Practice Areas

• Workers' Compensation
• Personal Injury
• Social Security Disability

Firm News

• When the injured worker returned to work he was immediately fired...
  
• Workers' Compensation: The IC ruled that the employer, who willingly paid the medical claim and workers comp for the employee's foot injury, must also pay for pain management because this injury aggravated the employee's pre-existing fibromyalgia and hypertension and was now considered a chronic condition. Although it is tough to win these claims we can usually do it if we the treating physician will agree that the pre-existing condition is worse now than it was and that this change is due to the worker's comp accident....
  
• Workers' Compensation: The Industrial Commission denied the employee's claim for temporary partial disability compensation. The Commission ruled that the reduction in wages that our client received was because of problems with the company's workload due to the economy. It was determined that he didn't receive less pay because of his injury or from the less-paying job within the company that he had to take because of the injury....
  
• Workers' Compensation: The NC Industrial Commission determined that the employer was required to pay our client's medical bills and also continue workers' compensation payments until our client could find a job with his limited physical capabilities. The employer was unable to find work for him at the company and he was fired, which was unacceptable, although it was explained by the employer as happening because of excessive absences....
  
• Workers' Compensation: The North Carolina Industrial Commission threatened to hold CNA in contempt of court because they refused to authorize the medical tests which would prove that the plaintiff was unable to do his job. This was a classic example of an adjuster getting an opinion from a reliable doctor and then refusing any other evaluation which could help the injured worker....
  
• Workers Compensation: The North Carolina Industrial Commission held that National Benefits Association had wrongfully denied this claim for more than a year...but only when the Industrial Commission finally heard all the evidence -- that the employer admitted that they knew the plaintiff was hurt, that they had sent him to a doctor but didn't follow his direction, and that there was no way our client could do his job with his severely-injured back....
  
• Workers' Compensation: North Carolina Industrial Commission says Liberty Mutual must provide yardcare and housecleaning to an injured brickmason....
  
• Workers' Compensation: North Carolina Industrial Commission rules that a restaurant dishwasher who slipped and fell, and was taken straight to an emergency room has proven that he was injured on the job....
  
• Workers' Compensation: North Carolina Industrial Commission finds that Diebold and Broadspire MUST pay weekly benefits even after they fired the injured worker from her "light duty" job....
  
• Workers' Compensation: North Carolina Industrial Commission rules against The Hartford Insurance Company and holds that a nurse who was still on her employer's property when she was hit by a car is within the course and scope of her employment and entitled to workers' compensation benefits....
  

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Library

Workers' Compensation

• Psssst! Who's that following you?
• NCIC Form 25T: Mileage Reimbursement form
• Form 28T: Notice of Termination of Compensation by Reason of Trial Return to Work
• Form 33R: Response to Request that Claim Be Assigned for Hearing
• 10 Things Your Insurance Adjuster Won't Tell You (download)

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"The quick response and action by Justin Wraight when my case came to a critical point was impressive."

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"Everybody was totally straight forward with me.  I didn't feel like I was just paperwork to them."

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DISCLAIMER: Please note that every case is different and these verdicts and settlements, while accurate, do not represent what we may obtain for you in your case.

This Illustrates the Options You Have When You Reach Maximum Medical Improvement.

The Case: "Maurice" injured his back when he was pushing loaded carts at his hospital job. His workers' compensation adjuster accepted the claim without delay and always paid Maurice on time. Although Maurice lived near a university hospital, the adjuster had him get treatment from a doctor in the next county over. Maurice started to complain about it, but he was pretty grateful that the adjuster was providing medical treatment and weekly checks. He'd heard horror stories from other injured workers so he decided to be happy with what he had.

Maurice's back didn't get better quickly. He went through physical therapy, had injections and finally had to have back surgery. Only a few weeks after his back surgery, the insurance company's doctor released him to return to work with 25-pound lifting restrictions, 50-pound restrictions on pushing and pulling, and a 10% permanent partial disability rating to his back.

Maurice didn't think he was really in shape to go back to work, but the doctor assured him that he was. Maurice asked his adjuster if he could get a second opinion. To his surprise the adjuster said "sure" and even offered to set it up for him. Maurice went to see the other doctor who had an odd office out by the airport and didn't appear to have a lot of patients waiting to see him. Maurice began telling him about the difficulties he would have returning to work. At this point, the doctor cut him off saying that the second opinion was only for a rating and not for any return to work issues. Flustered, Maurice asked if he could call the adjuster real quickly. The doctor agreed and Maurice managed to get the adjuster on the phone. "Yes," the adjuster stated, "the second opinion is only on the rating. That's all the law of the North Carolina allows. I wish there was more I could do for you, but it's the law." The doctor then gave Maurice a 5% rating to his back.

Fortunately, Maurice's employer said they would accommodate him at a new job which didn't require lifting over 25 pounds. Unfortunately he was going to have to take a $3.00 an hour pay cut to do so. The day before Maurice was scheduled to start work again, his boss called him in. Sitting on the desk was a Form 21 which the insurance adjuster had sent over to the company. It provided that Maurice would be paid for a 7.5% rating to his back, or 22.5 weeks of his compensation rate. The adjuster had sent a note along with this explaining that North Carolina law required her to average the two ratings together and that as soon as Maurice signed the Form 21 she could get him his settlement money. Maurice signed as his boss and the adjuster asked him to.

Within a couple of weeks on the new job Maurice was having real trouble with his back again. The adjuster didn't respond to his telephone calls and so he came to us.

Here's what we did: We explained to Maurice that his adjuster had taken advantage of him by getting him to sign the Form 21. His wage loss would pay a great deal more than the rating would, and quite frankly, we weren't even sure that he could do this job.

We immediately checked with the Industrial Commission. Unfortunately the Form 21 had already been approved. Our next step was to move to reopen the claim. This requires a change of condition which in back claims can be very tricky. As we expected, the adjuster declined to reopen the claim and announced that she thought Maurice might have a new claim for a new onset of back pain that would have to be investigated. What the adjuster didn't say but we knew full well, is that any new claim would be at the reduced wage rate.

We wrote to the doctor asking his opinion regarding Maurice's new symptoms. At the same time we arranged for Maurice to be seen by a different doctor entirely. At this point we got the break we needed. The newest doctor felt that this was all a continuation of the original injury, and Maurice should be out of work. The insurance adjuster balked at this but didn't take advantage of the opportunity to further direct Maurice's medical care. The result was that we were able to build up a substantial amount of evidence supporting Maurice's position that he should be drawing weekly checks again.

We requested a hearing before the Industrial Commission. Following the hearing, we took depositions of each of Maurice's doctors. During these, we were able to persuade the physicians that Maurice's current condition was nothing more than a change of his old condition. The insurance company quickly settled with Maurice.