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workers compensation indiana

Giving a Recorded Statement

It is not unusual for an insurance adjuster to ask the injured worker, or a witness, for permission to take a recorded statement. A request to take such a statement does not mean the claim will or will not be accepted. Likewise, you do not have to agree to give a recorded statement in order to receive worker’s compensation benefits.

The statement will likely be taken before any decision is made with regard to the injury claim. It is done as part of the insurance carrier’s investigation into the incident.

If you do give a statement, the questions that will be asked may include questions about your job, how the accident occurred, if you had prior medical problems and so forth. Here are some suggestions to follow if you are giving a recorded statement:

  1. Be honest and truthful. This statement may be used against you later on (if you are dishonest).
  2. Do not guess. If you do not know the answer, say that you do not know or do not recall. Otherwise, you will be held to your answer.
  3. You only have to answer the question. You do not have to give more information than asked for.

Before giving a recorded statement, it is wise to have an outline ready with the facts of your claim. Go over the details of the accident and the events that led up to it. You can also note the effects it’s had on your life and the treatment you’ve received up to this point. This will keep you on track during the statement. Remember to stick to the facts, do not stray.

If you’d like the advice and guidance of an attorney before giving a recorded statement, contact the attorneys at Klezmer Maudlin at 317.569.9644.

New Guidelines for Nurse Case Managers in Indiana

A Nurse Case Manager is a Registered Nurse who is hired by the insurance company to oversee your medical treatment. A good Nurse Case Manager can be very helpful to your recovery, but a poor Nurse Case Manager can interfere with your medical treatment.

The Indiana Workers’ Compensation Board has issued new guidelines for Nurse Case Managers.

The Indiana Worker’s Compensation Board has issued guidelines for the use of Nurse Case Managers (“NCM”) in the administration of compensation claims.  A NCM may be involved in a claim to schedule appointments, help facilitate care suggested by the medical provider, and to report back to the employer and/or carrier.  However, a NCM should not express opinions, to either the injured worker or the medical provider, regarding an injured worker’s course of medical care or otherwise attempt to influence the process.  Additionally, a claims adjuster should not attempt to direct the care provided to an injured worker by the authorized treating doctor.

If you feel a Nurse Case Manager is interfering with your medical treatment in a workers’ compensation case, please call us at 317.569.9644 to discuss your case.

Nurse Case Manager Misconduct

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Have you been hurt at work and the insurance adjuster assigned a nurse case manager to accompany you to your medical appointments?

We represented a worker who had a nurse case manager attend all doctor’s appointments with him. A nurse case manager is a nurse who is supposed to take a look at a workers’ compensation claim from a broad view, considering both the medical and legal aspects of the case. Some of the duties of a nurse case manager include:

  • Schedule appointments
  • Act as a liaison between the injured worker, medical provider, employer and workers’ comp benefit provider
  • Ensure the doctor keeps the employer/insurance agency informed of recommendations including work restrictions
  • Help facilitate care suggested by the medical provider

Before the nurse case manager’s involvement, the injured worker felt like he had a good relationship with the doctor that was treating him…until the nurse case manager came along.

Once the nurse got involved, the client felt that the doctor treated him differently and that the nurse controlled the medical visits. The doctor would defer to the nurse regarding treatment choices, such as authorizing an MRI and even the PPI.

The Indiana Workers’ Compensation Act does not currently regulate the conduct of nurse case managers. However, if a nurse acts improperly, that can result in sanctions being issued against the insurance company. We have seen nurse case managers that attempt to manipulate the medical care being given to our clients. Instead of helping the injured worker recover from his injuries, the nurse case manager is acting in the best interest of the insurance company to cut off your medical care and benefits.

If you have a situation where a nurse case manager is controlling your medical care, we can help. Call us at (317) 569-9644. Don’t let a nurse case manager impact your medical care, get the treatment and rehabilitation you deserve.

Hiring an Attorney for Your Worker’s Compensation Dispute

 

Should I hire an attorney?

It is your right to either represent yourself in a worker’s compensation dispute or to hire an attorney. If an Application for Adjustment of Claim (Form 29109) is filed with the Board in your case, then by law, your employer must hire an attorney. Thus, it is often advisable, although not required, that the injured worker be represented as well.

When deciding whether you want to involve an attorney, keep in mind that Indiana’s worker’s compensation laws are written in a way which tend to favor the employer as opposed to the injured employee.

How much does it cost to hire a worker’s compensation attorney?

A free legal consultation with an attorney experienced in the Indiana worker’s compensation system may help you to better determine whether your rights are being protected and whether legal representation is needed at that time.

Attorney fees are limited by the Indiana Worker’s Compensation Act. According to the law, attorneys can charge $200.00 up front, as well as a percentage of any recovery received in a worker’s compensation case. Attorneys may be willing to waive the upfront fee until the case is settled. The current recovery fee percentage is 20% of the first $50,000 and 15% of any remaining amount.

Example:

Deborah and her attorney settled her worker’s compensation case for $60,000. Since the attorney agreed to waive the upfront fee of $200 until the case was resolved, a breakdown of attorney’s fees includes $200, plus 20% of $50,000, plus 15% of the remaining $10,000.

Amount to Attorney: $200 + (.20 x $50,000) + (.15 x $10,000) = $11,700

Amount to Deborah: $60,000 – $11,700 = $48,300

At the end of the case, you may also be asked to pay for any out-of-pocket expenses incurred by the attorney for items such as medical records, postage, long distance phone calls, appointments with specialists, and so forth. These expenses were not included in the above example.

How can I receive the form that lets me get an Independent Medical Examination (IME)?

 

If you have not received a form that lets you get an independent medical examination (IME), but you have been released from the worker’s compensation doctor, then you can contact the worker’s compensation insurance carrier and ask about it.

If you find out that you are not eligible for an independent medical examination (IME) through the Board, then you can seek one at your own expense and try to use your doctor’s report as leverage to get your benefits reinstated. Obviously, this would only happen if the doctor’s report is favorable to you.

If you do seek an IME, make sure you select a doctor with an excellent reputation or the Board may discount your doctor’s opinion.

How long will you receive medical treatment for your worker’s compensation claim?

You will receive medical treatment until you are released from the doctor at maximum medical improvement, which basically means your injury is as good as it will get and will not significantly improve with more treatment.

workers comp indiana

From this point forward, you are free to treat with a doctor on your own, but you will have to pay for this treatment. Exceptions apply to those workers who qualify for permanent total disability, or who are eligible for future medical benefits.

Can an Employer use Surveillance Video Against You in an Indiana Worker’s Compensation Case?

Yes.

It is legal for an employer or their insurance carrier to use surveillance videos as part of their investigation.

And–if properly entered as evidence before a hearing– the video can be used against you if you were caught being dishonest. For example, if your employer has you on video tape hanging party decorations after claiming a shoulder and back injury, your employer may use this video evidence against your claim.