Aug 25, 2012 | Uncategorized, Workers' Compensation
In order to win a denied workers’ compensation claim, the claimant must show the alleged injury arose out of and in course and scope of employment. This burden of proof usually requires the submission of medical evidence from a doctor or other health care provider relating the injury to the work accident. South Carolina law [Section 42-1-160(g)] defines “medical evidence” as “expert opinion or testimony stated to a reasonable degree of medical certainty, documents, records, or other material that is offered by a licensed health care provider.” For years, the use of a “check the box” questionnaire has been used by workers’ compensation claimants’ attorneys. The letter format is much less expensive than scheduling a doctor’s deposition, and treating physicians have become used to receiving these requests for virtually all of their workers’ compensation patients. However, as claims are increasingly being defended more aggressively by insurance companies, many are now starting to question their sufficiency as “medical evidence.”
Questionnaires are customarily used in claims where there is a dispute as to the causal relationship of an alleged injured body part; where there is a question of whether the claimant has reached maximum medical improvement; whether additional medical treatment is necessary; and/or where a prior medical opinion has been changed or even reversed. The questionnaires themselves typically consist of three or four short statements regarding the issue(s) in dispute and then provide “boxes” the option to check “yes” (to agree) or “no” (t0 disagree) with the question posed. However, the questionnaires almost never seek further elaboration from the health care provider of how the opinion was reached or what objective medical evidence was used to base the opinion offered. Hence, the dilemma. While the claimant has technically complied with the statute and produced an opinion from a health care provider, stated to a reasonable degree of medical certainty. However, there is no real foundation offered for a hearing Commissioner to consider the sufficiency of the opinion.
To date, the Commission has not issued any regulation nor given guidance on the use of these medical questionnaires. For now, the questionnaires remain admissible as “medical evidence” at a hearing. But, it appears that the sufficiency and probative value of “check the box” questionnaires will be the subject of defense challenge in the future. Better make sure your lawyer’s questionnaire is clear and shows a basis for the opinion being offered.
Robert J. Reeves of Reeves, Aiken & Hightower LLP has practiced workers’ compensation law for over 23 years. His first seven (7) years was as an insurance defense attorney. He has proudly represented injured workers and their families in York County since 1996. Prior to becoming a lawyer, he was a Registered Nurse (RN). Given his insurance defense and nursing background, Mr. Reeves understands and has successfully prosecuted all types of complex, serious injury claims. He stands ready to fight for you and your family during this difficult and scary time in your life. Call him directly today on his mobile phone 704.351.7979 for a private consultation about your particular circumstances.
Aug 16, 2012 | Uncategorized, Workers' Compensation
While great strides have been made in workplace safety, in factories, mills, harbors and every other workplace, injuries on the job causing amputation or requiring amputation still occur. Whether the amputation is caused by a drill press, powered conveyor belt, unshielded or unguarded mechanical power press, power press brake, roll-forming or rollbending machine, food slicer, meat grinder, meat-cutting band saw, printing press, milling machine, hand tools, like shears, grinders, and slitters, or forklifts, doors, or trash compactors, the workers’ compensation recovery is based off of the same factors: time temporarily disabled, type of amputation injury suffered, and permanent total disability or permanent total disability rating.
The workers’ compensation amputation injury recoveries for a given type of amputation injury are calculated by multiplication of a statutory number of weeks times 2/3’s of the average of the worker’s weekly salary over the four quarters before the accident. Below are the maximum recoveries for amputation injuries in workers’ comp, given in weeks and multiplied by the maximum allowed average weekly salary of $705.
