Monday, June 30, 2008
When people wonder why there are delays in handling Social Security claims they have to realize that the agency is handling more claims with less people. Technology may help with efficiency but that is not enough. Service requires people helping people and over the last ten years there has been an actual reduction in personnel despite increasing claims. Here is a link to a story on this which sets forth the actual numbers per year decline in agency personnel. It does make you wonder if getting old or disabled is not a good idea. Click here.
Thursday, June 26, 2008
Effective for all injuries happening after July 1, 2008 a recent law addresses the subject of apportionment. This is where the claimant has a prior impairment and then sustains further injury. The issue caused much litigation so hopefully the new statute will clarify matters. There was one case in Colorado where the apportionment applied to reducing even medical benefits. Imagine re-injuring yourself at a job and then someone saying we'll only pay for half of your medical care due to a prior work injury. Anyway that is gone now. Claimants receive temporary and medical benefits in full even where it is a re-injury or aggravation. But also apportionment still can occur for any permanent impairment if it existed at the time of the latest injury. At the Division of Workers Compensation website they are also working on new rules to implement the new law. For a general overview check it out here.
Wednesday, June 25, 2008
Whether federal disability or workers compensation disability we all expect fairness and justice in the process. That expectation is not realistic. Far too often good people are misinterpreting lip service for reality. Lip service says you should be promptly and fairly treated. If you have an injury you should receive quality care and benefits. If you lose your job you should be compensated. You should be communicated with by the insurer and taken care of by the law. In Social Security you should receive benefits for total disability where you cannot effectively work anymore and it should kick in as soon as possible. Reality? No. Instead 25% of the people with a work injury in Colorado have their claim contested. This means prove it before a Judge and until then you may receive very little if any benefits. A hearing takes a few months to receive but even if successful the insurer can appeal. Starvation and lack of adequate medical care can be a big problem. Even with treatment and some benefits the insurance always looks for the lowest way to calulate benefits. This does not mean the adjuster is mean or being tough on you...it is just a fact that insurance seeks to save money and that can be at your expense. Social Security hearings take months to obtain and it could be years before benefits are coming if at all! Prompt and fair? No way. As Americans we believe in fairness and justice. That is the American way but reality can be quite different from the lip service. Here is a link to one story about how the Social Security office was cut back yet claims were increasing. Sometimes you do wonder if it is a planned effort to end the current system by making it worse then it should be. Anyway here is the link to the story.
Thursday, June 19, 2008
Anyone earning over $61321.00 receives no additional compensation for their Colorado work injury. As of July 1, 2008 the highest temporary and permanent weekly benefit is capped at $786.17. To get that you have to earn $1179.25 a week. If you earn more Colorado says too bad. If you earn less it's 2/3rds of your average weekly wage. So if you earn $600 a week then your weekly temporary benefits would be $400 (2/3rds of $600). What is your average? Add all your overtime and use a common sense approach. The insurer may only use your base pay. Often that is because that is what is told to them by your employer. However your average weekly wage can include overtime and other benefits (especially if they cancel or end your health coverage through work). Your employer or the insurer may decide to only count the last 3 months when that may not reflect a true average. Unless agreed upon you can seek a hearing to question what is a true average for you. However it also does not mean you only count the highest checks you've received. There is a statute on this but really just be sensible and if you are uncertain try to resolve it before seeking a hearing. In any event there is a lid or cap on benefits and for July 1st til next year the figure is set forth above. Also disfigurement is now capped at $4174 or possibly double that if you have extensive and visible disfigurement. It can be less so when I say cap it does not mean that is what you get. You may have a very minor scar and receive only a few dollars.
Thursday, June 12, 2008
The Office of Administrative Courts is where they handle workers compensation cases that are disputed or contested in the sense that they need a hearing. For example if the insurance is contesting the claim then you may have to go to a hearing. Or, you disagree with something and wish to make an issue of it for a judge to decide then it may need go to a hearing. Issues can be over temporary benefits, medical benefits, permanent benefits and much more. Perhaps you seek to change doctors and the insurer won't agree or maybe the average wage they have for you is too low so you feel it is shortchanging your benefits. Hearings are needed in many different types of disputes. Unfortunately some people do not have an attorney. If so they must try to do it themselves. The websites maintained by the Division of Workers Compensation and the Office of Administrative Courts have set forth their rules (yes there are rules at both websites) and other information for you. At this webpage the Office of Administrative Courts has provided information on representing yourself at a hearing. You can view it right here.
Tuesday, June 03, 2008
On June 2, 2008 the Colorado Supreme Court issued a decision which addresses the right of the insurer to compel the production of tax returns. It was not a workers compensation case but the issue of trying to obtain such records does come up in workers compensation cases too. So the decision is important whenever the insurer seeks your tax returns. As noted by the court tax returns contain much information about a person. Aside from income the returns disclose personal information, debt information, investment information and much more. Often it can be considered by a plaintiff or claimant attorney as a "fishing expedition" into a persons private life. In this case the insurer sought an order to compel the turnover of several years of records in an auto accident case. The order was granted and when it was appealed the highest Colorado court said the order was not proper. The burden is on the insurer to show the discovery of any tax returns is relevant to an issue and there is a compelling need which cannot otherwise be obtained elsewhere. Finding the order was overbroad the court sent it back for application of the test it set forth in its decision. Further it also can mean that even if the returns can be relevant and needed it can still mean limiting full disclosure of the returns. A Judge can edit the disclosure. So whenever a workers comp insurer seeks your tax returns this case may be important to the issue. Read it by clicking here.