medical treatment

Published on: October 14, 2019

Is The Case Nurse A Helpful Friend Or Insurance Company Investigator?

Case nurses are common in Alabama workers’ compensation cases. Many insurance companies use case nurses to “assist” with medical care.

If you suffered a work-related accident and injury, the work comp process can be challenging. Maybe frustrating is the better word.

Suddenly, you have a serious accident. Your life changes immediately and drastically. When can you return to work? When will you heal? Can you take care of your family? You are hurting and you are worried. Now, you are leaving messages for an insurance adjuster or sitting in waiting rooms simply to see a doctor.

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Published on: July 1, 2019

How Work Comp Ignores Chronic Pain

By Jeff Blackwell

I read an interesting article last week in a work comp blog where the author asks the question: What’s Next for Pain — Pharma? The author then discusses available medications he believes could serve as alternatives to prescription opioids. Opioid abuse is a major issue nationwide.

The article’s author is an executive at a pharmacy benefit manager (PBM) in the work comp industry. I started the article with a little bias and hesitation. If you work for a PBM, your main concern centers on prescriptions — reimbursement and cost. After suing a different PBM several years ago, I developed a healthy degree of skepticism as to whether drug payers are really interested in patients. I don’t say that to judge the author or his company.

I will say this author begins with the right issue. He points out that as opioid prescriptions decline, providers and payers have not embraced other treatment modalities. That is an important issue for injured people suffering chronic pain. We must address and treat hurting people. The author then discusses several alternative medication therapies. I represent many injured workers facing chronic pain. So, the discussion of alternative treatments peaked my interest.

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Published on: June 17, 2019

Who Does The Company Doctor Serve?

By Jeff Blackwell

You suffered a work-related accident. You properly reported the accident to your company. You did everything correctly. Now, you expect work comp to provide medical care. After all, that’s how workers’ compensation should work. If you are like most people, all you really want is to heal as quickly as possible.

What happens next? Many companies have an occupational doctor or medical clinic to treat injured employees. Some people call them “gatekeepers.” Some of these “gatekeepers” wrongly and unjustly try to lock the gate to real medical care. In northern Alabama, we have just a couple clinics that handle almost all initial workplace accidents and injuries. These occupational clinics are supposed to treat injuries. Their doctors are supposed to help you. Don’t doctors take an oath to help their patients?

Most doctors take their responsibility seriously. Most doctors care deeply for their patients. I know many doctors who do. Yet, these few gatekeeper occupational clinics are NOT like most doctors. These clinics work for industry for a reason — Cost Savings. Fewer recorded injuries means cost savings. Less medical treatment means cost savings.

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Published on: May 13, 2019

Will Legal Marijuana Impact Workplace Injuries In Alabama?

By Jeff Blackwell

I’m not writing to debate the pros or cons of medical marijuana. I’ll leave that to others. It’s a debate playing out in many states. Last week, two Alabama Senators (both of whom are doctors) debated the topic in the Senate chamber. One Senator, an anesthesiologist, debated in support of medical marijuana. The other, an obstetrician, debated against it. The Alabama Legislature has been debating bills that would allow medical uses.

Again, I’m not writing to debate the proposed legislation. My blog deals with Alabama personal injury issues. How would legal marijuana impact Alabama workers’ compensation claims? I believe the issue intersects personal injury law in a number of ways. From car wrecks to work comp, it’s an issue that will impact claims. For today, let’s talk about possible impacts on work comp.

Impairment or intoxication from drugs and alcohol can be a defense to work-related injury claims in Alabama. While substances like alcohol may be legal (for adults), a delivery driver who injures himself in an accident caused by his own drunk driving is not going to receive full work comp benefits.

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Published on: April 29, 2019

Medical Bills Raise Many Questions In Personal Injury Cases

By Jeff Blackwell

When I write a legal article, I never know whether it will gain reader interest. Some of the legal topics I find most fascinating, gain little or no reader interest. I’m often surprised at the articles generating the most readership and commentary.

One topic that always generates questions and commentary — Medical bills in accident and injury cases! I understand why. Medical bills are confusing and difficult to read. Every medical provider uses a different billing format. The charges vary widely. Who would think different hospitals could charge hugely different amounts for the same over-the-counter pain pill? Yet, they do.

On top of the medical charges, add the issue of health insurance and payment. Who pays? Blue Cross. Medicare. Tricare. Medicaid. Some other health plan. How much do they pay? Face it, each health plan pays differently. Most patients are confused by their medical bills when there is NO issue of any accident claim or lawsuit. I get it.

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Published on: April 1, 2019

When The Work Comp System Fails Injured Workers

By Jeff Blackwell

A recent news article tells the story of a severely injured worker in Florida. It’s an all too familiar story. It’s a common story we frequently see in cases across Alabama.

