Attorney Jim Reed recently posted a very informative blog about school-sports injuries at “NY Accident Lawyer Explains Why He Probably Won’t Take Your School Sports Injury Case.”  However, if you’re injured while participating in work-related athletic activity you may very well have a Workers’ Compensation case.

You might have a Workers’ Comp case if you’re injured when the employer required you to participate in the athletic activity, the employer compensated you for participating in the activity or the employer otherwise sponsors the activity.

I’m certainly not interested in discouraging employers from sponsoring athletic activity.  I am encouraging employers to keep safety in mind.  For example, some time ago the folks at the Ziff Law Firm got together for some firm sponsored paintball.  Anyone who knows anything about paintball will tell you that you can, and often will, get injured playing paintball.  Beyond that, given the competitive nature of folks at this firm, permanent disabilities were likely.  I encouraged Jim Reed, the firm’s managing partner, to make sure good safety equipment was available and used.  I’m happy to report that no employees of the Ziff Law Firm were seriously physically injured :  )

If you’re injured while participating in work-related athletic activity, protect yourself and talk to an attorney.

Thanks for reading,
Eric

____________________________________________
Eric L. Johnson, Esq.
Workers’ Compensation and Disability Attorney
Ziff Law Firm, LLP
303 William St., Elmira, NY 14901
Tel: (607) 733-8866
Fax: (607) 732-6062
Toll Free: 1-800-943-3529
Email: ejohnson@zifflaw.com
Web: http://www.zifflaw.com
Twitter:  http://twitter.com/AttorneyEric
Admitted to practice in New York and North Carolina

Got a terrific Board Panel decision today that will make my client happy and an insurance company and its lawyers unhappy.  A unanimous Board Panel penalized the insurance company $500 for filing a frivolous appeal.  That $500 is paid to my client.

There are a couple of things about this Board Panel decision that make it particularly sweet.  First, the decision that the insurance company frivolously appealed was a decision that awarded my client a penalty of nearly $4,400.  I sought this first penalty for late payment of his lost wage benefit.   So the $500  penalty for frivilous appeal was on top of the nearly $4,400  penalty for late payment of lost wages.

The other thing that makes this Board Panel decision special  is that this is the first time I’ve gotten a penalty against a carrier for filing a frivolous appeal.  Insurance companies delay and deny and they endlessly appeal.  I routinely seek and obtain penalties when the insurance company delays in paying my clients’ lost wage benefits and I routinely seek penalties for frivolous appeal.  I’ve been trying to get insurance companies penalized for frivolous appeals since I started practicing Workers’ Compensation and I was beginning to wonder if the Board would find anything frivolous.  Well . . . I’m happy to say that the Board will assess a penalty for filing a frivolous appeal.  Insurance companies beware.
Thanks for reading,
Eric

____________________________________________
Eric L. Johnson, Esq.
Workers’ Compensation and Disability Attorney
Ziff Law Firm, LLP
303 William St., Elmira, NY 14901
Tel: (607) 733-8866
Fax: (607) 732-6062
Toll Free: 1-800-943-3529
Email: ejohnson@zifflaw.com
Web: http://www.zifflaw.com
Twitter: http://twitter.com/AttorneyEric
Admitted to practice in New York and North Carolina

There was an inaccurate statement in my blog post yesterday “Good News for NY Workers’ Compensation Claimants and Physicians.” In my rush to get that information out, I didn’t read the Board’s release as closely as I should have and I apologize for that. I got an email this afternoon from Joseph Cavalcante, Assistant Director of Public Information for the NYS Workers’ Compensation Board, informing me about my error. I thank Mr. Cavalcante for reading and letting me know about the inaccuracy.　

