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Author: Keenan Powell

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When the insurance company owes you money arising from a Workers Compensation case, the checks have to be mailed on time or it owes you a 25% penalty.

The first installment of temporary total disability is due 14 days after the employer has knowledge of the injury or death. The subsequent installments are due every 14 days. AS 23.30.155(c).

If compensation without an award is not paid with 7 days it became due, then there is a 25% penalty.

If compensation with an award is not paid within 14 days of it becoming due, then there is a 25% penalty.

Sometimes, the insurance company will cut a check and the check will show the date it is cut, but they don't mail it until a day or several days later. They "pay" when they mail the check, not when they cut the check.

So it's critical that you save the envelope to see what date the check was mailed. It could be worth a lot of money to you.

Keenan Powell has practiced law in 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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When injured workers call me and ask me why the insurance company did something, I tell them I can’t explain it logically. That’s the short answer.

I’ve never worked inside an insurance company and I don’t know how they organize their tasks (if they do), but having observed their behavior for 35 years, I have drawn some conclusions.

Greed makes the greedy paranoid and then they behave insanely. When you’re broke, you think having money would make you feel secure. It doesn’t make you feel secure; it makes you afraid of running out of money. So you need more. The more you get, the more you need.

Insurance companies are a profit industry. The workers compensation insurance carriers who operate in Alaska make between 45 and 100 million dollars per year profit.

Insurance companies are a profit industry. The workers compensation insurance carriers who operate in Alaska make between 45 and 100 million dollars per year profit.

One way for insurance companies, or any greedy employer, can improve their profits is by hiring less people to do more work. Then they give them the minimal amount of training to do the work. Then very little supervision and guidance. And they pay the adjusters poorly so the adjusters quickly develop the opinion that the injured worker, who may be receiving more money on workers compensation than the adjuster makes, is bilking the system.

Add to that a corporate philosophy that the injured workers are trying to “get away with something”, and you have an adjuster who doesn’t really care if the injured worker gets his comp check on time or if his surgery is preauthorized. You are just another file to them.

So don’t waste your time trying to rationalize their behavior. It’s impossible. Instead, talk to an experienced attorney who will tell you what your rights are and how to enforce them.

Keenan Powell has practiced law in 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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Collect all the medical records from every provider that has seen you since the date of injury. Also collect all the correspondence from the insurance company and its attorney, all claims, answers, petitions, and prehearing conference summaries and notices that were filed with or by the Alaska Workers Compensation Board.

When you start looking for an attorney to handle your workers compensation claim, you will quickly find out that attorneys will ask you to pull together a number of records to review. At the very least, he or she will want to see all of your medical records since your date of injury, the report of the insurance doctor (EIME), if one exists, and the controversion notice, if one exists. Depending on the circumstances, the attorney may want to request more documents in order to review your case.

There are two basic reasons why attorneys ask for the file before deciding whether to accept the case: first, in order to evaluate the case properly, and second, it is a test.

Ab attorney cannot determine whether he or she can help the claimant without reviewing the entire file. Workers Compensation law is complicated and each case is unique.

The second reason for asking claimants to gather the records: it is a test. If a claimant does not have enough motivation to collect the files, then he or she probably doesn’t have enough motivation to see the case through. If he or she cannot or does not follow directions, then he or she will be a difficult client to work with.

So if you are serious about your workers compensation claim, collect the records which are asked of you. All of them.

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.

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The Employee won her case in Lena v Fred Meyer Stores, Decision and Order 16-0135 issued on December 30, 2016.

http://appeals.dol.alaska.gov/docs/workerscomp/2016/16-0135.pdf.

In Lena, Fred Meyers lost both defenses it claimed. First it claimed that the Employee had not timely report her injury. The Board determined that she had reported the injury.

Fred Meyers then claimed that the condition, an aggravation of foot condition that required surgery, was not work-related. It relied upon the opinion of a doctor it hired, Dr. Scot Youngblood, an "independent medical examiner", in which he stated what the Employer hired him to write. The Board discounted his opinion because he didn't understand Alaska’s legal standard.

Under the Alaska Workers Compensation Act, if a work event aggravates, accelerates or combined with a pre-existing condition to create a disability or need for medical treatment, then it is workers compensation injury.

Most importantly, there is no distinction between aggravation of symptoms and aggravation of an underlying condition.  If a work event, even chronic overuse, aggravates symptoms creating a disability or need for treatment, then the injury is workers compensation. The Employee is entitled to have her medical treatment paid for by the Employer and to be compensated for her lost wages.

