Understanding the Alabama Workers Compensation System

Alabama workers’ compensation benefits provide payment for benefits including medical and lost benefits for workers who suffer occupational health problems or who are injured on the job. Compensation and the necessary medical care are generally limited to personal injuries which occur during the course of employment. If the worker is killed from a work injury, compensation may also be extended to the dependents of the worker.

Injured employees do not have to prove the employer is at fault for their Alabama work injury to receive compensation, but workers compensation does limit the employee’s ability to sue the employer (unless the employer denies workers’ compensation benefits). Alabama workman’s compensation is viewed as a compromise, limiting the worker’s ability to sue while providing compensation for work injuries.

Employees may forfeit their right to Alabama workman’s compensation by willfully injuring himself or others, or using illegal drugs or alcohol. More information can be found in the Code of Alabama, with supplements, beginning with Volume 15, Section 25-5-1.

The Workers’ Compensation Division in Alabama is responsible for managing workers compensation in the state of Alabama. Their duties include: compliance inspections, compiling injury and cost statistics, safety promotion, auditing and enforcing claims payments and settlements, dispute resolution, and regulating costs.

Alabama Workers’ Compensation Insurance Options

Most private employers in the state of Alabama who employ more than four full or part-time workers must provide workers’ compensation coverage (exceptions exist in Code of Alabama 1975, § 25-5-50(a)).

Employers have several options for purchasing Alabama workman’s comp insurance including:

  • Workers’ compensation purchased from a commercial workers’ compensation carrier.
  • Workers’ compensation purchased through an Assigned Risk Pool.
  • Workers’ compensation purchased through a group self-insurance fund.
  • Workers’ compensation purchased through a self-insured plan. Under this plan the workers’ compensation coverage is assumed by the company. The company must meet the qualifications outlined in under Alabama’s Workers Compensation laws.

Work injuries and conditions covered under Alabama Workers’ Comp Law

Alabama workers’ compensation laws specifically cover work injuries which “arise out of and in the course of employment”. This can include not only work related injuries but also occupational diseases that were “caused by a hazard recognized as peculiar to a particular trade, process, occupation, or employment as a direct result of exposure over a period of time to the normal working conditions of such trade, process, occupation or employment”.

Although employers are required to provide adequate training to reduce or eliminate work injuries, regardless of training or the safety precautions, work injuries do occur. Common work injuries can include: back and neck injuries, burns, abrasions, heart attacks, carpal tunnel syndrome, amputations, and diseases caused by exposure to harsh chemicals or toxins.

If a worker’s injury or illness meets the criteria specified under Alabama work comp law, the employer is required to provide medical benefits, lost wage compensation and death benefits (if the worker dies from their work injuries or illness).

  • Lost wage benefits

o    Temporary Partial Disability Benefits – Temporary partial disability benefits may be paid if the worker is able to work but has lost some amount of wages due to their work injuries. Compensation is based on two-thirds of the difference in the employee’s earnings before and after the Kansas work injury. Temporary partial disability benefits are limited to a maximum of 300 weeks.

o    Temporary Total Disability Benefits - Temporary total disability benefits may be paid if the worker is unable to work in any capacity due to their work injury or illness. Compensation will be equal to two-thirds of their average weekly earnings for the fifty-two week period before the work injury.

o    Permanent Partial Disability Benefits - Workers who are partially and permanently disabled from their work injury or illness may be compensated. The amount of compensation is determined by the extent of the work injury. Alabama state laws provide a list of possible work injuries and the amount the state will compensate per work injury.  The maximum amount of permanent partial disability payment the state will provide is $220 per week.

o    Permanent Total Disability Benefits – Permanent total disability benefits may extend for the duration of the work injury or disability and are equal to two-thirds of the total weekly earnings at the time of the work injury. Some workers may also choose to take a lump sum payment for work injury (if the court and both parties agree). Compensation does not accrue until the 4th day of disability but if the work injury continues for 21 days the first three days may be compensated.

  • Medical Benefits

o    Alabama workers’ compensation laws require employees to provide reasonable and necessary medical care to injured employees. Necessary medical care can include: medicine, medical treatment, surgery, medical supplies, and other apparatuses needed by the employee.

o    Employees who are not satisfied with their initial treating doctor who was selected by their employer may request a new physician. Employees who do not comply or do not accept the medical treatment provided by their employer may forfeit their right to compensation for the refusal time period.

  • Death Benefits

o    If a worker dies from a work injury within 3 years from the date of the injury the dependents may be eligible to death benefits. If the worker has one dependent the dependent is eligible to receive 50% of the employee’s average weekly earnings. If the deceased worker has 2 or more dependents they will split 2/3 of the worker’s average weekly earnings. Dependents can include a wife, child, husband, mother, father, grandmother, grandfather, sister, brother, mother-in-law or father-in-law if they are supported in full at the time of the worker’s death.

Death benefits may also include up to $3,000 in burial expenses. Death benefits may be paid for 500 weeks but may stop if the dependents die or if the spouse remarries.

