Q: Will I be treated fairly by the Workers’ Compensation Carrier?
Let me just say this, the interests of a workers’ compensation carrier are at odds with yours. Their job is to provide you with the minimum benefits required by law. It just makes since doesn’t it? They are looking at their bottom line. Our job is to make sure our clients get the maximum benefits provided by law. Don’t get me wrong, there are lots of fair adjusters out there that I am sure are trying to do the best job they can, I have met a few of them. But who do they answer to? If you think it is you, please read on.
The following are just some of the areas that we check very carefully for our clients:
a) Are you getting paid the proper temporary disability rate?
Adjusters are human. They can make mistakes in calculating average earnings to determine the proper rate. Are they taking all your income into account? Are there periods of time when you were cut off of Temporary Disability when you should not have been? Sometimes an adjuster gets a partial report from a doctor and concludes that you have reached MMI (Maxim Medical Improvement) and cuts you off. We go through all the calculations and check the reports. We also have the means to petition the Workers' Compensation Appeals Board in cases where are clients were not being treated fairly in regards to this benefit.
b) Is your doctor treating you fairly?
The insurance companies now “own” the treating doctors now through their “Multiple Provider Networks” (MPNs). Don’t be looking for any favors here. If a doctor gets too liberal with a patient, they run the risk of being expelled from the MPN by the insurance carrier. Often the doctor is just not listening to the patient, nor giving them the benefit of the doubt and ordering appropriate diagnostic studies. We go to court and get treatment issues on track if a client is not getting appropriate treatment.
c) Is your level of disability being fairly evaluated?
To add insult to injury, some of treating doctors are unfairly conservative when it comes to judging your level of disability. They are now directly paid by insurance companies under the MPN network, so they have a reason to be stingy. There is a distinction between a treating and an evaluating doctor. Some doctors simply do not know how to evaluate an injured workers disability within the context of the Workers’ Compensation System. We like to have Agreed Medical Evaluators that we have had experience with decide these issues.