Work Compensation Settlement and SSDI

Years ago in Georgia, applying for SSDI during your Georgia Workers Compensation case was a good idea. The same standard used for SSDI was used by the Georgia State Board of Workers Compensation to determine whether your case was "catastophic" that is, "whether your injury has prevented you from finding work of substantial numbers in the national economy."

However, several years ago, the Federal Government changed some SSDI laws and now if you are on SSDI or have applied for SSDI and have a Georgia Workers Compensation Case, the insurance company will only settle it in conjunction with a Medicare Set Aside Trust (MSA for short).

Effectively money that would/could be used towards your settlement (so you can pay your own medical bills) will not be applied towards the money going to you but rather placed in a trust account you cannot touch unless you specifically use it to pay for your job related medical expenses.

As a rule of thumb I do not normally encourage my Georgia workers compensation clients to apply for SSDI prior to settlement of their workers compensation claim.

This is a very tricky area of the law and there are exceptions, seek legal help by discussing your specific facts with a lawyer how knows this area of the law.

Settlement

Most insurance companies want to settle their claims. If they don't they have to keep hiring more adjusters, more lawyers, more office space, etc. Not to mention that many serious cases tend to get worse and more expensive over time rather than better and cheaper.

I heard an adjuster say once that the only good workers compensation case is a settled workers compensation case.

Putting a value on the proper amount for the settlement is the trick. Adjusters will not tell you all your rights so many injured workers who think the adjuster is their friend get taken advantage of.

Make sure your settlement takes care of your income benefits, medical care, rehabilitation, and your future needs like housing and transportation.

Top 10 List: Reasons to Hire an Experienced Personal Injury Attorney

10. EXPERIENCE ASSESSING CLAIMS. Personal injury attorneys are experienced with cases like yours and can tell you at the outset whether it is worth your while to pursue legal action. If you are unlikely to prevail, you will not need to incur the time and expense of preparing for litigation.

9. NO FEES IF YOU DON'T RECOVER. Most personal injury attorneys work for a contingency fee, which means that if you do not win your case, you will pay no attorneys' fees.

8. RED TAPE. An experienced attorney can work through the maze of paperwork necessary to resolve your claim so that you can get on with your life.

7. INVESTIGATIVE TEAM. Experienced attorneys work with a team of investigators who have experience in specialized areas and will skillfully investigate the technical aspects of your case.

6. OBJECTIVITY. A personal injury attorney can be more objective about your case than you can and will not make a rash decision. Whereas you may be tempted, for instance, to go for a quick payout, your attorney may counsel you that it is in your best interests to wait for a more appropriate offer.

5. ALTERNATIVE DISPUTE RESOLUTION. An experienced attorney will know whether your dispute may be best resolved through mediation, thereby saving you time, money, and emotional energy.

4. EXPERIENCE WORKING WITH OTHER LAWYERS. An experienced personal injury lawyer can deal most effectively and expediently with opposing counsel.

3. EXPERIENCE WITH INSURANCE COMPANIES. Lawyers are also used to working with insurance companies and will not be confused by their tactics or feel pressured to settle for an unsatisfactory amount.

2. BEST SETTLEMENTS. Personal injury attorneys work hard to reach the best settlements for their clients, as early in the litigation process as possible.

1. BEST JURY VERDICTS. If a trial becomes necessary, a personal injury lawyer can zealously represent you in court and work toward achieving the best possible jury verdict in your favor.

Amputations and Paralysis

Amputations

Amputation is defined as removal by surgery of an external body part, usually all or part of a limb. Amputation may be required when a limb has been severely crushed or when blood circulation is impaired. Other conditions which could lead to amputation include infection, frostbite, burns, or ateriosclerosis. Even though a body part has been removed, some amputees report the feeling of painful sensations from the removed part. This condition is called phantom-limb pain.

Paralysis, Paraplegia, and Quadriplegia

It is a tragic event when you or a loved one suffers an injury so severe that it results in paralysis, paraplegia, or quadriplegia. If the injury was caused by someone else's negligence, you owe it to yourself and your family to consult with The Keener Law Firm, so that one of our legal professionals can explain the rights you may have against the negligent party.