If you have been injured in a work-related accident in Alabama it is important to notify your employer by written notification within five days from the date of your work injury. The courts have suggested oral notification may be honored, but written notification is preferable. Failure to notify your employee within 90 days from the date of the work injury could result in forfeiture of workers’ compensation benefits.

Alabama workers comp laws can be complicated, and the rules and regulations are subject to change. It is important to consult with an Alabama workers’ compensation lawyer as soon as possible if you have been injured in a work-related accident.



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Georgia Workers Compensation Information

Georgia workers’ compensation or workman’s compensation is provided to Georgia employees who are injured while performing their job or who have contracted an occupational illness. Georgia workers’ compensation program is managed and administered by Georgia’s State Board of Workers’ Compensation (SBWC).

The goal of the SBWC is “to provide superior access to the Georgia Workers’ Compensation program for injured workers and employers in a manner that is sensitive, responsive, and effective and to insure efficient processing and swift, fair resolution of claims, while encouraging workplace safety and return to work”.

Workers’ compensation or workers comp is a mandatory insurance policy that certain employers in the state of Georgia are required to purchase to protect their employees who are injured in a Georgia work injury. Mandatory workers’ compensation has eliminated the rights of most injured employees to file a personal injury claim and sue their employer. The trade-off for the worker, who may have forfeited a larger payout, is immediate medical benefits and potential wage loss compensation without the need for a costly legal battle.

Work Injuries covered by Georgia Workers’ Compensation

Work injuries are generally covered if they occur while an employee is performing a job duty. Work injuries which were the result of an employee’s horseplay, intoxication, failure to follow company policies or which were intentionally self-inflicted may not be covered.

Common work injuries which should be covered under Georgia’s Work compensation laws include:

  • Neck injuries                             Back injuries
  • Carpal Tunnel                            Concussions
  • Heart attacks on the job             Strokes on the job
  • Amputations                             Injuries from inhaling toxic chemicals
  • Closed head injuries                  Paralysis
  • Burns                                        Spinal cord injuries
  • Abrasions                                 Electrocution
  • Puncture wounds                       Post Traumatic Stress Disorder (PTSD)

Georgia Workers Compensation Benefits

  • Medical Benefits

Medical benefits including rehabilitation and other treatments considered reasonable and necessary are covered under Georgia workman’s compensation laws. This can include hospital stays, prescribed medication, doctor’s visits, medical services and laboratory tests. In some cases the non-emergency care services may require approval from a panel of approved physicians. Georgia workers’ comp laws also allow the employee to choose their physician, but the choice must be from a list determined by the employer.

  • Temporary Total Disability Benefits (TTD)

Temporary total disability benefits are paid to workers who have been injured on the job and are unable to return to work due to their work injuries. Employees receiving TTD will receive 2/3 of their average weekly wage up to a predetermined maximum. TTD benefits are paid for a maximum of 400 weeks from the date of the work accident. Under some conditions, such as a catastrophic accident, TTD benefits may be extended. There is a 7 day waiting period prior to receiving TTD benefits. Workers who are injured for 21 or more consecutive days may receive payment from the first day of the work injury.

  • Temporary Partial Disability Benefits (TPD)

Temporary partial disability benefits are paid to injured workers who are able to return to work but who, due to their work injury, are unable to make a similar wage. TPD benefits are paid at 2/3 the difference between the injured worker’s average weekly wage prior to and after the work injury. TPD benefits can be paid for 350 weeks or up to a maximum established under Georgia workers’ compensation law.

  • Permanent Partial Disability (PPD)

Permanent partial disability benefits are paid weekly to injured workers who have been permanently disabled and may be unable to work their previous job, but may be able to do alternate work. Prior to determining the compensation amount, a medical examination is conducted by an independent medical examiner. The disability examiner rates the level of impairment. Disability payments are calculated by using the American Medical Associations ratings guidelines.

PPD payments are made by multiplying 2/3 of the injured worker’s average weekly salary by the PPD percentage and a specified number of weeks. The number of weeks is determined according to a pre-determined schedule. The calculation for PPD benefits is not made until the treating physician has determined the worker has reached their maxim medical improvement.

  • Death Benefits

Death benefits are paid to the surviving spouse or dependents of Georgia workers who have died from a work injury or illness. Death benefits are 2/3 of the deceased employee’s average weekly wage at the time of the work injury. Death benefits are paid to the surviving spouse who has does not have children up to $150,000 maximum. Surviving children may be eligible to receive death benefits until they are 18 years old or longer if they are a full-time student.

  • Vocational Rehabilitation Benefits

Vocational rehabilitation benefits may be offered to qualifying injured workers who are unable to return to work due to their physical health condition after a work injury. Georgia vocational rehabilitation may include: job placement, custom job training, job matching, counseling, technological accommodations and resource assistance.