Keenan Powell has practiced law in 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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Preauthorization usually becomes an issue when you need surgery because a doctor will not perform surgery if someone doesn’t promise to pay the bill. And if you can’t get the insurance company to preauthorize the surgery, you’re stuck. You can’t work without the surgery and you can’t get the surgery.

Insurance companies will sometimes say that they are under no duty to preauthorize medical treatment. That’s not true. In Alaska workers compensation cases, the insurance company has a duty pay all reasonable and necessary medical treatment which is caused by the work-related injury. If they don’t want to pay the bill, the insurance company must justify its refusal.

The right way for the insurance company to do that is to controvert the recommended surgery based upon an EIME report. Sometimes the insurance company will stall preauthorization while it sends the injured employee to an EIME (Employer “Independent” Medical Evaluation) to see if the doctor of their choosing agrees that you need surgery and the recommended surgery was caused by the work injury.  When the insurance company controverts, it should send you a Controversion Notice.

But sometimes the insurance company will just blow you off. That is called “controversion-in-fact.”

In each of these cases, there is something you can do. You can file a claim for medical benefits including obtaining a Board order authorizing the surgery. The claim must be filed with the Workers Compensation Division. http://labor.state.ak.us/wc/home.htm.

If the insurance company is refusing to preauthorize your surgery, you need to find out whether you are being treated fairly. Call an experienced Workers Compensation attorney.

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. www.keenanpowell.com.

All consultations are free.  To make an appointment, use the contact form on this website or call:  907 258 7663.

 

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The Alaska Workers Compensation Act provides that a disabled injured worker is entitled to TTD (Temporary Total Disability) or TPD (Temporary Partial Disability) for the period of time during which he or she cannot work.

TTD is paid when the injured worker cannot work at all.  TPD is paid when the injured worker is working part-time.

These payments begin when the employer, or his insurance adjuster, receives written notice that the injured worker is disabled. This is where a lot of injured workers make their first mistake. They trust the doctor to send the note to the right people. Or they trust a nurse case manager who the insurance company sent to get the note to the right people.

Don’t trust anyone to do your work for you. Doctor’s offices do not routinely send out work releases. They might. But they don’t always do it, nor do they think to do it. The folks at the doctor’s office front counter who process your bill don’t need to see the work release so they probably won’t look for it.

The nurse case manager is an insurance company spy. Her job is not to make sure you get the most you can out of your case. Her job is to make sure the insurance company pays as little as possible. So she has no incentive to ask for the work release and deliver it to the right people.

You need to get a copy of the written work release during your doctor visit. Do not leave the office without the work release. Ask for three copies: one for you, one for your employer and one for the insurance adjuster. Then, drive straight to your employer’s office and deliver a copy of the work release to them. Make a note on your copy of the work release of the date and time when you delivered it and the person you handed it to.

Then drive to the adjuster’s office and do the same thing. Make a note of the date and time you delivered it and who you gave it to. If the adjuster doesn’t have an Alaska office, go to Mail Boxes Etc or the UPS store or the Fed Ex store and fax it to the adjuster with your claim number, if you have it. If you don’t have the claim number, fax it anyway with the name of your employer and your date of injury. Keep a copy of the fax confirmation sheet for your records.

Get a new doctor’s work release every time you go see the doctor. Every time you get the work release, give a copy to your employer and a copy to the adjuster documenting again when it was delivered, as before.

Your first TTD or TPD check is due on the 14th day after the employer received the work release. AS 23.30.155(b). Subsequent payments should be made every 14 days after that. The payments will continue until you go back to work or are deemed medically stable or you are controverted.

If the payments are more than seven days late, you are entitled to a 25% penalty. AS 23.30.155(e). Some insurance companies will voluntarily pay the penalty but the recent trend is that you have to fight for it.  To do that, you must file a claim with the Workers Compensation Division. http://labor.state.ak.us/wc/home.htm.

If your payments are not paid, or paid late or if you are controverted, you need to find out whether you are being treated fairly. Call an experienced Workers Compensation attorney.

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. www.keenanpowell.com.

All consultations are free.  To make an appointment, use the contact form on this website or call:  907 258 7663.

 

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The 2015 Annual Report from the State of Alaska Division or Workers Compensation shows what a big business workers compensation claims are and insurance companies’ trends to improve their profits. The full report is accessible on the Division’s website at: http://labor.state.ak.us/wc/forms/2015AR.pdf

In 2015, Reports of Injury increased 6.5% from to 19,909 reported injuries. Insurance companies controverted 3,682 claims and after cases were filed with the Board, the insurance companies controverted 2,645 claims.

And the insurance companies are often wrong. 1,200 claims were filed in the Division (cases filed after the insurance companies controverted the claim). 614 cases settled after the insurance company controveted benefits and the Employee filed a claim. That’s more than one-half.  Another 164 cases went to hearing.