Paralysis occurs when there is a loss or impairment of motor function due to lesion of the neural or muscular mechanism. There are many causes of paralysis, including trauma.

Paraplegia refers to paralysis from approximately the waist down.

Quadriplegia refers to paralysis from approximately the shoulders down.

Serious spinal cord injuries can result in a loss of sensation. The causes of spinal cord injuries vary. Statistics show that motor vehicle accidents cause 48% of spinal cord injuries and falls cause 21% of spinal cord injures.

Beat The Insurance Adjuster

Don’t let the adjuster keep you from getting the money you deserve!

Insurance adjusters thrive off of the confusion that an auto accident causes in people's lives. The adjuster’s job is to make the insurance company more money by paying less money to people injured. They do this by taking advantage of any instances where an injured person does not have proof of damages or injuries. We know that’s not fair, so we’ve put together some ways that people injured in an auto accident can show proof of their injuries and beat the insurance adjuster at his own game.

At the Scene of the Collision:

Make observations (Also see our Auto Accident Procedures page)
Identify the witnesses so there will be someone to support your case if it goes to court. Write down their names and addresses and interview them. Ask them what they saw and make a note of phrases they used like "slammed into," "plowed," "speeding," or "he ran the red light." Beware of insurance representatives at the scene of a car wreck in Georgia. It has been rumored that some insurance companies send adjusters to auto accident scenes in order to catch people off guard with incriminating questions or to have them sign away any rights they may have to future compensation.

Immediately After the Collision:

See a Doctor
If you are injured, schedule an appointment with your own doctor as soon as possible. Don’t let the insurance adjuster choose a doctor for you. You have the right to a doctor of your choice.

Take Photos
Take photos of your car as soon as possible after the car accident. When the adjuster asks for proof of damage, it is difficult to dispute a picture taken of your car at the collision scene. Photos of the damage will help tell your story. If possible, take photos of the other cars involved as well. These pictures will help supply information about the severity of the impact associated with your car wreck in Georgia.

Take photos of your injuries before they heal. In many cases, the seat belt strap will bruise a client across the shoulder and chest, but after several weeks those bruises heal. Months later, when the insurance adjuster is arguing that the auto accident was not very significant, pictures of your bruises and other injuries will help solidify your personal injury claim.

As Time Passes:

Write Down Your Observations
Keep notes about your injuries. In 6 or 7 months, you might forget how it hurt just to get dressed, and the adjuster will try to make it seem like any description you give is an exaggeration. Write down your pain medications. These kinds of written documents can be very valuable when presenting your personal injury claim to the insurance adjuster or to a judge and jury in court.

Keep Records of Expenses
The adjuster will ask for proof of anything you claim as an expense. Be sure you keep receipts for prescriptions, household services like lawn-mowing and getting someone to cook for you, car rentals, and so forth. Keep each of those receipts so you can document every expense.

Most Importantly:

Consult an experienced personal injury lawyer.
Without legal help from a Georgia auto accident lawyer like The Keener Law Firm Personal Injury Lawyers, you may have no idea of the real value of your claim. And, the Insurance Research Council found that on average injured people who use a lawyer receive three and a half times more money than those who do not! (Source: Insurance Research Council 1999 study).

The bottom line is that the insurance adjuster is not on your side. His goal is to save the insurance company money by giving you as little as possible. Whether you choose The Keener Law Firm Personal Injury Lawyer to represent you or not, you need an experienced, tough law firm on your side, with experienced, tough auto accident litigators on the case. Don’t go it alone.

If you have been injured, contact The Keener Law Firm Auto Accident Injury Lawyers today!

What Should I Know About Auto Insurance

In auto insurance, there is first party coverage and third party coverage. First party coverage covers you and your property (such as medical expenses, damage to your vehicle and the insurance company's duty to defend you in the event that you are sued as the result of your operation of a vehicle, etc.). Third party coverage is for your responsibility to pay for injury caused to other people, whether in your vehicle, or another vehicle involved in the accident. The coverage (and its exclusions) is set forth in your insurance policy. In exchange for the payment of a premium, the insurance company promises to provide compensation in the event of certain occurrences. You can speak to an insurance representative to find our more about the options available to you, and their costs.. Before purchasing auto insurance, it is a good idea to shop around and buy the coverage that best suits your needs at the most reasonable price. You may wish to consider factors such as customer service, claims paying ability, claims payment record, general reputation and independent rating organization's ranking.