Hiring a Georgia Workers’ Compensation Lawyer

Not all workers will need to hire a Georgia workman’s compensation lawyer, but if the injuries suffered are severe or permanent or the worker and employer have an adversarial relationship, it may be a good idea to seek legal counsel. Many workers’ compensation cases are litigated in Georgia simply because the insurance company wants to pay a low settlement amount and close the case as quickly as possible.

If you feel you have received poor medical treatment, if your Georgia workers’ compensation case has been denied or if you have been severely injured, contact a Georgia workman’s comp attorney.



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Sometimes? The lines get blurred: recent cases from Illinois, North Carolina, Arkansas & New Mexico

Newspaper reportage has led to the announcement of an Illinois state probe into possible workers’ comp fraud at the Menard Correctional Center, where nearly 400 guards and workers–including the warden–have filed claims totaling nearly $10 million in three years. As discussed in a previous post, Illinois is in the middle of a workers’ comp debate, with one side denouncing proposed losses for injured workers while the other side claims the high cost of workers’ comp premiums deters new business from locating in the state.

According to a Dec. 30 story at the Belleville News-Democrat’s Web site, the chairman of the Illinois Workers’ Compensation Commission told the paper that he was “surprised that with all the different agencies that are involved, that it’s taken you guys [i.e., the newspaper] to bring this to my attention. My eyes are wide open. … It’s hard for me to imagine it’s all kosher.”

According to the article, “More than 500 claims, including a $75,678 payment to the prison’s warden in June, have been filed since Jan. 1, 2008. Approximately 290 cases are pending. More than 230 prison workers contend they were injured not because of an accident but through repetitive trauma caused over years mainly by operating manual cell locking mechanisms. Carpal tunnel syndrome can result from repetitive trauma.

“After learning the results of a News-Democrat investigation that revealed these figures, Mitch Weisz, chairman of the Illinois Workers’ Compensation Commission, said Wednesday he has called for an official investigation of the Menard claims by the state’s Department of Insurance and has contacted the agency’s Director Michael McRaith.”

We’ve discussed before the degree of differences among state rules and regulations governing workers’ comp coverage, noting that in some states workers are covered while traveling to and from work although other states are more restrictive. This is but one reason to consider hiring a trained, experienced attorney for complex, adversarial injury cases.

Today we have plenty of examples that illustrate such differences.

In North Carolina, an ex-Marine who became a public school principal known for visible, anti-gang efforts was injured by a shotgun blast to the face on the way to work at Robeson County’s Fairmount Middle School. According to this Dec. 30 story, former principal James Hunt was subsequently awarded workers’ comp payments for the shooting injuries by the state Industrial Commission.

So…does the school district hold a rally to commission a statue of Hunt?

Nope.

Here’s the lede: “Robeson County Schools has appealed a state commission’s ruling that a principal who was shot last year on his way to school deserves workers’ compensation for his injuries.”

Here’s the finale: “School district lawyers maintain that taxpayers shouldn’t have to pay compensation because the shooting happened while Hunt was away from school property.”

Makes you wonder what the district will do if a coach or athlete gets hurt in an away game.

Now, in Arkansas, the state Supreme Court had to get involved in the case of a worker who got tired waiting in line with everybody else who simply wanted their paychecks. She decided to smoke outside while the line thinned out and apparently got hurt in a fall on her way back to the paycheck line.

The original workers’ comp panel ruled the injury compensable–after all, she was on break–but the medical provider appealed.

From the Dec. 13 piece at Insurance Journal: “The Arkansas Workers’ Compensation Commission originally found for Woods, deciding that her injury was compensable. But Jonesboro Care & Rehab Center appealed, maintaining that she was not performing employment services when she sustained the injury. Instead the Center asserted ‘that at the time of her injury, appellee was taking a personal break that did not directly or indirectly advance her employer’s interest,’ the Court explained. The appeals court sided with the Center.

“The [Supreme] Court ruled Woods was doing work at the time of her injury — by remaining on site until she could pick up her paycheck, as required by her employer. It vacated the decision of the appeals court and affirmed the ruling of the Workers’ Compensation Commission.”

Our last case of the day involves alcohol consumption, and, curiously, the ruling hinges on performance criteria rather than the rules ‘n regs of what legally constitutes “being drunk.”

Merely judging from the Dec. 29 Insurance Journal story, it seems as though the Las Cruces, NM, trash-truck worker may have been drinking either before-shift or during. At some point, in what sounds like a fairly intricate maneuver to extract “a trash bin that was stuck in the truck hopper,” Edward Villa:

. . . reached for the chain, he lost his balance, fell and seriously injured himself.

The city argued that on the day of the accident, Villa’s blood-alcohol level was 0.12, over the New Mexico legal driving limit. However, in assessing Villa’s intoxication for the purpose of recovery benefits, the workers’ compensation judge noted that although Villa was intoxicated, his co-worker and supervisor did not notice a problem with Villa’s behavior.

“[T]he fact that workers was inebriated … does not resolve the legal effect of it on his claim for benefits,” the WCJ concluded. Thus, the judge issued a 10 percent penalty for being intoxicated, and said the state had to award the remaining 90 percent of workers’ comp benefits.

