COULDA WOULDA SHOULDA By Joe Miller, Esq. Yet Another Reason You Should Not Wait to Hire an Attorney for Your Workers’ Compensation Claim
Recently, we started working with a woman who hired us long after her work accident and after she had already undergone surgery. We were, at first, somewhat reluctant to accept the claim, because we recognized that the surgeon who treated her was notoriously a “puppet” of the insurance companies. Despite that, we hoped that we could move forward, since this doctor did, in fact, elect to operate on this woman. As is typical after we become involved, we wanted to ensure that the client remained covered under her workers’ compensation claim, even after she would be released to light duty. Accordingly, we were about to proceed with filing her claim for benefits to begin that process, so we could get her under an award order from the Virginia Workers’ Compensation Commission. Up until that point, it appeared the workers’ comp insurance company had been voluntarily paying her medical bills; however, they had not been providing this woman with any workers’ compensation weekly checks. Unfortunately, shortly after we began our representation, we received a “laundry list” opinion letter from the defense lawyer that was meticulously filled out by the “puppet” surgeon. What I mean by “laundry list” is that the defense lawyer had gone through each and every possible question that she could ask the physician to help the defense, looking for particular answers that would basically destroy our client’ s claim. And of course, this insurance industry physician did not disappoint. The physician said that the entirety of our client’s injuries were the result of pre- existing arthritis and that there were no mechanical changes of any kind that were caused by the work accident.
I have no doubt that if we had been advising this unfortunate woman at that crucial juncture in her claim, we could have steered her to a more neutral and fair surgeon to choose out of the three- doctor panel, who would likely at least been able to give an opinion that some portion of our client’s injury was due to the work accident. That would have been sufficient to keep the claim compensable, obtain an award, and likely would have led to a substantial settlement for our client. At this point in the claim, after the specialist had already become our client’s authorized treating doctor and already operated
After this letter was sent to us by the defense attorneys, we had no choice but to withdraw from the claim and advise our client that there was really nothing more we could do for her. Fortunately, she did have short-term disability insurance coverage, as well as private health insurance.
on her, there was no way to go back and obtain a panel. It was way too late, and we were essentially stuck with the authorized doctor’s opinion. The moral of the story: Do not wait to hire an attorney if you have a workers’ compensation claim. You
How did this occur and why could we not help her?
What had happened is that long before we became involved in the case, the workers’ compensation insurance company had initially told this woman to be seen at their go-to medical facility. That facility, in turn, referred the claimant to the puppet surgeon who operated on our client and also utterly ruined her claim. Had this woman hired us initially, we would have advised her that the medical facility had no right to make a direct referral to the insurance-friendly surgeon specialist. She was entitled to a three-physician panel from which she could have chosen a different surgeon. Although there is certainly more than one local doctor who is insurance-friendly, it just so happens that none is quite as bad as this particular physician.
must be fully aware of your rights every step of the way, because the employer and insurance company are under no obligation to inform you of those rights. There are deep holes full of quicksand all over the place for your claim to fall into. This story is just one of them!
2 | www .J oe M iller I njury L aw . comjoemillerinjurylaw.com
Made with FlippingBook - Online Brochure Maker