In determining what Liability Limits you should purchase, you need to consider the amount of exposure that you have. As a general rule, the more property and wealth you own, the greater your exposure is, and the greater the need for protection against claims from third parties. Often, liability limits are set as a combination of numbers, such as 25/50, which means coverage of loss of up to $25,000 per person and up to $50,000 for all injuries which occur in a single accident. Many states require a minimum amount of third party liability insurance be purchased before a you may drive a vehicle on public roads. This is referred to as the minimum liability limit. Often the minimum liability limit is inadequate to protect all of your property and wealth. Increased limits, such as 100/300 or 300/500 are very common and can be purchased at modest addition cost to you.

Your vehicle itself can be covered in several different ways. Comprehensive coverage provides coverage for loss to your vehicle due to certain proximate causes (such as fire, theft, vandalism, and acts of nature). Collision covers damage to your vehicle in the event that it collides with another vehicle of object, often regardless of who is at fault in the event of an accident. Both comprehensive and collision coverage may be subject to a deductible, that is, damage to the vehicle must exceed the deductible amount before the insurance company will pay you for a covered loss. Deductibles for this coverage are available is various amounts, generally the greater the deductible, the lower the premium for the coverage.

Most insurance policies require Notice of Loss be provided to the insurance company. When you are involved in an accident, the terms of most insurance policies state that you must contact your insurance company and tell them about the accident. Should you fail to tell your insurance company about an accident in a timely manner, the insurance company may try to deny coverage for the occurrence.

After you have notified your insurance company of an accident, the policy may require you to "Tender the Defense" of any claims arising out of the occurrence to the insurance company. This means that you are required to allow the insurance company to hire an attorney or otherwise participate in the settlement and litigation of claims against you by third parties. This also protects you, as the insurance company will provide a defense for you in the event that you are sued as a result of your operation of a vehicle.

Once an insurance company has provided benefits to you, such as the repair of your vehicle under collision damage coverage, you must give the Subrogation Rights arising from the accident to the insurance company. This means that once your insurance company has "made you whole" after a loss, you must give your right to pursue negligent third parties for compensation to the insurance company. This enables the insurance company to be "made whole" for its payment to you by recovering damages from the negligent third party. In other words, if your insurance company pays you for damages incurred in an accident which was not your fault, you give them the right to sue the party at fault, and you give up that right.

Some states, and many insurance companies, have Mandatory Arbitration of disputes arising out of auto accidents. In a mandatory arbitration state or insurance policy, liability for damages must be determined as a result of an arbitration process before a civil lawsuit can be filed in the court system. In arbitration, neutral arbitrators (knowledgeable practicing attorneys) are selected, and evidence is presented to them. The arbitrators then determine the amount of the arbitration award. If the arbitration award is agreed to by both parties, the matter is ended (the arbitration award may be made a court judgment for further enforcement purposes). If either of the parties involved refuses to accept the arbitration award, a lawsuit may then be filed to have a new trial in a court of law, with liability to be determined by a judge or jury.

Car Accident Procedures

1. Stop immediately. Stay calm and do what you can within reason to avoid blocking traffic. Never leave the scene of an accident in which you or your car were involved no matter how slight the collision. Failing to stop at an accident may subject a person in the Georgia to a criminal action for leaving the scene of an accident, even though the accident is not the person’s fault. Pull over to the side of the road as soon as possible without endangering any other person and without obstructing traffic.

2. Check to see if anyone is injured. Take care of any person that is injured, including rendering medical attention as soon as possible. Contact 911 or any other ambulance service in order to receive medical treatment. Do not assume that a lack of an injury means that a person it not hurt.

3. Call the police. An accident should be reported to the proper authorities. The report may not only be helpful later if you determine that you are injured or there is damage to your car but it may be helpful later if the other person tries to avoid responsibility for the accident.

4. If an insurance adjuster shows up at the scene, don't give any statements and don't sign anything.

5. If possible get the names, addresses and phone numbers of witnesses. Make a mental note of what witnesses say, like, "That black car was flying."