My statement should be corrected to read “as a measure to deal with that shortage, Mr. Beloten temporarily rescinded the mandate that AUTHORIZED providers IN THE PROVIDER TEMPORARY SHORTAGE AREA file a C-4 form in order to be paid for seeing claimants. With regard to the rest of New York, authorized providers may file the new or older versions of the C-4. Doctors outside provider temporary shortage area are not authorized to submit the CMS-1500 as a result of this subject number.”

In short, only providers in the temporary shortage area are relieved of having to file C-4 forms. However, the good news for any provider statewide is that they have the option of filing the older and easier C-4 form and still have their bills enforced by the Workers’ Compensation Board.

Being in a rush is a pitfall of having a busy practice area such as Workers’ Compensation, but I’m not going to make any excuses and I do apologize for any inconvenience this may have caused.

As always thanks for reading,
Eric

______________________________________
Eric L. Johnson, Esq.
Workers’ Compensation and Disability Attorney
Ziff Law Firm, LLP
303 William St., Elmira, NY 14901
Tel: (607) 733-8866
Fax: (607) 732-6062
Email: ejohnson@zifflaw.com
Web: http://www.zifflaw.com

It’s not news to most New York Workers’ Compensation claimants and certainly not news to physicians and other health care providers that the Workers’ Compensation Board has been imposing increasingly rigorous paperwork requirements on providers without a commensurate increase in the amount providers can charge and the fee schedule was already set at a rate where many providers considered seeing Workers’ Comp claimants as a money-losing proposition.  

This was something that could only last so long.  This afternoon Robert E. Beloten, the Chair of the NY Workers’ Compensation Board, announced in Subject Number 046-398 that there is a provider shortage in the Rochester Area or more specifically in Monroe, Livingston, Steuben, Allegheny, Wyoming and Ontario counties.  As a measure to deal with that shortage, Mr. Beloten temporarily rescinded statewide the mandate that providers file a C-4 form in order to be paid for seeing claimants.  Providers’ bills will be enforced if they are submitted on universal claim forms (CMS-1500 or HCFA-1500) with sufficiently detailed office or narrative notes.

Hopefully this reduction in mandatory paperwork will stem the tide of providers turning away Comp claimants.   Let’s also hope that this temporary measure is made permanent.

I would only caution claimants who are temporarily disabled and who have lost time from work that if your doctor is no longer submitting the C-4 form, it’s a really great idea to remind him or her to document your degree of disability in the office or narrative note.  That little bit of advice will go a long way to making sure you get paid for your lost time.

Thanks for reading,
Eric

___________________________________________
Eric L. Johnson, Esq.
Workers’ Compensation and Disability Attorney
Ziff Law Firm, LLP
303 William St., Elmira, NY 14901
Tel: (607) 733-8866
Fax: (607) 732-6062
Toll Free: 1-800-943-3529
Email: ejohnson@zifflaw.com
Web: http://www.zifflaw.com

“A World of Hurt” is right.

Last April, the New York Times ran an in-depth expose of the New York State workers’ compensation system. The articles and associated videos and resources ran under the umbrella title, “A World of Hurt.”

What did the Times discover? I quote: “New York State’s workers’ compensation system serves no one well and is arguably the most adversarial of any state in the nation.”

IME: The test doesn’t deliver the truth

As a personal injury attorney in New York and Pennsylvania and managing partner of the Ziff Law Firm – which has a Workers’ Compensation and Social Security Disability group headed by attorney Eric Johnson – I’ve long felt strongly about some of the issues this series examined.

In particular, I’m galled about the practice of giving injury victims insurance company-ordered, so-called “Independent” Medical Exams, or IMEs, to prove the validity of injuries. These exams are NOT INDEPENDENT.

As a doctor was quoted in the story: “If you did a truly pure report… you’d be out on your ears and the insurers wouldn’t pay for it. You have to give them what they want, or you’re in Florida. That’s the game, baby.”

Check out the video embedded in this post, depicting a typical IME given by a semi-retired doctor WHO DOESN’T TAKE NOTES.