Bottom line, I guess, Villa was not driving. So how or why would driving rules apply?

Then there’s the problem with co-workers’ testimony about Villa’s behavior.

From getting shot in the face, to falling off a garbage truck…strange world.

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Frequently enough, a worker’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Injury on the job

Filing a claim



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What Is Workers’ Compensation In Oklahoma

Oklahoma workers compensation can provide employees who suffer an injury at work with fixed monetary benefits and medical care without having to file a personal injury claim against their employer. Employers provide benefits without the employee proving the employer’s negligence contributed to the work injury, and employees accept less than they may have won with a personal injury claim.

Workers comp insurance does not pay for work injuries which are the result of intoxication, reckless actions or intentional actions which are meant to injure themselves or other employees. Most Oklahoma employers are required to pay for all other work injuries or occupational illnesses which occur while an employee is engaged in their normal job duties. Common injuries which may be covered include:

  • Back and neck injuries
  • Abrasions and burns
  • Amputations of arms or legs
  • Concussions
  • Heart attack or strokes on the job
  • Carpel Tunnel
  • Diseases caused by inhalation of chemicals or other toxins

Oklahoma Workers Compensation Benefits

Work comp insurance was created to help the employee have easy access to medical benefits, temporary disability benefits, permanent disability benefits, vocational rehabilitation and death benefits. The following benefits are described below:

  • Medical Benefits – Work comp insurance provides necessary and reasonable medical care for Oklahoma workers who are injured on the job. All medical costs are paid including: laboratory services, surgery, medications, hospital visits and physical therapy.  There is no cost or time limits for medical care.
  • Temporary Total Disability – Oklahoma workers who are temporarily totally disabled and are unable to work, but will at some point return to work at full capacity, are eligible to receive 70% of their weekly wage (with a limit of $473 per week) for a maximum of 156 weeks. Benefits may be extended for additional weeks with authorization from the Oklahoma’s Workers’ Compensation Court. The first three days of incapacity are not paid.
  • Permanent Partial Disability – Oklahoma workers who suffer a permanent partial injury must be evaluated to determine the extent of the injury and the amount of compensation they can receive. Work injury compensation is 70% of the employee’s average weekly wage, but the duration of the payment is determined by a set schedule. For example: A loss of a thumb entitles a worker to 66 weeks of disability payments.
  • Permanent Total Disability – Oklahoma workers who suffer an injury at work and are unable to return to any type of employment may qualify for permanent total disability payments. Work injury compensation for a total disability is 70% of the AWW for the duration of the disability.
  • Vocational Rehabilitation – Oklahoma employees who sustain an injury at work and need help to return to their job or to find new employment may be eligible for vocational rehabilitation.
  • Death Benefits – Oklahoma spouses of a deceased worker may be eligible for lost wage compensation of 70% of the deceased worker’s average weekly wage and an additional 15% for each child up to 30% which is the maximum established by workers compensation law. Benefits may change if the spouse remarries. Funeral expenses are paid up to $10,000. Variations and requirements for death benefits can be complicated and should be evaluated by a work injury lawyer.

Do I Need an Oklahoma Worker’s Compensation Attorney?

Thousands of Oklahoma workers file workers compensation claims each year and depending on the work injury, the statutes and laws can be complicated. Work injury lawyers may be a good resource to help the employee file their work compensation claim and get the benefits they deserve. Oklahoma worker’s compensation lawyers can also help the injured worker if they have become the victim of workplace discrimination or harassment.



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Understanding Worker’s Compensation In Charlotte, N.C.

Charlotte at dusk
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Charlotte workers who have been injured at work may be eligible to receive medical benefits and lost wage compensation under North Carolinas workers’ compensation. Workers compensation eliminates the need for workers who suffer an injury at work to file a personal injury lawsuit to receive compensation for their work injury. North Carolina employers, without accepting liability or claiming negligence, avoid an expensive protracted lawsuit by paying the injured employee limited monetary benefits.

Not all work injuries are covered by workman’s compensation. Work injuries which are covered must have occurred while the employee was engaged in their regular job duties and while performing them in the required manner. Work injuries which are the result of drug or alcohol intoxication or horseplay are not covered. Work injuries which occur while travelling to and from work or during voluntary, recreational work activities also may not be covered.

