GADSDEN WORKERS COMPENSATION LAWYER
SERVING CLIENTS IN GADSDEN AND NEARBY AREAS OF ALABAMA
If you were injured at work and now you are being deprived of your worker’s compensation benefits, you are going to need an army of attorney’s at your side. Dani Bone & Sam Bone in Gadsden, AL will fight for you. When they fight for you they are fighting for what they believe in. Workerplace injury compensation is a benefit provided by employers to employees who are hurt Many people work their lifetime paying into these protective benefits, but when they need the money, the company denies their claims or keeps them on “scavenger hunts”, demanding paper work based on statutes in efforts to deflect the plaintiff. We are dedicated to our craft.
Workplace injury is familiar case and our attorneys are well informed of state and federal laws pertaining to worker’s compensation claims and recent court decisions. If you are looking for legal representation, finding the right attorney can be a daunting task full of false promises. At Dani V. Bone & Sam D. Bone, Attorneys at Law, our integrity is the most important part of foundation and is the basis of our conduct. We as people believe in fighting for what is right, and you know that no matter what the case may be, when you have someone with heart fighting for you justice will always prevail. We value our clients as people always taking into consideration theirs feelings and desires. Our goal is to represent the injured and help them get their lives back on track.
Some people may have injuries that totally alter their lives and in these cases we need to consider all possibilities and problems that may arise in the future from these conditions. Accidents often affect more then the victims, also they greatly affect the entire family. Spouse, parents, and children have to take off work sometimes without pay to take care of their loved ones. Getting the financial support you need in these times is your right as US citizens and as human beings. You need someone who is going to cater to your needs and request. A passionate attorney that will stand up for your rights with knowledge and heart. Our law firm has received several prestigious awards, but achieving justice is the best award in the hearts of our firms attorneys. Established in 1997, we have built a legacy on providing the best legal services by being attentive and honest, representing good people who are in bad circumstances and need help.
If you have had your worker’s compensation claims turned down, then now is the time to take legal action, and if you want the best possible outcome for your case then you need to contact Dani Bone & Sam Bone. They can assist you in fighting for your rights!
What is recommended for getting the correct and proper treating medical provider from the beginning of the claim for workers compensation in alabama?
Alabama Department of Labor Administrative Code 480-5-5-.12 - The employer/carrier directs care. Except in the case of an emergency, claimant should be sent to the employer/carrier's chosen primary care provider who will treat and recommend referral to a specialist, when necessary. The employer/carrier directs the care from the moment the injury notice has been given, not after treatment has been ongoing.
If the approved treating physician refers the employee to another physician, is the employer obligated to approve that particular physician?
Who controls medical treatment?
The employer or carrier.
When is an IME (independent medical exam) needed?
Code of Alabama, 1975 §25-5-77(b) - An IME is an independent assessment of the claimant's physical condition and/or bodily functions performed by a non-treating physician with written report of findings. Generally occurs prior to return-to-work status. May be requested by employer or employee. It does not equate to utilization review. It is not a second opinion in that it is not a confirmatory evaluation. It is not an impairment rating in that no impairment rating is given. The examination is done by someone other than the individuals' family physician or a physician who is currently treating or has previously treated the claimant for the same complaint.
Can the employer or agent conduct utilization review?
Yes, any entity involved in the administration or payment of workers' compensation claims may, but are not required to implement utilization review.
Does medical treatment require pre-certification?
Alabama Department of Labor Administrative Code 480-5-5-.08 lists those services that require certification. The list is not all-inclusive. From a practical standpoint all medical treatment can be pre-certified. The carrier and provider may mutually agree to procedures that will not require pre-certification.
Is my employer responsible for paying my medical bills - Worker's Compensation Alabama?
Code of Alabama, 1975 § 25-5-77(a) Upon approval of the workers' compensation claim, the employer is responsible for paying only medical bills associated with the injury in question.
Do I receive mileage reimbursement for my doctor visits -Workers Compensation Alabama?
Yes. Refer to https://labor.alabama.gov/docs/guides/wc_mileage_rate.pdf for specific amounts. Contact your adjuster regarding how to submit for reimbursement.