You can hear the doctor describing the patient’s pains and limitations in the video. The insurance company report of the exam was that the patient was healthy and did not have a valid workers’ comp claim.

When questioned about the different results, the doctor denies responsibility. It must be the fault of the appointment booking agency that transcribed his notes, or the insurance company, he says. Without the video record, it’s the patient’s word against the doctor’s. Guess who wins that bout.

How can insurance companies pay for “independent” exams?

IMEs are meant to flush out people who are faking or exaggerating their injuries. More than 100,000 of these exams are given each year in New York State.

The big irony of the system is that the people who are truly hurt – workers who are suffering both physically and financially – are often further victimized by the system. Their cases get ground to dust by the interlocking gears of the big insurance companies, the “expert” doctors who are essentially paid to save the insurance company money, and the “entities” – exam booking and transcription agencies – who give the doctors and the insurance companies plausible deniability.

Check back on the NY Injury Law Blog soon for my tips about IMEs. My recommendations are based on experience advising clients for more than 20 years. It’s a must-read for clients before they have what I refer to as their “Insurance” Medical Exam.

Thanks for reading,
Jim
_________________________________________
James B. Reed, Esq.
Personal Injury & Malpractice Attorney
Ziff Law Firm, LLP
303 William St., Elmira, NY 14902
Tel. (607) 733-8866 Fax. (607) 732-6062
Toll Free 1-800-943-3529
mailto:jreed@zifflaw.com http://www.zifflaw.com

For the next 30 days, in the spirit of Trick or Treat and good fun, the Ziff Law Firm will send a batteryless flashlight to any New York resident who can post as a comment to this blogpost, an original good reason why a represented Workers’ Compensation claimant should talk to any representative of the insurance company.

The flashlight is pictured in this post. It doesn’t require batteries and don’t ask me how it works. It’s approximately the size of a business card, but gives off a surprising amount of light.

My 5th Commandment of Comp is: Do not talk with insurance company claim representatives or investigators. Inform them that you’re represented and let your attorney talk to them. I said that in my “10 Commandments of Workers’ Comp” and I stand by that statement.

I issue this challenge in the spirit of good fun and I promise to use good faith in deciding whether or not an answer qualifies for a flashlight. As I said, to qualifiy the answers have to be posted as original comments to this blogpost.

By the way, I didn’t talk to my managing attorney about this so I reserve the right to withdraw this offer if he pitches a fit. I don’t expect to send out a single flashlight, but I look forward to any and all comments.

Good luck and thanks for reading,
Eric

___________________________________________
Eric L. Johnson, Esq.
Workers’ Compensation and Disability Attorney
Ziff Law Firm, LLP
303 William St., Elmira, NY 14901
Tel: (607) 733-8866
Fax: (607) 732-6062
Toll Free: 1-800-943-3529
Email: ejohnson@zifflaw.com
Web: http://www.zifflaw.com

Disability.gov was launched today to coincide with the 19th anniversary of the Americans with Disabilities Act. Disability.gov is operated by the Department of Labor and incorporates information from 22 federal agencies.

Disability.gov has social media tools to encourage interaction and feedback, and new ways to organize, share and receive information. Visitors can sign up for personalized news and updates, participate in online discussions and suggest resources for the site. Features include a Twitter feed, RSS feeds, a blog, social bookmarking and a user-friendly way to obtain answers to questions on such topics as finding employment and job accommodations. Additional tools will be added during the months ahead.

Given the wide range of government programs about which you can find information on Disability.gov it’s very likely that you can find information useful to you or someone you care about so click on Disability.gov and have a look around.

Thanks for reading,
Eric

___________________________________________
Eric L. Johnson, Esq.
Workers’ Compensation and Disability Attorney
Ziff Law Firm, LLP
303 William St., Elmira, NY 14901
Tel: (607) 733-8866
Fax: (607) 732-6062
Toll Free: 1-800-943-3529
Email: ejohnson@zifflaw.com
Web: http://www.zifflaw.com

Robert William Service said “be master of your petty annoyances and conserve your energies for the big, worthwhile things. It isn’t the mountain ahead that wears you out – it’s the grain of sand in your shoe.” Truer words were never spoken.