There are a variety of work injuries or occupational diseases which are covered by workers comp insurance. Some of the most common are:

  • Back and neck injuries
  • Abrasions and burns
  • Amputations of arms or legs
  • Concussions
  • Heart attack or strokes on the job
  • Carpel Tunnel
  • Diseases caused by inhalation of chemicals or other toxins

Charlotte Workers Compensation Benefits

  • Medical Benefits – Charlotte workers who sustain an injury at work are entitled to medical benefits. The Charlotte employer is responsible for paying all medical costs which can include: doctor’s bills, surgical costs, medications and rehabilitation services.
  • Vocational Rehabilitation Services- If a Charlotte worker sustains an injury at work and is unable to return to their job, they may receive certain types of vocational rehabilitation services which can help them find another job which they can do given their current work capabilities.
  • Temporary Total or Temporary Partial Disability Benefits – Temporary total disability payments can be awarded if the injured employee is unable to work at all for a specific period of time. Work injury compensation for total disability payments is 66 2/3% of the workers average weekly earnings. There is a minimum and maximum allowed under North Carolina’s workers compensation law. If an employee is allowed to return to their job, but because of their disability, they are on restricted duty, workers compensation may award temporary partial benefits.
  • Permanent or partial disability – If a work injury causes a permanent disability or if the worker loses the function of a specific body part, work injury compensation is paid according to a schedule as outlined by North Carolina’s workers compensation law. If the work injury causes severe disfigurement to the face, head or damage to vital organs the worker may receive additional work injury compensation.
  • Death Benefits – Dependents of a Charlotte worker who dies from a work injury or occupational disease may be eligible to receive workman’s compensation for death benefits which equals 66 2/3% of the workers average weekly wage. Benefits are generally paid for 400 weeks, but for spouses (meeting certain requirements) they may be paid until death or remarriage and for minor children they may be paid until the child reaches age 18. Funeral benefits are also allowed up to $2,000.

Do I Need a Charlotte Worker’s Compensation Attorney?

Charlotte workers who suffer an injury at work have the choice of filing their workers compensation claim themselves or hiring a worker comp attorney to help. Unfortunately, Charlotte employers, who may be more focused on company costs and less on the worker’s welfare, will have their own work injury lawyers helping them.

Charlotte workers who have suffered discrimination or harassment due to the work injury or who have been injured by a third party may want to contact a worker’s compensation lawyer.



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In battle of suits and countersuits over workers’ comp premiums, AIG gets to subpoena more than 400 competitors

AIG, the giant insurer and a major player at the core of the Great Recession, has been allowed by a federal judge to begin issuing subpoenas to 400 of its competitors in the workers compensation insurance business, according to a March 16 piece at businessinsurance.com.

The ruling, which allows AIG to pursue “nonparty discovery,” is part of a larger dispute between AIG and several competitors–but extends to “discovery of practices by insurers not named in the lawsuit, AIG said Monday in a statement.”

Industry leaders involved

The fracas involves some heavyweights in the industry, including some who joined forces in the original RICO suit against AIG: “The ongoing litigation grew out of a May 2007 lawsuit against AIG originally filed by the National Workers Compensation Reinsurance Pool made up of AIG competitors and operated by Boca Raton, Fla.-based NCCI Holdings Inc. That suit alleged violations of the Racketeer Influenced and Corrupt Organizations Act by AIG, among other assertions.”

It also involves some colorful language, for what might seem an otherwise dry topic.

Let’s pick up the story in 2005 when, according to an August 26, 2009 post at an insurance law blog, “a New York state investigation revealed that AIG had, over several decades, provided false reports of its workers’ compensation premiums to NCCI and state tax authorities to evade its residual-market obligations.” Id. Thereafter, in 2006, AIG entered into settlement agreements, including a $1.6 billion settlement with New York and federal authorities. The Participating Companies contested that the settlement agreements offered full and fair restitution. Id. at 5.

“On May 24, 2007, NCCI filed suit against AIG, alleging underreporting of premium data. AIG interposed numerous defenses and asserted counterclaims for an equitable accounting and an action on an open, current, and mutual account, both of which survived NCCI’s motion to dismiss. AIG also filed a 12-count third-party complaint against 24 named companies and numerous unnamed companies. Id. at 3.”

Court dismisses NCCI suit

But in August 2009, a federal district court dismissed the suit against AIG, “holding that the NCCI failed to establish standing to assert claims on behalf of the Pool.”

That’s when AIG came out swinging, inserting itself as plaintiff, and as described at workerscompsc.com, in September 2009 amended that complaint “in its Chicago racketeering conspiracy fight alleging fellow members of the National Workers’ Compensation Reinsurance Pool conspired to suppress a state and federal probe of the systematic underreporting of workers’ compensation premiums.”

AIG’s amendment, according to Michael Whiteley, “names as defendants the pool, NCCI and 19 insurance companies. It focuses on the actions of Liberty Mutual Group, Travelers, The Hartford, Ace INA Holdings and Sentry Insurance Co. as carriers AIG says have dominated the governing board of NWCRP.

“The amended complaint, which was filed under the Racketeer Influenced and Corrupt Organizations Act (RICO), alleges that NCCI flagged significant problems with the misreporting of premiums as early as 1986 and then conspired with pool members to conceal the problem while then-New York State Attorney General Eliot Spitzer was investigating the practice at AIG.”

AIG says it was targeted as scapegoat

Furthermore, AIG alleges the whole thing was a longstanding sham-up, designed to hurt AIG.