6. Visit your doctor as soon as you can. Even if you are not sure whether or not you are injured or anyone else in your vehicle is injured in the accident it is best to be examined by a doctor at the earliest possible time or to go to the nearest emergency room. If you are examined by a doctor, make sure that you are specific in explaining to the physician how the accident happened and any and all injuries and problems you sustained as a result.

7. Inform your insurance company of the collision. Make sure that you call your insurance company immediately to report the accident. Failing to report the accident immediately could in some instances result in the insurance company not covering you for the accident. You should contact the company immediately and if you are injured make sure that you ask the company to start paying your medical bills and open up a file to not only pay the property damage but all of your medicals.

8. Do not immediately pay citations and tickets. If you receive a traffic citation or ticket it does not mean that you are necessarily at fault, however, if you are anticipating bring a claim against the other driver and receive a ticket, it is best to get advice from an attorney prior to paying the ticket.

9. Cooperate with your insurance company’s investigation completely: Make sure you copy all documentation you receive regarding the accident for your records. Also, if you provide a statement under oath to any insurance company, even yours, make sure that you obtain a copy of it.

JOINT AND SEVERAL LIABILITY

I was recently asked by a client to explain joint and several liability in Georiga. Basically, it's a legal doctrine which apportions liability between two or more defendants. Currently, in Georgia, you can collect the entire judgment against one, or all, of the defendants.

For example, let's say you were injured in a car wreck, while a passenger in A's car, when it entered an intersection and was impacted by a car driven by B. Both A and B claim they entered the intersection on a green light, a lawsuit is filed, and liability is assessed 50/50 against both drivers. You obtain a verdict in the amount of $50,000.00. Under joint and several liability, you have the right to collect the entire amount from A or B, and they can then try to collect their share (in this case 50%) back from the other driver.

Joint and several liability is more favorable to the plaintiff, because it gives the plaintiff the option to collect from any defendant able to pay the judgment.

IS THE GEORGIA WORKERS COMPENSATION INSURANCE COMPANY HAVING ME FOLLOWED?

Sometimes the insurance company will hire a private investigator to follow you around. I would say that 90% of my clients do not know when they are being followed around by an investigator.

I had a client one time who, after taking his pain medicine took out his trash. The insurance company got a video of that and cut off his benefits claiming he was obviously better since he could take out his trash. After all they reasoned, he had a 20 lb lifting restriction and his trash must have weighed more than that.

First of all, they had no idea how much his trash weighed. They didn't go to his trash can, lift out the bag and weigh it. They took the video to his doctor and tried to get his doctor to release him to return to work with no restrictions. Fortunantly the doctor wouldn't fall for that ruise.

Just because someone has a good day, or feels better after taking their pain medication does not mean they are healed.

If the insurance company is having you followed, call a qualified Georgia Workers Compensation Lawyer

GOING BACK TO WORK

Sometimes I will receive a call saying I'm currently receiving a weekly income check from workers compensation because of my job injury. My doctor told me I can work on modified duty yesterday and miraculously the employer (or the insurance company adjuster) called me today and told me to show up for work tomorrow (some even have the nerve to incorrectly say, if you don't go back to work tomorrow, your benefits will be cut off).

There is a formal process put in place by the Georgia Legislature that the insurance company needs to follow before you go back to work. This procedure was put in place in order to protect you from unscrupulous employers and insurance companies and has certain safeguards built into it that protect you in case you try to go back to work and and can't do it. By forcing you back to the job without going through the correct formal process, you can seriously jeopardize your ability to continuing to receive all the benefits you are entitled to.

Do not risk making your injury worse by going back to work doing things that may end up hurting you even more.

If you have been receiving a weekly income check through workers compensation and your employer or the insurance company is trying to rush you back while you are still on restrictions, call a qualified Georgia Workers Compensation Lawyer to help you with you case.

GEORGIA WORKERS' COMPENSATION SETTLEMENTS

In a Georgia workers compensation case only resolves at settlement. There will never be a judge or jury who will slam down his gavel and order the other side to pay you a large final judgment.

Settlement is volumtary. If the employer/insurer does not want to settle, your Georgia Workers Compensation case won't settle, if you don't want to settle, your case won't settle.