What happened? A sudden workplace explosion! An employee badly injured and badly burned. Days and nights in the hospital followed.

Life after the hospital is often difficult for injured workers seeking treatment. The worker and his or her family are often left trying to navigate a maze of doctors, case nurses and insurance adjusters. For many injured workers the process is beyond frustrating.

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Published on: March 25, 2019

Proposed Alabama Legislation Would Correct Hospital Lien Injustice

By Jeff Blackwell

You suffer injuries in a car accident. Paramedics arrive at the scene and carry you to the local hospital. When you arrive at the hospital, you provide your health insurance or Medicare information. You assume the bill is covered. Wrong. A few weeks later you receive a “hospital lien” in the mail. What?

Why is the hospital filing a lien against you and your car wreck claim? Why did the hospital refuse to bill your health insurance or Medicare? After all, you paid premiums (probably for years) for your health coverage. You paid premiums so you would have coverage when needed. I’ll tell you why the hospital refused to bill your insurance and filed a lien. Greed.

When you seek hospital treatment, the charges are inflated. Sometimes, they are greatly inflated. The hospital charges you inflated amounts knowing it will accept less (a reasonable amount) from health insurance. Look closely at your hospital lien paperwork! The hospital did NOT file a lien for the reasonable amount it always accepts from insurers or Medicare. No. The hospital filed a lien for the full, inflated charges. When you have an accident claim, Alabama law allows hospitals to file liens against your eventual settlement or recovery. Under existing Alabama law, the hospital has a right to collect those inflated amounts from any settlement of your car accident claim. So, hospitals often choose to file a lien rather than submit the bills to your health insurer.

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Published on: March 4, 2019

When Injured Workers Choose Health Insurance Over Workers Compensation

By Jeff Blackwell

A new study by the Workers Compensation Research Institute (WCRI) asks whether employees injured at work are more likely to file under workers’ compensation instead of group health insurance when their group health plan has a higher deductible. That’s interesting but it misses the real issue. The real question is why an injured worker would ever consider seeking medical care outside the workers’ compensation system at all. Really? Workers’ compensation systems were enacted in Alabama (and other states) to provide basic benefits like medical treatment. If those systems worked as intended, this would be a non-issue. Yet, workers consider using private health insurance because the work comp system has largely failed its primary purpose.

I speak with injured workers on a daily basis. Almost all of them have one goal. They want to get better and resume their normal life with work and family.

The WCRI research article wrongly frames the issue as a decision based simply upon medical deductibles. Let’s really examine why an injured worker would consider private health insurance (instead of work comp) in the first place. Injured workers should face NO barriers obtaining necessary medical care under workers compensation. But, they do. Those barriers are substantial and unjust. Here are three big ones:

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Published on: February 4, 2019

Eight Mistakes Personal Injury Victims Make With Their Doctors (Part 2)

By Jeff Blackwell

Last week, I began discussing eight mistakes personal injury victims make during medical visits. You can read the first four mistakes with my advice, here. Today, I’m going to finish this topic with a discussion of four more mistakes. My hope is that you make the most of your visits and the treatment offered you. Your health and healing should be your top priority. With that in mind, here are four additional mistakes with my commentary about each:

V. Stopping Treatment Before Completion

This issue frustrates doctors. The doctor recommended a course of treatment because he or she felt it necessary to treat your injury. You should complete treatment. If you do not want to complete a specific course of treatment, you should talk with your doctor. Do not simply quit.

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Published on: January 28, 2019

Eight Mistakes Personal Injury Victims Make With Their Doctors (Part 1)

By Jeff Blackwell

Doctor visits can be uncomfortable and unfamiliar. You worry about treatment, recovery and cost. You worry about missing work or other activities. You wait for an appointment (maybe a long time). When you finally see the doctor, he or she is very busy. You are rushed to an examination room and have just moments to discuss your injury. The whole process is stressful.

I spend a lot of time reading about doctor visits from the medical records. In personal injury cases, the medical records are critical. Documentation is key. If you have a workers’ compensation claim, the insurance carrier will only approve prescribed treatment if the medical documentation supports it. If you have any type of personal injury case (whether car accident, workers’ compensation or anything else), the insurance company will only factor issues into its settlement offers if the documentation justifies them. If your claim eventually goes to trial, you will need the doctor’s testimony. When the doctor testifies, he will likely stick to the facts and issues documented in the medical records. Documentation is essential at every stage — Treatment, Negotiation and Trial.

At every visit, the doctor documents your history, treatment and condition. Because of that, an open and honest dialogue is essential. You need to pick a skilled and caring physician. Then, you also need to communicate properly regarding the injuries and treatment.

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