Again from the Whiteley piece: “And AIG repeated assertions that its competitors – led by Liberty Mutual, which last year overtook AIG as the leading comp insurer in America – conspired to make AIG the scapegoat in the Spitzer probe to prevent investigators from broadening their target.

“AIG said a Liberty Mutual representative on the pool’s governing board said at a board meeting in 2005 that the Spitzer probe gave the board ‘an opportunity to get the bastards at AIG.’ “

The residual market

What’s at stake is who-owes-what to cover costs in the so-called “residual market,” the pool for employers who can’t workers’ comp coverage in the primary market. As the insurance law blog explains:

“The action concerned the workers’ compensation insurance market. Employers obtain workers’ compensation insurance coverage from insurers in what is known as the “voluntary market.” Insurers that provide coverage to the voluntary market are required by state law to provide coverage to the “residual market,” which is the market for employers who cannot obtain coverage on the voluntary market. Those employers obtain workers’ compensation insurance coverage through an individual state’s assigned risk plan. Under that plan, the amount of insurance an insurer is required to provide for the residual market is directly proportional to the amount of premiums it collects for the policy it writes for the voluntary market. Mem Op. 3″

“Therefore, ‘any company that underreports its premiums to NCCI decreases its reinsurance participation rate and the overall total used to calculate all the rates.’ Id.”

‘Common practice in the insudtry’

Looking through the various accounts of the lawsuits and countersuits, it’s hard to find any instances in which AIG denies under-reporting these premiums. After all, it did settle for at least $1.6 billion in 2006. So far, it seems like AIG is merely saying, well, everybody did it.

From the businessinsurance.com conclusion, re AIG’s most recent action: “Now AIG is seeking proof through its subpoenas that premium underreporting practices it is alleged to have engaged in were common practice in the industry.”

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Regardless of whether you’ve been hurt on the job, it’s wise to know the basics of workers compensation in case you, a friend or family member need to file a claim in the future. If you do get hurt, you should be aware of the first things to do or what to tell a co-worker who has been injured.

Sometimes an injured employee takes all the correct steps but still has trouble getting the claim taken care of; in that case here’s some information for problems with denial of benefits. If legal help is needed to help with the case, be sure to speak to a trained, experienced attorney.



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Worker’s Compensation In Minnesota

Minnesota workers compensation is a no-fault system of laws which was created to provide work injury compensation to employees who sustain an injury at work while performing their normal job duties. Worker’s compensation is provided to the Minnesota employee without their proving their employer’s negligence contributed to their work injury.

Not all work injuries are covered by insurance workers comp, only those which are aggravated or accelerated by the employer’s job responsibilities or accidentally occurred while performing a job duty. Work injuries are not covered if they are caused by an intentional employee action, rough housing, recklessness or intoxication.

Minnesota workers compensation provides benefits for a variety of occupational diseases and work injuries including:

  • Abrasions and burns
  • Amputations of arms or legs
  • Concussions
  • Heart attack or strokes on the job
  • Carpel Tunnel
  • Diseases caused by inhalation of chemicals or other toxins
  • Back and neck injuries

Minnesota Workers Compensation Benefits:

Minnesota’s workers comp insurance provides wage loss compensation and medical benefits to employees who are injured.

  • Medical Benefits – Medical compensation is provided to Minnesota workers who suffer an injury at work without a time or monetary limit and includes all medical care which is reasonable and necessary to treat a work injury. Care can include: doctor’s visits, laboratory services, prescriptions and hospital visits. Employees, under most circumstances, can choose their own physician and change doctors as desired.
  • Wage loss compensation –
    • Permanent partial disability – Minnesota employees who have lost permanent use of certain body parts from their occupational illness or work injury will receive permanent partial disability benefits based on a rating assigned to them from worker’s compensation. To determine worker’s compensation benefits the rating assigned is multiplied by the dollar amount for the injury for a specific number of weeks to determine the amount paid.
    • Permanent total disability – Minnesota workers who have sustained an injury at work and are unable to continue working may receive permanent total disability payments. These benefits are calculated using a similar formula as temporary total disability benefits.
    • Temporary partial disability – Minnesota workers who sustain an injury at work and are able to return to work but their wage is lower due to their work injury, may be able to receive work injury benefits to compensate them for lost wages.
    • Temporary total disability (TTD)- Minnesota workers who temporarily can not work at all due to their work injury can receive weekly temporary total disability payments (with a waiting period). Benefits are 2/3 of the worker’s gross average weekly wage at the time of the work injury. TTD benefits may end when 1)the maximum number of weeks for benefits has been reached 2)the employee is not taking part in the vocational rehabilitation program 3)the worker has found new employment or has returned to their current job.
    • Vocational Rehabilitation Services – Minnesota worker’s compensation may provide vocational rehabilitation services to help an employee return to their current job or to find new employment if they can not perform their current job due to their physical or mental limitations.

Do I Need a Minnesota Worker’s Compensation Attorney?

