I spoke with someone earlier this week who had waited five weeks for the doctor to review his MRI. The caller suffered a work-related injury. He was seeing a doctor authorized by work comp. He underwent an MRI. Now, he is sitting and waiting to hear the results. It’s a slow process in normal times. Even in normal times, our injured neighbors wait too long for treatment. These are NOT normal times.
Our attorneys answer workers compensation questions for callers on a daily basis. We’ve compiled some of the most frequent questions to create a Workers Compensation FAQ page on our website. If you cannot find your question on that page, let us know. We are happy to discuss the issue with you. Our consultations are always free.
In these strange times, what are some ways the coronavirus may affect your work comp claim or treatment? Here are four ways the coronavirus may impact your claim:
You wait for the insurance company to authorize a doctor. Then, you wait for an appointment. If the doctor prescribes treatment, you wait some more for approval by the insurance company. Your calls to the adjuster or case nurse are NOT answered. These are problems in normal times!
It’s a vicious cycle. We could improve the work comp system if our legislature would add some penalties for insurance company delays. I’ve discussed this issue in prior posts. I won’t hold my breath waiting for help from the Alabama Legislature!
Our office takes a proactive approach. We stay involved in medical care to try and speed the process for our injured clients. Whenever possible, we work with doctors and clinics to obtain medical care. When needed, we go to court and force the insurance company to provide treatment. Injured workers are not the only ones frustrated by insurance company delays. Some adjusters delay responding to the doctors as well. Through the years, many doctors have spoken with us about insurance adjuster delays.
Again, these are NOT normal times. Our medical professionals face huge challenges fighting the coronavirus. Many medical professionals are risking their own health to help our neighbors. Will the coronavirus further slow your medical treatment? Yes, it probably will.
What can you do? First, be patient. Remember your doctors and staff are dealing with this new reality as well. When you speak with them, be kind and patient. I understand it’s hard to be patient when you are hurting. Doctors and nurses are humans. Like all humans, they often remember who is patient, kind and helpful. They also remember who is difficult and unreasonable. It can impact their opinions and treatment. If needed, you can consider letting a spouse, relative or close friend handle calls for appointments.
Second, be aware of the coronavirus protocols in place from your doctors. Many doctors are running their offices with special protocols. Some are consulting patients by telephone. Some are operating with special hours. Most have waiting room protocols to minimize exposures. Find out the protocols and work within them to move your treatment forward.
If you are hurt on the job and unable to work while healing, you may be entitled to temporary total disability (TTD) benefits. Maybe you are currently receiving TTD benefits. Many of our injured clients are receiving TTD benefits while trying to recover and return to work.
Yesterday, a doctor placed one of our clients at maximum medical improvement (MMI). When you reach MMI, the work comp carrier will terminate your TTD benefits. At that point, you may be totally healed. Or, your disability / impairment may be permanent. If you have a permanent issue, you may be entitled to additional work comp benefits. It’s usually at this point that we can really fight to get our permanently injured clients the benefits due them.
Will the insurance adjuster take advantage of the coronavirus to stop TTD benefits? That’s a real worry to us. In normal times, some insurance carriers will stop benefits for the least little ridiculous excuse. Miss an appointment? Some carriers will claim you are refusing treatment and stop benefits. Fail to return to work for any reason? Some carriers will stop benefits despite your ongoing disability.
We are closely monitoring our work comp cases because of the potential that an adjuster may use the coronavirus as an excuse to stop benefits. If this happens, we can talk out the issue with you. If you are still restricted by the doctor from work and receiving care (even if slowed by this health crisis), you should still be receiving your TTD benefits.
“The adjuster won’t call me back.” If I had a nickel for every time someone contacted us with this problem, I could retire. First, let me say the problem is not unique to you. Some adjusters are never available and never return phone calls. I routinely hear from doctors and nurses who cannot get the adjuster to call them and approve treatment.
Is the lack of adjuster response intentional? In many cases, it is. In other cases, the insurance company is short-staffed. You suffer from this lack of response.
This is a problem in normal times. And, insurance companies should be penalized for the issue but they are not.
I would provide the following advice. One, the adjuster has NO EXCUSE for not returning your call and should not blame matters on the coronavirus. Most insurance companies have their adjusters continuing to work remotely. They are available. They have phones. Insurance adjusters can, and should, return your phone calls. Two, do not lose your cool with the adjuster. It’s easy when you are hurting to lose your cool and leave a nasty message. Don’t do it! That message can be used against you. Or, the adjuster may just use it as an excuse to never call you back. Try your best to stay cool. We evaluate this issue on a case-by-case basis. In many cases, we will handle the calls or suggest a family member handle the calls. That way, someone hurting severely does not have to deal directly with a bad adjuster. In many cases, we put our communications to adjusters in writing and take action when responses are delayed. You have options and we are happy to give you some advice if you are dealing with this situation.
Maybe you’re familiar with the Tom Petty song. He sings, “the waiting is the hardest part.” When you are hurt on the job, waiting is a definite problem. You wait for everything. Authorization to see the doctor. Medical appointments. Disability checks. An answer to whether you can return to work. All involve needless waiting!
With Covid-19, you can add temporary courthouse closures to the list of waiting. Some law firms have also temporarily closed. Yet, you should not have to wait for a basic legal consultation.
At the Blackwell Law Firm, we have taken steps to remain open and operational. Some other firms have as well. We are staffed with a lawyer to answer questions on the phone. We are staffed with a paralegal for case support. We are also equipped for videoconferencing. In the last couple weeks, we have interviewed new clients by both telephone and videoconference. We provide advice to callers with questions every day. We have conducted teleconference mediations. We have even settled and resolved claims during the current crisis. For our filed cases, we have used the court closure time for study and preparation. The current health crisis requires some temporary modifications. But, you should not have to wait for basic advice. You should not have to wait to discuss your legal issues. The coronavirus may slow the process of completing your claim but it should not stop you from getting the timely advice you need.
From its office in Huntsville, the Blackwell Law Firm helps people with serious personal injuries across Alabama. We focus on providing the hard work and preparation needed to build your case.