that when the adjuster told the doctor that the account was "open and billable" but refused to specifically authorize the surgery, it was illegal.

2.  They will claim they need an Employers Medical Evaluation (or "Independent Medical Evaluation") before they can authorize.  Again, untrue.  Although the insurance company has the right to demand an EME, it is not bound to do so.  Bockus.

3.  They will claim they need to send a letter to the doctor for clarification and cannot authorize the surgery until the doctor responds.  Again, not true.  In Kamitchis v Swan Employer/Liberty Mutual, AWCB Decision No 14-0039 (3/24/14), the Alaska Workers Compensation Board ruled that when Liberty Mutual adjuster Sam Moore failed to promptly authorize surgery, his actions were illegal.  In that case, Liberty Mutual said would not specifically authorize the surgery until the doctor responded to a letter Mr. Moore had sent him.

Under these cases, it is clear that the insurance company must tell the doctor that they will pay for the recommended surgery (preauthorize) and if they don't, they must have a legally recognizable reason and they must controvert within 30 days of the surgical recommendation.

So what do you do if the insurance company is stalling your surgery? You call an attorney and get a claim filed. The Board can order the insurance company to pay for the surgery, award you money penalties against the insurance  and order the insurance company to pay your attorneys fees.

Keenan Powell has practiced Workers Compensation law in the State of Alaska for more than 30 years and has dedicated her practice to Workers Compensation representing injured Alaskans.

All consultations are free.  If you want to set up a meeting, use the contact form on www.keenanpowell.com or call:  907 258 7663.

xrayHow much a doctor is paid for providing services to an injured worker in Alaska is regulated by Alaska law. Most Alaska doctors get that.  The problem comes up when an injured worker moves out of state.  It used to be the out of state doctors were paid under the Alaska fee schedule but a new bill, HB 141, which became effective a few months ago provides that out of state doctors are entitled to be paid fees pursuant to the rates set for workers compensation in their state.  HB 141.

Keenan Powell has practiced Workers Compensation law in the State of Alaska for more than 30 years and has dedicated her practice to Workers Compensation representing injured Alaskans.  A sample of verdicts she has obtained for Employees is found at  http://www.keenanpowell.com/settlements_wc.html.

There is absolutely no fee for a consultation, all consultations are free.  If you want to set up a meeting, use the contact form on this website or call:  907 258 7663.

 

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It is the position of most insurance companies that they do not have a duty to pay medical benefits, that the only duty they have is to reimburse the Employee for medical expenses 30 days after the Insurer received notice of the Employee’s expenditures, and that, just to be nice, the Insurer’s arrange to pay some of the medical benefits directly to the providers.

 That’s not what the law says.  The law says the insurance companies have a duty to pay medical benefits immediately on demand.  In other words, “now” means “now”. The case which said interpreted the law to hold that the benefits are due immediately is Harris v. M-K Rivers, 325 P.3d 510 ( Alaska, 2014)  decided in March of 2014 by the Alaska Supreme Court. “To determine when an employer's payments for medical care are due under the Workers' Compensation Act, for purposes of determining whether the employer is subject to a penalty for failing to timely pay amount due, payments due are more appropriately characterized as payable immediately or on claimant's demand, rather than owed as a debt.”  Id, 519. Harris v MK

So if the insurance company is dragging its feet in pre-authorizing surgery, some other medical benefit, it will owe penalties and interests and is flirting with the possibility of being referred to the Division of Insurance for an investigation.

Keenan Powell has practiced Workers Compensation law in the State of Alaska for more than 30 years and has dedicated her practice to Workers Compensation representing injured Alaskans.  A sample of verdicts she has obtained for Employees is found at  http://www.keenanpowell.com/settlements_wc.html.

There is absolutely no fee for a consultation, all consultations are free.  If you want to set up a meeting, use the contact form on this website or call:  907 258 7663.

 

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The question is:  Do an injured employee get workers compensation benefits when he or she is assaulted in the workplace?

The answer is: sometimes.

The Alaska Workers Compensation Act is meant providers benefits to workers injured in the course and scope of their employment.  If an assault or sexual assault is reasonably foreseeable and incidental to the employment, then the employee is entitled to workers compensation benefits.  Obvious examples of an occupation where an assault is reasonably foreseeable and incidental to the employment include jail employees, hospital employees, police, security employees.

If the employment provided a unique opportunity which led to the assault, then workers compensation should apply.  In Temple v Denali Lodge, 21 P 3rd 813 (Alaska, 2001), the Supreme Court cited a North Carolina case where a cocktail waitress stopped to help a stranded motorist who she recognized as a customer.  He kidnapped and sexually assaulted her and she sustained serious injuries escaping.