Minnesota workers who would like assistance navigating complex workers compensation laws can contact a worker’s compensation lawyer. Minnesota workers do not have to hire a worker comp attorney to file their work compensation claim, but a work injury lawyer may be able to help the employee get the work injury compensation they deserve.



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Workers’ comp violators face prison or slap on wrist–while Florida worker seems trapped in pain, agonizing delay

Three recent news items reflect the breadth and depth of disparity among the states’ regulations concerning workers’ compensation.

The first and third are from California and Florida, the second from Pennsylvania; taken together they reveal a shocking disconnect between treatment of perps and victims.

Roofer injured in 2003

According to a March 1 article in the Orange County (CA) Register, roofing contractor Michael Amzie Hollings “is expected to be sentenced to three years in state prison” after pleading guilty to various charges that boiled down to trying to hide workers, thereby paying nothing to the state’s workmen’s comp fund. No word from the Register on how long the scheme lasted, but it began unraveling in 2003 when a worker “fell from a roof and filed a workers’ compensation claim,” which resulted “in a denial of benefits,” according to prosecutors. The account also makes no mention of whether the injured worker ultimately received benefits–or even treatment.

On the one hand, the plea agreement shows how long such cases can slog through the system; on the other, even though Hollings faced a maximum sentence of 21 years and eight months, the expected three-year sentence should serve as a red flag for those who attempt to run similar schemes–at least, in California.

Agency owner dodges more than 1,000 counts

In another plea agreement reported today at pittsburghlive.com, 80-year-old William R. McCandless has apparently slipped through the system with a pretty sweet deal. Charged (along with his business) of “1,054 counts of failure to insure” from August 2006 through July 2009, McCandless “entered a general plea of no contest to a single count of failure to insure,” which is expected to net him a mere $3,000 fine plus probation.

One presumes the agency’s workers are now covered–and, of course, there’s no mention of anyone falling from a roof–but, still…more than a thousand counts? That must be one happy old guy.

Holdup victim awaiting surgery for more than a year

The next case is flat out tragic and has the father of an injured man taking on reform of Florida’s statutes, which were altered to prevent abuse by scam-running workers.

Posted March 01 at myfoxtampabay.com, this account tells the tale of Sam McGinnis, a drug store clerk gunned down during a holdup that netted $88 in Nov. 2008.

“We’ve all seen video of people caught on tape playing up their injuries and claiming benefits: people walking with a walker, and later walking just fine, or using or a cane where now you see it, now you don’t,” writes investifative reporter Doug Smith.

“But there’s nothing funny or phony about the video of Sam McGinnis, a clerk behind the counter at a drug store in Tampa, Florida on November 29, 2008. A camera inside the store shows a holdup.”

Cursed at by the robber and shot twice–for not moving fast enough–McGinnis still has a slug lodged in his back and remains “in constant pain,” with “[e]ven the simplest tasks . . . a challenge . . . and he says the workers’ compensation system is compounding his agony.”

Apparently, Florida’s worker-abuse reform went too far: Not only have the new regs have resulted in denial of surgery that would help McGinnis but also he’s been prevented from using his own private insurance–because he was hurt on the job.

“McGinnis hasn’t been able to get surgery that his doctors say could ease his pain because so far workers’ compensation won’t approve it. McGinnis says he had very good private insurance, but because he was hurt at work, he can’t use it.”

The article also says “McGinnis will need a lifetime of care.”

McGinnis’ father has begun a campaign to change the regs, creating a dual-track system, with one track for more routine on-the-job injuries and another for “for people who are catastrophically injured. . .” The father (Facebook profile here) has launched a Web site with a brief background and links to a youtube video and an online petition.

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Regardless of whether you’ve been hurt on the job, it’s wise to know the basics of workers compensation in case you, a friend or family member need to file a claim in the future. If you do get hurt, you should be aware of the first things to do or what to tell a co-worker who has been injured.

Sometimes an injured employee takes all the correct steps but still has trouble getting the claim taken care of; in that case here’s some information for problems with denial of benefits. If legal help is needed to help with the case, be sure to speak to a trained, experienced attorney.



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Get help with your Minneapolis workers’ compensation case

Minneapolis workers compensation is a no-fault system which is designed to provide work injury compensation to Minneapolis workers who suffer a work injury from their normal employment activities. To receive work injury compensation the Minneapolis worker does not have to prove their employer’s negligence caused their work injury.

A work injury can be any type condition which is accelerated or aggravated by an employee’s job duties, but the employee must be able to prove that their job substantially contributed to their work injury. Not all work injuries are covered by workers compensation. Work injuries which are the result of an employee’s intentional actions, intoxication or horseplay may not be covered. Work injuries sustained travelling to and from work may not be covered as well as work injuries suffered while engaged in voluntary, recreational or social activities at work.