How long should a medical provider have to wait for reimbursement?
Code of Alabama, 1975, §25-5-77(h) & Alabama Department of Labor Administrative Code 480-5-5-.04
Twenty-five (25) working days from the date of receipt.
How long does a medical provider have to submit a bill?
Alabama Department of Labor Administrative Code 480-5-5-.33 - One year from date of service.
Do HIPAA regulations change the procedure of providing medical records within the worker's compensation law?
No, HIPAA law does not preempt state law on workers' compensation and should not impede the process.
Can a medical provider bill a workers' compensation claimant for medical services?
Code of Alabama, 1975 §§25-5-77(g) & 25-5-293 (g) - Not if the treatment was authorized; however, the employer is not liable for medial or surgical treatment obtained by the employee without justification or notice to the employer.
Must I submit to medical examinations arranged by my employer?
Code of Alabama, 1975, §§25-5-77(a)(b) - Yes, the injured employee shall submit to examination by the employer's physician at all reasonable times.
Can a medical provider charge for copying medical records in a workers' compensation case?
Code of Alabama, 1975, §§25-5-77(b) & 12-21-6.1 - Yes, however, no charge is allowed for the initial bills sent by institutional and non-institutional providers for reimbursement.
The insurance company has denied my claim. Should I hire an attorney?
The moment any complexity arises in your case is the moment you should hire an attorney. Here are some examples of situations that call for a lawyer’s intervention:
Your employer denies your claim or doesn’t pay your benefits promptly. Employers and workers' comp insurers routinely reject bona fide workers' comp claims, confident that many workers will fail to appeal. Unfortunately, they're usually correct. Hiring a workers' comp attorney costs nothing up front (more on that later), and it gives you the best chance to receive a fair settlement or award for your injuries.
Your employer's settlement offer doesn't cover all your lost wages or medical bills. If you're not sure a settlement offer is good enough, don't rely on the workers' compensation judge to make sure that you're getting a fair deal. Although workers' comp settlements must have judicial approval, judges will usually sign off on any agreement as long as it's not grossly unfair. If you really want someone to get you the best settlement possible, call an attorney.
Your medical issues prevent you from returning to your prior job, limit what you can do at work, or keep you from performing any work at all. If you've suffered permanent disability—whether partial or total—you may be entitled to weekly payments (or a single lump sum) to make up for your lost wages. These cases can be very expensive for insurance companies, and they'll often stop at nothing to avoid paying you what you deserve. A knowledgeable workers' comp attorney is essential in cases involving permanent injuries or illness.
You receive or plan to apply for Social Security disability benefits. If your settlement isn't structured properly, your workers’ comp benefits could significantly lower Social Security disability payments. An experienced attorney will understand how to draft your settlement agreement to minimize or eliminate this offset.
Your boss retaliates against you for filing a workers' comp claim. If your employer has fired you, demoted you, slashed your hours, reduced your pay, or engaged in any other form of discrimination because you filed a workers' comp claim, contact a workers' comp attorney immediately to protect your legal rights.
You were injured because of a third party’s actions or your employer’s serious misconduct conduct. The workers' comp system was designed to prevent civil lawsuits for work-related injuries. However, you are permitted to sue outside workers' comp in certain situations, including when someone other than your employer contributed to your injury (such as a negligent driver who hit you while you were driving for work), your employer doesn’t have workers’ comp insurance, or your employer intentionally caused your injury. An experienced lawyer will be able to explain how the law applies to your situation.
What Your Attorney Will Do for You
In addition to making sure you file all the necessary forms and meet the deadlines, an experienced attorney will know how to gather the evidence needed to support your case, negotiate effectively with the insurance company, and write a settlement agreement to avoid unanticipated consequences. If you can’t agree on a good settlement, an attorney can prepare for and represent you at the hearing or trial.
What is the Statute of Limitation of a workers' compensation claim?
Two years from the date of injury or two years from the date of last compensation payment.
My employer does not have light duty. Will I receive benefits, and if so, for how long?
If the employer does not have light duty, the injured worker will receive benefits until he reaches MMI or until the employer can accommodate restrictions and possibly return the injured worker in a light duty capacity. If in the light duty capacity, the injured worker received post injury earnings less than pre-injury earnings, the injured worker will receive 66 2/3% of the difference between post injury earnings and pre-injury earnings, subject to the state maximum.