The grain of sand in the shoe of many Workers’ Compensation claimants is medical and travel reimbursement (M&T). I first discussed M&T in my blog “New York Workers’ Comp Attorney Discusses Mileage Reimbursement.” Please see that blog for the basics. This blog offers an inspirational quote (see first sentence) and a few more tips.

Simple mileage reimbursement requests are rarely a problem unless you are seeking years of unpaid mileage. I recommend you submit M&T at least annually. One important point for anyone using a taxi or bus is that you MUST get a receipt. The insurance company will not reimburse you for your actual taxi or bus expenses unless you provide receipts for them.

Similarly, for durable medical equipment and over-the-counter (OTC) medications, receipts are the key. Additionally, regarding durable medical equipment (ex. heating pad) and OTC medications (ex. colace), make sure your doctor is writing in his or her medical narrative that he or she wants you to have it because of your work related injury. Please remember that if your doctor doesn’t write that you need it for your work injury, it’s unlikely the insurance company will voluntarily pay for it and the Workers’ Compensation Law Judge will be without power to order the insurance company to pay.

Thanks for reading,
Eric

___________________________________________
Eric L. Johnson, Esq.
Workers’ Compensation and Social Security Disability Attorney
Ziff Law Firm, LLP
303 William St., Elmira, NY 14902
Tel: (607) 733-8866
Fax: (607) 732-6062
Toll Free: 1-800-943-3529
Email: ejohnson@zifflaw.com
Web: http://www.zifflaw.com

Jack Schamel, Eric Johnson, and Terri Ziegler, their assistant, at Jack's retirement party.

Curiosity and a need to be challenged – those are the qualities Jack Schamel says have led him around some interesting corners in life.

He has been a Marine, a teacher, a town justice, and a labor negotiator – to name just a few of his careers. Since 2002, Jack has been the Workers’ Compensation go-to guy at the Ziff Law Firm. In 2007, attorney Eric Johnson began working with Jack in the firm’s Workers’ Compensation and Social Security Disability group. They were a team, ensuring that injured workers in New York and Pennsylvania received fair treatment.

Now Jack is ready for new challenges. He retired Feb. 1st from the firm, handing over the helm of the Workers’ Comp and SSD group to Eric.

The opportunity and the ability

The staff at the Ziff Law Firm, the people he fought for, and the actual battles in Workers’ Compensation court – those are the three things Jack Schamel says he’ll miss most about his work with the firm.

“I also have a strong belief that we should help people when we have the opportunity or the ability,” he says.

Jack has spent much of his life making a difference in the Twin Tiers. He came out of the Marine Corps in 1958 and went to Mansfield University (two years ago he was inducted into the Hall of Fame there.) He worked his way through college, then started teaching and coaching at Southside High School in Elmira in 1962.

He was vice president of the teachers’ union, served on the Waverly School Board, had a scuba-diving on the side and in 1971 was national sales manager for a company from California.

“In late ‘71 what became NEA-NY hired their first UniServe directors. I was the first in New York State,” Jack says. “I worked in Elmira until I retired in 2001.” (Note – that was his first retirement!)

Jack did a lot of labor consulting on the side when he worked with the union. Jim Reed, Managing Partner of the Ziff Law Firm, suggested that Jack train to try Workers’ Compensation cases.

“He said check it out and I found out that if you pass a test and orientation you can get licensed to do comp either for carriers or injured workers,” Jack says. “I took the test for injured workers and passed.
“The test is a b—–!”

In this retirement, Jack says he’ll still do some investigation work for the firm. He’s held a private investigator’s license for about 20 years.