If the employment creates a special risk, then subsequent injuries should be covered by workers compensation.  The Supreme Court also cited a California case of a woman whose job required her to do home visits.  Her husband posed as a customer under an assumed name and shot and killed her when she came to his apartment.

It is unlikely however that an employer would be responsible merely for failing to protect his employees from assault.

Keenan Powell has practiced Workers Compensation law in the State of Alaska for over 30 years and has dedicated her practice to Workers Compensation representing injured Alaskans handling hundreds of cases.  A sample of verdicts she has obtained for Employees is found at  http://www.keenanpowell.com/settlements_wc.html.

There is absolutely no fee for a consultation, all consultations are free.  If you want to set up a meeting, use the contact form on this website or call:  907 258 7663.

 

SettersphotoYes you do!  Before you get into a car accident, you need to have car insurance.  Alaska law requires you to carry liability insurance of at least $50,000.  If you can't afford any of the other benefits, get medical payment coverage as well.  Medical payment benefits pay 100% of your accident-related treatment.  The limits offered usually start at $5,000 and go up from there. $5,000 isn't enough. That's a trip to emergency room and maybe a few follow up with your doctors.  Anymore, $5,000 won't even cover treatment for a typical whiplash injury.  Get at least $25,000.  With $25,000 of coverage you have enough money for conservative treatment, and if you don't get better, at least you can be evaluated properly for more serious injuries.  Xrays, MRIs cost money.  Lots of it.  Surgery costs even more.

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Workers Compensation insurance companies can, and do, spend a lot of money on private investigators following injured employees around and videotaping them.

 

Then, the private investigator will provide the insurance company with confidential reports which are not automatically produced to the injured employee (nor are the videotapes) because the insurance company wants to blind side the injured employee with the report and videotapes at a hearing and use the report and videotapes to influence its doctors.  If the injured employee doesn’t know about the surveillance, reports and videotapes, there is nothing s/he can do.

 

In a recent case before the Juneau board, Cornielson v Rappe Excavating, the insurance company’s attorney introduced the report and edited video.  The Board demanded to see the entire video, unedited, and when it saw the entire video, unedited, the Board came down hard on the insurance company.

 

In the first place, the private investigator’s report didn’t match the unedited videotape and in the second place, the video was edited to cut out all of the scenes showing the injured worker was in real pain, not knowing that he was being videotaped.

 

Word to the wise: if you’re in a Workers Compensation case and you think you’re being followed, you are.  Even if you don’t think you’re being followed, you may be.  You need to demand all surveillance videos and reports.

 

Keenan Powell has practiced Workers Compensation law in the State of Alaska for nearly 30 years and has dedicated her practice to Workers Compensation representing injured Alaskans for the past 9 years handling hundreds of cases.  A sample of verdicts she has obtained for Employees is found at  http://www.keenanpowell.com/settlements_wc.html.

 

There is absolutely no fee for a consultation, all consultations are free.  If you want to set up a meeting, use the contact form on this website or call:  907 258 7663.

 

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A Second Independent Medical Evaluation (SIME) is ordered by the Alaska Workers Compensation Board. It can be ordered for three different reasons.  First, SIMEs are most commonly ordered when there is a dispute between the injured Employee's treating physician and the the Employer's expert doctor.

A SIME can also be ordered if, second, there is a gap in evidence or, third,  if the Board wants an evaluation for the purpose of developing the evidence before a hearing.  A gap in the evidence occurs when there is not a clear cut dispute between the treating physician and Employer's physician but there is some evidence of a dispute.

When the Board orders a SIME, it sends the injured Employee to a physician on its list. See: SIME list Bulletin 13-06. The physicians on this list were approved by a committee but it does not mean that the physicians on the list are neutral. If you are facing a SIME, it is important to review cases in which that physician has been involved to determine whether s/he is fair.  All decisions issued by the Board are available to the public and can be accessed on the Board's website: http://labor.state.ak.us/wc/legaldir.htm.  

There are two ways to obtain a Board order for a SIME: the first is to obtain the agreement of the Employer's attorney.  The second way is to file a Petition for SIME and go to hearing on the Petition.  The forms for requesting a SIME are on the Board's site as well.  You will need a Petition, form 07-6111, and a SIME form, form 07-6147.

Once a SIME is ordered, a Board employee will pick the physician(s) unless the injured Worker and Employer have stipulated to a particular physician and will send a letter out to the injured Employee and the Employer informing them of the date and time of the appointment and the name and location of the examination. The Employer is responsible for arranging, and paying for, transportation, hotel and meals for the Employee.

If you have questions about your workers compensation claim, call my office.  I have more than 30 years experience fighting for the rights of injured Alaskans. Consultations are FREE.  Call 258-7663.