How much am I going to get paid under workers' compensation?
Based upon an approved claim, and after the 3-day waiting period, payment will be 66 2/3% of the employee's average weekly wage subject to the maximum and minimum. This is also depending on the authorized treating physician's approval of the missed days from work.
How is an injured workers' average weekly wage (AWW) determined?
AWW is calculated using your earnings for the 52 weeks prior to the injury and reportable on a Federal W-2 form. If an employee has not been employed for 52 weeks, the employer may base the AWW on a similarly situated employee. AWW is subject to the State maximum at the time of injury.
Earnings during last 52 weeks ÷ 52 weeks = AWW
How long do I have to wait before my first check?
Code of Alabama, 1975 §25-5-59 (b) - After the 3-day waiting period, the indemnity period or disability period starts on the 4th day you are out of work. Payment of compensation benefits should be paid within 30 days after it becomes due unless there is a sufficient reason it has not been paid.
Is there a waiting period before I start receiving pay? Will I get the 3-days' back or do I lose them?
Code of Alabama, 1975 §25-5-59 - There is a 3-day waiting period. You will receive the 3-days back only if you are out of work for a period of time exceeding 21 days.
Can a workers' compensation claim be denied if the injured worker refuses to submit to a drug/alcohol screen?
Code of Alabama, 1975 §25-5-51 - Yes, no compensation shall be allowed if the employee refuses to submit to or cooperate with a blood or urine test.
Can an employer refuse to file a workers' compensation claim because there was no witness to the accident?
No. Just because an accident wasn't witnessed doesn't mean it didn't happen. A first report of injury must be filed with our Department.
Can an employer continue an employee's salary in lieu of workers' compensation benefits?
Yes, an employer can continue your salary in lieu of workers' compensation benefits but the insurance company still has to file a WC 3/4 form with Workers' Compensation Division showing monies paid. It is necessary to report to the Division that the employer is paying salary in lieu of workers' compensation benefits.
Is the insurance company required to notify the injured worker of cessation of TTD benefits before they are actually stopped?
Code of Alabama, 1975 §25-5-57 - No, the law does not require notice of the termination of temporary total benefits before they can be stopped.
How many employees must you have before workers compensation coverage is mandatory in alabama?
Any business that has five (5) or more employees, other than contractors, is required by law to have workers' compensation coverage. The term employee includes all full or part-time employees, officers of a corporation or members of an LLC.
Where can an employer purchase a workers' compensation insurance policy in Alabama?
You may obtain workers' compensation coverage from your local insurance agency. The State of Alabama does not sell workers' compensation insurance.
Can a general contractor charge a sub-contractor for workers' compensation insurance?
Yes, but an employer cannot charge an employee for workers' compensation.
How can I get a file review for medical issues?
Pursuant to the Code of Alabama, 1975, §25-5-77(i)(5) we offer medical dispute resolution. Once we receive an opinion from one of our independent medical experts on the disputed issue or issues, we will prepare a non-binding recommendation in writing.
What are the options for the injured employee if he or she gets an adverse determination pursuant to medical dispute resolution? For the employer if determination is in employee's favor?
The employee's attorney may petition the court.
How can abuse of prescription pain medications be controlled?
All medication can be pre-certified to insure medical necessity is met. The employer can initiate background checks and surveillance if the situation warrants it. The physician may be contacted concerning possible addiction or asked to perform random unannounced drug screens.
What is the purpose of a medical mediation and how is it conducted?
A medical mediation is handled the same as our compensation mediations, except the issues to be mediated are medical issues and not settlement of compensation. If the parties agree to a resolution of the medical issues in question, the parties shall sign a binding mediation agreement.
hire a gadsden, alabama workers compensation attorney
A knowledgeable workers' comp attorney is essential in cases involving permanent injuries or illness. You receive or plan to apply for Social Security disability benefits. If your settlement isn't structured properly, your workers' comp benefits could significantly lower Social Security disability payments. Call an experienced lawyer today at 256-547-1005.