Common work injuries or occupational diseased which may occur while performing job duties may include:

  • Back and neck injuries
  • Abrasions and burns
  • Amputations of arms or legs
  • Concussions
  • Heart attack or strokes on the job
  • Carpel Tunnel
  • Diseases caused by inhalation of chemicals or other toxins

Minneapolis Workers Compensation Benefits:

Workers comp insurance provides medical benefits and wage loss compensation for Minneapolis employees. These benefits include:

  • Medical Benefits – Minneapolis workers who suffer an injury at work are eligible for all medical care related to their work injury. There is not a time limit or monetary limit for workers comp medical benefits.  Medical benefits can include: doctor’s services, laboratory services, hospital stays and medication.
  • Wage loss compensation –
    • Permanent partial disability – If a Minneapolis employee has lost permanent function of certain body parts from a work injury or occupational disease workers compensation will assign a rating for the loss according to a permanent disability schedule. The rating is then multiplied by a dollar amount or a specific number of weeks to decide the work injury compensation amount.
    • Permanent total disability – If a Minneapolis employee who has suffered an injury at work is not going to return to gainful employment they may receive permanent total disability payments which are calculated the same as temporary total disability.
    • Temporary partial disability – Minneapolis workers who are injured at work and return to work, but due to their work injury are unable to make as much as they were making before their injury, may be eligible to receive temporary partial disability work injury compensation.
    • Temporary total disability (TTD) Minneapolis workers who suffer an injury at work and are unable to work at all may receive weekly compensation (subject to a waiting period) which is 2/3 of the employee’s gross weekly wage amount at the time of the work injury. Workers compensation law does establish statutory minimums and maxims for TTD payments and the payments can not be paid along with permanent partial disability benefits.
    • Vocational Rehabilitation Services – If a work injury prevents an employee from returning to work, workers compensation may provide vocation rehabilitation services to retrain or help place an employee in another job position.

Do I Need a Minneapolis Worker’s Compensation Attorney?

Workers who sustain an injury at work do not have to hire a worker comp attorney but some work injuries can be serious and sometimes work compensation claims are denied. Employers, who may be more interested in their bottom line and saving costs, will have their own worker’s compensation lawyers.

Workers compensation lawyers can also help if a work injury was caused by a third party product or if an employee is suffering workplace discrimination or harassment due to the work injury.



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Fill out the short form below and a local Workers Comp attorney will review your case for FREE!
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Need Help With Your California Workers’ Compensation Claim?

California workers compensation law is similar to other state’s laws which provide medical benefits and lost wage compensation to California workers who sustain an injury at work while they are performing their normal job function.

Workers compensation or workman’s compensation is an insurance program created to provide immediate relief to employees without the employees having to file a personal injury claim for compensation. In exchange, California workers compensation law limits the amount of money which can be recovered from California employers.

Only work injuries or occupational diseases which are caused from the normal job requirements are covered by workers comp insurance. Work injury compensation is not provided to California workers who are injured while intoxicated, attempting to injure themselves or another employee or who are injured travelling to and from work.

There are a variety of occupational diseases and work injuries which are covered by California’s workers compensation. Some of the most common include:

  • Back and neck injuries
  • Abrasions and burns
  • Amputations of arms or legs
  • Concussions
  • Heart attack or strokes on the job
  • Carpel Tunnel
  • Diseases caused by inhalation of chemicals or other toxins

California Worker’s Compensation Benefits

Californian workers comp insurance includes: medical benefits, temporary disability benefits, permanent disability benefits, vocational rehabilitation benefits and death benefits.

  • Medical Benefits – California workers who sustain an injury at work are entitled to full medical benefits provided by their employer with no limits to time or money. The employer generally selects the first physician the employee is required to see and after 30 days the employee generally is allowed to choose their own doctor. Additional medical expenses are paid such as doctor’s visits, hospital stays and medications.
  • Temporary Disability- California employees who suffer an injury at work are entitled to temporary disability payments which are 2/3 of their lost wage amount. California workers compensation outlines a maximum limit for lost wage compensation.
  • Permanent Disability- California workers who suffer an injury at work and are unable to return to work are eligible for permanent disability. California workers who sustain an injury at work and can return to work but due to their work injury they can not make the same wage they could before the work injury, may be eligible for workers compensation benefits. California workers compensation will determine the amount for permanent disability based on a variety of factors including the worker’s age, occupation, work capacity and work injury date.
  • Vocational Rehabilitation – California workers who suffer an injury at work and are not able to return to their job may qualify for vocational rehabilitation benefits including job retraining and job placement.
  • Death benefits – Dependents of California workers who die from their work injury or occupational disease are entitled to death benefits to compensate them for the deceased worker’s lost wages. Burial expenses are also paid up to an established limit.

Do I Need a California Worker’s Compensation Attorney?

Workers compensation law can vary by state and can be complicated. Many insurance workers comp cases are settled easily and without dispute, but many are denied. Work injury lawyers can help California workers get the compensation they deserve and help fight employers and their worker comp attorneys if they are more concerned with saving money than helping the employee recover from their work injury.



Need Help with your Workers Comp Claim?

Fill out the short form below and a local Workers Comp attorney will review your case for FREE!
Don't wait -- Get help winning your workers comp case today!




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