Tuesday, July 31, 2007

Social Security Average Wait 17 Months!

Here is a link to a USA Today article that points out the average wait time for a hearing to appeal a Social Security disability denial is now 17 months. Staffing is down and claims are up so this makes for problems. Please realize this can be solved by Congress and the President providing more funds for the Social Security Administration. The fact is that it is not happening, at least not yet. Political change and a social willingness to deal with this...making it a priority is needed. To know we are a great and free country but cannot take care of our old, disabled or injured is unfortunate. So pay attention to those seeking your vote...what plan do they have to solve this?

Friday, July 27, 2007

New Court Case on Apportionment

In Colorado apportionment relates to reducing a permanent impairment calculation or reducing benefits because of previous impairment(s). The law has changed by caselaw and statute over the years. The issue remains a complicated one. In this case the claimant had multiple back problems but returned to work until his latest injury. His treating doctor did not apportion but the DIME doctor did. A DIME is a Division Independent Medical Examination and has special value and weight in a workers comp case. Here the DIME doctor reduced the impairment rating because of what he considered some prior impairment that allowed apportionment. The claimant appealed and in this Court of Appeals case tried to assert this was wrong and there should be no apportionment. The case is troubling in that there was no actual previous impairment issued in his prior injuries. Also he was working without further treatment or symptoms from those prior injuries. The claimant argued how can it now count against him? Nonetheless the Court ruled that apportionment was proper and that it is more a matter of there is not enough evidence to overturn the DIME opinion to apportion. I do understand that this is a complex matter but I have to question the speculative nature of a DIME doctor finding prior impairment when there was no documented or objective evidence of prior impairment. In any event here is a link to the court decision just issued on July 26, 2007:

Wednesday, July 25, 2007

Medical Ops....UPDATE!

Yesterday a Denver station Channel 7 noted that Medical Ops Management is now out of business. Here is a link to the full article:

This pertains to doctor examinations going through the above noted company. It has been alleged that doctor reports were altered or changed without approval by the doctor. Since this can affect the treatment and outcome of cases it was a very serious matter as reported by this station.

Tuesday, July 24, 2007

Attorneys do make a difference!

One statistic kept by the state of Colorado shows that having an attorney does make a difference in the amount of your benefits. On average a decent attorney can increase your compensation by around 150% when compared to not having an attorney. In some cases this is much much higher. Insurance companies rarely admit someone is totally disabled and here the difference can be huge. One recent case resulted in $180,000.00 additional dollars or 4 times more then first offered. In other cases the workers comp doctor may say the person is released without impairment only to be proven wrong. This can lead to both medical and dollar benefits. The injured worker is led to think the doctor said he is without impairment so the case seems worth little. Turns out more treatment is needed and likely far more dollar benefits then zero! You'd be surprised how many people seek out an attorney when they are denied further care and simply want to get well. So while there are no guarantees attorneys frequently do make a big difference in most cases. In any event here is the stat on attorneys as of the year 2004...click here.

Monday, July 16, 2007

National Health Care?

Health coverage under workers comp is variable. One plus is that for covered and reasonable care the benefit is 100% coverage as long as necessary. The problem is that insurers often deny coverage for one reason or another and this can slow down or eliminate needed medical care. Also you go to one doctor for your injury, another for your overall health and must deal with varying coverages. VA, Medicare, Medicaid, perhaps even coverage under auto policies and a great array of insurance companies all with their own set of rules and payment plans make our current health care system terribly inefficient. To limit benefits is to ration them so the cry that we have the best health care system is questionable. Lately I've come around to accept that drastic change is called for and so have others. Even physicians have a website that promotes a national plan. While I strongly believe in free enterprise I realize the current hodgepodge is not working. One recent proposed law to allow Medicare to negotiate drug prices like the VA does failed and so lower drug prices for medicare beneficiaries was denied. To me that is not free enterprise it is favorable treatment for the drug companies. In any event here is the link to the Physicians website with various articles on healthcare:

Tuesday, July 10, 2007

Less Hearings and Applications for Hearing

According to the Division (Workers Comp) website it appears very clear that over less then ten years there has been a dramatic decrease in hearings and even hearing applications. There may well be many factors to explain this but the stats speak for themselves:

1997 : 12840 hearing applications were filed; actual hearings held were 1987

2006 : 9595 hearing applications were filed; actual hearings held were 1166
By the way the population of Colorado increased ten percent in the last ten years.