Can A Claimant Refuse Recommended Medical Treatment?

December 29, 2011

Under the New York State Workers’ Compensation Law, an injured worker cannot benefit from unreasonable refusing a mode of medical treatment.  This does not mean that if a doctor recommends a certain course of treatment, that an injured worker must go forward with that specific treatment. However, the appellate division case of Wilkins v. NY [...]

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New Guidelines For Determining Permanent Impairments

December 28, 2011

The New York State Workers’ Compensation Board has announced that in January 2012, they will institute medical guidelines to be used to determine permanent impairments and loss of wage earning capacity. This document, which is 124 pages, changes how permanently disabled claimants will be classified. The guidelines do not change the schedule loss of use [...]

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Medical Impairments Guidelines And New C-4.3 Form

December 27, 2011

Beginning in January 2012, the New York State Workers’ Compensation Board will implement a new method of assessing the level of non-schedule permanent impairment.  The most common types of non-schedule type of impairments involve neck and back injuries among many other types of injuries that may qualify. The new form C-4.3 requires the attending physician [...]

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When Offered Light Duty Work: Beware

December 22, 2011

Under the New York State Workers’ Compensation Law, an injured worker who is able to perform restricted work activities should not refuse any job that fits those restrictions.  Refusing such work can, and usually, will lead to a suspension of lost wage benefits by the insurance carrier. A more complicated issues arises when the insurance [...]

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Home Health Care/Nursing Services

December 21, 2011

Under the New York State Workers’ Compensation Law Section 13(a), home health care/nursing services may be covered.  A statement of medical necessity from the attending physician indicating the nature and extent of the necessary nursing services should be secured and provided to the insurance carrier. In many instances, it is cheaper for the insurance carrier [...]

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Work Related Hip Replacement

December 20, 2011

Work related hip injuries can be caused by a traumatic event or repetitive activities.  Many such injuries or conditions ultimately require total hip replacement surgery. Total hip replacement is an extensive procedure usually resulting in many months lost time for recovery.  Additionally, a significant mobility deficit almost always results. The Workers’ Compensation Board Medical Guidelines [...]

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Permanent Facial Scars and Disfigurements

December 18, 2011

Workers’ Compensation Law Section 15 allows for a monetary award for a permanent facial scar or disfigurement above the neck or extending partially onto the neck area. A medical report indicating that the scar is permanent must be produced before the case is ready for a formal award.  Unfortunately, the maximum award for facial disfigurement [...]

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New York State Workers’ Compensation Law: Proving Causation Issues

December 16, 2011

One of the most common defenses by insurance companies in New York State Workers’ Compensation cases involves issues of causal relationship. In order for medical treatment or lost wage claims to be valid, it must be shown that there is a causal connection to a work related injury. Issues of causation are often resolved through [...]

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Be Honest With Your Physicians

December 14, 2011

A recent trend in New York State Workers’ Compensation claims defense involves insurance carriers alleging fraud because patients allegedly misrepresent their symptoms and abilities at the time of examination. When a Workers’ Compensation claimant treats with his doctor and complains that he or she is in debilitating pain all day, everyday, and that they are not [...]

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Pre-Hearing Conferences

November 30, 2011

Once the insurance carrier filed form C-7 to contest a claim, the Workers’ Compensation Board will review the medical records that have been submitted.  If they believe that the records sufficiently reference a work related condition or injury the next step is to schedule a Pre-Hearing Conference. A Pre-Hearing Conference allows the Judge to review [...]

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