- Thumb – 65; Max: $45,825
- Finger – Index (1st) 40; Max: $28,200
- Finger – Middle (2nd) 35; Max: $24,675
- Finger – Ring (3rd) 25; Max: $17,625
- Finger – Little (4th) 20; Max: $14,100
- Toe – Great 35; Max: $24,675
- Toe – Other 10; Max: $7,050
- Amputation: Below 1st joint – Entire Digit
- Amputation: Above base of nail – 1/4 wks; Max: $176.25
- Amputation: Above 1st joint – 1/2 wks; Max: $352.50
- Hand – 185; Max: $130,425
- Arm – 220; Max: $155,100
- Leg – 195; Max: $137,475
- Foot – 140; Max: $98,700
Rock Hill Workers’ Compensation Attorneys
If you have been injured or killed in an accident on the job, call the South Carolina Workers’ Compensation attorneys of Reeves, Aiken and Hightower at 877-374-5999 to talk to an attorney who can help you understand and evaluate your claim and help you get the best recovery possible.
Aug 8, 2012 | Uncategorized, Workers' Compensation
The South Carolina Supreme Court just published a new opinion on what an interlocutory appeal is for the purposes of Workers’ Compensation appeals. Bone v. US Food clarified the existing case law and establishes plainly that to appeal a Workers’ Compensation case there must have been a “final judgment,” not merely a judgment “affecting the merits.”
In this Workers’ Compensation case, the Workers’ Compensation Commission at hearing ruled that Bone’s injury was noncompensable. An appellate panel of the Workers’ Compensation then upheld the decisiob. Bone then appealed to the Circuit Court (today the appeal would have went to the Court of Appeals, but then the first appeal went to Circuit Court). The Circuit Court overturned the Commission, ruling that the injury was compensable and remanded for determination of damages. Employer then appealed this decision to the Court of Appeals which ruled that the appeal was impermissible as an interlocutory appeal not allowed by the APA. Employer appealed this decision to the Supreme Court which affirmed.
The issue at the Court of Appeals and the Supreme Court was whether the final judgment rule applied to appeals of an appeal. The majority decided yes; the dissent decided no. The majority’s position was that the final judgment rule applied both to appeals from the Commission and appeals from judicial branch review of a Commission decision. The dissent disagreed arguing that that to appeal from judicial branch review only a judgment affecting the merits was necessary.
The Workers Compensation Attorneys of Reeves, Aiken & Hightower
If you or someone you know has been injured or killed on the job, you need the help of a serious workers’ compensation attorney like those at Reeves, Aiken & Hightower. Call us at 877-374-5999, or contact us at this link, to schedule a free, private consultation. We can help you evaluate your claim and get you the recovery you deserve.
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Jul 30, 2012 | Uncategorized, Workers' Compensation
Saturday another accident befell the new Charleston Boeing plant as parts fell out of a 787 engine onto a Charleston, SC runway, starting a fire and shutting down the Charleston airport temporarily. The National Transportation Safety Board (NTSB) is investigating the problem, along with Boeing and GE (the engine’s manufacturer).
The Charleston area Boeing plant (actually in North Charleston) opened last year and is adjacent to the Charleston Airport. The company employs 3800 workers in the area.
The Workers’ Compensation Attorneys of Reeves, Aiken & Hightower
If you or someone you know has been injured or killed on the job, you need the help of a serious workers’ compensation attorney like those at Reeves, Aiken & Hightower. Call us at 877-374-5999, or contact us at this link, to schedule a free, private consultation. We can help you evaluate your claim and get you the recovery you deserve.
Jul 26, 2012 | Uncategorized, Workers' Compensation
In workers’ compensation news, it turns out that accidents on the farm are more than 2.5 times more likely to result in amputation than the average work accident. Farmers hurt on the job are at a 11% chance of having an amputation, an astounding number considering how frequent accidents are on the farm.
Also worrying from the employee’s perspective is that the prosthetic limbs provided by doctors will often be too flimsy to allow the worker to return to a farm job.
Amputation injuries do result in hard to deny workers compensation claims, and to the extent employees are unable to find employment due to a prosthetic necessitated by the injury, employees will have an additional workers’ compensation remedy.
Rock Hill Workers’ Compensation Attorneys of Reeves, Aiken & Hightower
If you or someone you know has been injured or killed on the job, you need the help of a serious workers’ compensation attorney like those at Reeves, Aiken & Hightower. Call us at 877-374-5999, or contact us at this link, to schedule a free, private consultation. We can help you evaluate your claim and get you the recovery you deserve.
