What is the Run Around?
Workers’ Compensation is a wage replacement system. By design, you lose money even under the best circumstances since your employer or their insurance company only has to pay 2/3rds of your average pay and that is only if you are considered totally incapacitated from all work, not just your normal job. The “run-around” is sort of a process that tracks the beginning and end of your case with certain little tricks of the trade that look a lot more like a game than a system seriously attempting to quickly and fairly pay claims for medical treatment and lost wages.
It starts with proving your injury is related to your work.
Most times the insurance company will look to point the finger at something other than your work activity as being the cause of your injuries…for example an old injury you had in a car accident, an old sports injury, or very often, an injury that occurred while working for another employer. If it is an occupational disease, like a repetitive trauma case, they will claim you never had an “accident” like some traumatic event where they could actually see you fall to the ground or get struck by an object. They do not want to recognize that repetitive use of your hands, or arms or exposure to loud noises or hazardous inhaled chemicals for hours at a time can cause physical harm.
Next, it is about proving you are not faking or exaggerating your injury.
If you are lucky enough to get your case established as work-related, they then turn the focus on chiseling your benefits. Even good people with fine work records get chisled by insurance companies. It’s not personal, it is business. Insurance companies are not in the business of paying claims, they are in the business of collecting premiums. The law is very favorable for insurance companies in this regard because they can have their doctor see you at any time and your benefits can often be cut without warning. Sometimes they cannot be restored without a full trial and several appeals. Many times most claimants cannot afford to go the distance in that fight because they need their benefits now to pay their bills. Full payment will be no good to them 6-8 weeks down the road, so many times they end up having to settle for a compromise rate.
Then they get really nasty.
Some tactics include scrutinizing your doctor’s reports with a “magnifying glass” for some seemingly trivial defect in order to assert that you have no disability at all. Sometimes it includes surveillance by a private investigator. Although you are the injured party, make no mistake about it, you are the one on trial.
Past results do not guarantee results in your case. Every case must be assessed on facts unique to your claim. However Mike has gotten the following results for his clients in the past:
- $257,723 for a factory who suffered a Pulmonary Embolism during a comp related back surgery
- $240,000 for a former Kodak production worker
- $133,000 for a physical therapist suffering a 50% loss of his leg
- $150,000 indemnity only settlement for a home health aid with full medical benefit remaining open
- $460,036 for an injured delivery driver, $186, 322 for future lost wages and $273, 714 for future medical coverage
Do you need a lawyer to avoid the “Runaround.”
That is hard to say. I tell my clients it is a lot like asking whether you need a doctor. You never know before it is too late. Just like a good doctor, an experienced compensation lawyer can help prevent certain problems before they ever arise. An ounce of prevention is worth a pound of medicine.
The Compensation Law has changed dramatically in the last few years so you can throw out almost anything anyone has told you about their experience with a compensation injury. The Workers’ Compensation system is very politically influenced since the “Board” is an Administrative body appointed by the Governor. It does not take much research to see how much political pressure there is in New York State by private interest groups to make it a more employer-friendly place to live in the Global Economy. The voice of workers and “the little guy” are seldom mentioned in the media. Labor unions and liberal politicians are not looking out for workers. Lawyers are the only ones left looking out for the little guy. It’s not right but….we are all you have got.