The point is: when insurance companies controvert benefits, the controversion is not always fair. According to these numbers, in more than half of the cases the insurance companies initially controverted, they later paid out settlements. They would not have done so if they thought they could win the case.

If you have been controverted, you need to find out whether you are being treated fairly. Call an experienced Workers Compensation attorney.

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. www.keenanpowell.com.

All consultations are free.  To make an appointment, use the contact form on this website or call:  907 258 7663.

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The 2015 Annual Report from the State of Alaska Division or Workers Compensation shows what a big business workers compensation claims are and insurance companies’ trends to improve their profits. The full report is accessible on the Division’s website at: http://labor.state.ak.us/wc/forms/2015AR.pdf

In 2015, payments made to injured workers during the reemployment process (“41k”) were down .4 million dollars. Employee evaluations were down .9 million. Plan developments were down .03 million. And job dislocation benefits were up 1.7 million.

Why the push for job dislocation benefits when at first look it seems the insurance companies are spending more money on those benefits than they would have had they retrained the Employee?  The insurance companies are playing the long game in reemployment for two reasons:

First, reemployment can last for up to two years. Spending a little extra in the first year on job dislocation benefits will result in a savings the following year in retraining costs that weren’t paid.

Second, Employees only get reemployment or job dislocation benefits once in their life. By offering a few thousand to an Employee instead of retraining, when he is broke and needs it most, the insurance companies have insured that Employee will never be able to ask for reemployment benefits again. Ultimately, years down the line the savings will be huge.

There has been at least one recent important development in the law of reemployment: the job description which is used when evaluating an Employee’s ability to return to work in the job he was performing when injured. It used to be the Reemployment Benefits Administrator would pick one job description even if that description did not encompass all of the Employee’s duties. That is now against the law, they must consider more than one job description if that better fits the job that the Employee was doing. This difference can be crucial in whether or not an Employee received retraining or job dislocation benefits.

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. www.keenanpowell.com.

All consultations are free.  To make an appointment, use the contact form on this website or call:  907 258 7663.

 

 

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Events in Anchorage this weekend include: the immortal ballet, The Nutcracker Suite, at the PAC, the immortal warriors, Alaska Aces, playing at the Sullivan Arena and the immortal theater experience, Christmas in Spenard, at Hard Rock Cafe.

If you don't want to spend money, there's sledding at Kincaid Park and the various hills around town. The lakes are still a little thin, use caution if you're skating. The cross-country trails haven't been groomed yet so you can still walk your dogs. IceTrailsStatus.

Temperatures are predicts to drop to single digits over the weekend.

Only twelve days to Solstice and counting.

 

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The 2015 Annual Report from the State of Alaska Division or Workers Compensation shows what a big business workers compensation claims are and insurance companies’ trends to improve their profits. The full report is accessible on the Division’s website at: http://labor.state.ak.us/wc/forms/2015AR.pdf

In 2015, a total of 301.7 million dollars of benefits was paid, an increase of 2% over 2014. Medical benefits of $162.5 million and indemnity (temporary total disability, temporary partial disability, permanent partial impairment and permanent total disability) in the amount of $73 million were paid.

There were some interesting changes in the amount of indemnity benefits paid in 2015. TTD (temporary total disability) was down by 4.8 million. TPD (temporary partial disability) was down by .1 million while PPI (permanent partial impairment ratings) were up 2.4 million.

One could infer from these numbers that insurance companies are forcing PPI ratings earlier which in turn terminates the Employee’s TTD or TPD benefits sooner at a huge savings to the insurance companies.  In 2015, the savings to the insurance companies for rushing the PPI rating according to these numbers is 2.5 million dollars!

These numbers are consistent with what I have been seeing . More and more Employees are sent to an “independent” medical evaluation (arranged by an insurance company) where that doctor states that they are medically stable, able to go back to work and have a small, if any, PPI rating – even while the Employee is still in pain and still seeing his doctor for treatment, even while the treating doctors are contemplating surgery or a second surgery.

Although it looks legal enough on paper, so much so that a trusting Employee would not contest the insurance doctors’ statements, the Employee still has rights. He always has the right to fight unfair treatment by the insurance company. Being rushed to a PPI rating is one such example of unfair treatment.

If an Employee is disabled from work and requires medical treatment, he is entitled to TTD or TPD and medical benefits regardless of what the insurance doctor says. The Employee has the right to file a Claim to pursue his rights and to hire an attorney to assist him.

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. www.keenanpowell.com.

All consultations are free.  To make an appointment, use the contact form on this website or call:  907 258 7663.