More causes that will keep him busy include “Union stuff on the side, working for the Democrats and whatever looks interesting,” Jack says. “Since about 1991 I have been doing arbitrations around the country for the National Staff Organization. It’s pro-bono work, but I really enjoy it,” he says. “Right now I have cases in six states.”

Jack adds, “I also have 13 grandchildren, so that will also take some time, too.”

Learning from a tenacious, patient advocate

Jack leaves the Ziff Law Firm’s Workers’ Compensation and Social Security Disability group in the very capable hands of Eric Johnson.

“Virtually everything of value I know, I learned from Jack,” Eric says. “There are a couple of things that stick out: tenacity and patience. Jack was a tenacious advocate who would go to any length for the client and he was an incredibly patient man who wouldn’t jump to any conclusions, but allow the facts to develop.”

Like Jack, Eric has taken a few detours in his career path.

His undergraduate degree (1998, East Carolina University) was in nursing, and he worked as a registered nurse in a number of practice areas, including North Carolina, Pennsylvania, California, and Hawaii.

Yes, Hawaii. Eric’s an avid surfer who took travel nursing assignments where the waves were.

Eric earned a law degree from Penn State’s Dickinson School of Law in 2002 and was licensed in North Carolina the same year. When he decided to practice law, he worked in the areas of bankruptcy and housing law with a public interest law firm in North Carolina.

Eric maintained a friendship with law school classmate Matt Hughson, bankruptcy and real estate attorney with the Ziff Law Firm, and that’s how this surfer/nurse/lawyer found his way to Elmira.

Three things he’s found to truly appreciate about his new home are the seasons, the availability of a wide range of outdoor activities, and the people.

“There are a lot of fun things to do in this area of upstate New York – and friendly people to do them with,” Eric says. “You can ski, hike, swim, take a beautiful drive or any number of things.”

Eric was licensed to practice law in New York in September 2008. His years of nursing experience make him ideally suited to the practice areas of Workers’ Compensation and Social Security Disability.

“What’s rewarding about my practice areas is the ability to help folks who had a work injury get back on their feet and get back to work,” he says. “For those who can’t return to work, I can help them secure an income so they can eat and have a roof over their heads.”

• If you have questions about Workers’ Compensation and Social Security Disability, visit Zifflaw.com or e-mail ejohnson@zifflaw.com.

Mileage reimbursement may not seem like an exciting topic, but I’m here to tell you that this benefit can add up to real money that can make all the difference if you’re struggling to make ends meet on Comp. It never ceases to amaze me how many Workers’ Comp claimants, represented and unrepresented, don’t know that they’re eligible for mileage reimbursement.

Workers’ Comp claimants are entitled to mileage reimbursement round-trip from their homes to all medical, chiropractic and therapy treatment for their work related injuries (mileage to and from the pharmacy, the court and your attorney’s office are not reimbursable). The reimbursement rate from July 1, 2008 to January 1, 2009 was 58.5 cents per mile. The reimbursement rate after January 1, 2009 is 55 cents per mile.

Mileage is to be put on form C-257, commonly known as the M & T form, which refers to the fact that this form is to be used for both medical and travel expense reimbursement. We counsel our clients to submit the completed form to us and to let us know if they haven’t been paid in 6 weeks (45 days is the industry standard for mileage reimbursement). We submit the form to the insurance carrier and the Workers’ Compensation Board. If our client hasn’t been paid in 6 weeks, we’ll contact the carrier and if necessary we’ll request a hearing before a Workers’ Compensation Law Judge.

Thanks for reading,
Eric

___________________________________________
Eric L. Johnson, Esq.
Workers’ Compensation and Social Security Disability Attorney
Ziff Law Firm, LLP
303 William St., Elmira, NY 14902
Tel: (607) 733-8866
Fax: (607) 732-6062
Toll Free: 1-800-943-3529
Email: ejohnson@zifflaw.com
Web: http://www.zifflaw.com