Settlement can be handled through mediation. Mediation is when all the parties get together and discuss the value of the case and attempt to reach a resolution.

Some cases settle with what is called open medicals (that's where you are allowed to get medical care for a limited amount of time after settlement). some with closed medical care.

I tell my clients that workers compensation cases are like apples on a tree, there is a right time to pick the apple. You don't want to settle too early, you don't want to wait too long.

Knowing when to settle your case and how much to settle for is an art. We can tell you what your case is worth and when it is ready to settle. If you want to settle your case for full value, call a qualified Georgia Workers Compensation Lawyer

DON'T TAKE AWAY MY DOCTOR!

If you have a doctor you like and he is providing you with helpful medical care you need, some unscrupulous insurance companies will try to get you away from that doctor over to a doctor who will do what they want him to do. That is, provide you with limited "conservative care" and release you to full duty with no restrictions even thought you are still having problems. Once that happens, the insurance company will cut off your benefits.

Many times after that happens, the employee will try to go back to work and get fired . That puts the employee on the street with no income, a medical issue and a doctor who does not want to see him. What could be worse.

Do not allow the insurance company to get you away from a good doctor who is intereted in helping you and what is best for you. If the insurance company is trying to get you away from a doctor that is helping you or if the insurance company has already gotten you over to a doctor who is not addressing the issues you are discussing with him, I would recommend getting a lawyer involded to represent your rights.

HOW LONG WILL MY CASE TAKE?

Today I'm going to talk with you about a frequent question I receive.

How long will it take to resolve my case?

Whenever I hear that question, I always give the same answer It depends. It depends on how much medical care you require.

At the beginning of your case the most important thing is reporting your injury to your supervisor (if you were injured on the job), getting diagnosing your problem and getting you proper medical care for your diagnosis.

That could take 2 months, it could take 2 years. It depends on the seriousness of your injury and how you respond to the doctor's treatment plan.

Nevertheless , one day you will reach what is called Maximum medical improvement or MMI for short. That doesn't mean you are healed 100% but rather that you are as good as you are going to get.

Once you reach MMI we will discuss your case with the doctor and get him to tell us what your future holds.
You may require ongoing medical care or prescription medication.

You may have permanent restrictions.
He will help us understand how your injury have changed your life and how your injuries will affect your ability to earn money in the future.

After you have completed your medical care and we talk with your doctor we can discuss what your case is worth and talk about resolving your case for the full value of the claim.

FAST SETTLEMENT? BE CAREFUL

Three days after you have a car wreck, you are contacted by the other person's insurance company offering you a FAST personal injury settlement . You have not finished your medical care and are not exactly sure what your medical future holds. Nevertheless, fast money sounds great and they dangle it in front of you like a worm on a hook to a hungry fish.

Many times, after a car wreck here in Georgia, the insurance company will contact you about a FAST settlement. Some Georgia law firms even advertise on TV about how FAST they can get your money. While fast money sounds enticing, it may not be the best thing for you.

If you settle fast and then find out later that there is something terribly wrong with you that you did not realize when you settled your claim fast and early it's too late. I have received multiple phone calls from people saying, "I didn't realize my injuries were so bad when I accepted the check from the insurance company early in the case, what can I do now." The answer is NOTHING. It's too late. Once you settle your case, it's over.

WHY DO INSURANCE COMPANIES OFFER FAST MONEY?

It’s a great deal for the insurance company. They have done the math and realize that what appears to be a minor injury in the beginning can mushroom into a huge claim costing them millions. If they can get out early and cheap, they cut their risk and their losses. It's good business for them but a bad deal for you.

A REAL LIFE CASE

I was contacted by a client, I'll call her Sherry, (not her real name) after her car was rear-ended by another driver. Sherry was sitting still, waiting to turn into a convenience store to get gas when the other car (actually it was a truck) hit her at full highway speed. Though her car was totally demolished, she was able to get out, stand up and call her husband to come pick her up and take her to the hospital. She didn't want to leave in an ambulance, she was scared and she wanted her husband to come take her to the hospital.

Sherry wasn't bleeding, no broken bones sticking out of her body. She was able to stand up and talk with the police officer, so he allowed her to bypass the ambulance and ride with her husband to the hospital.
Upon arrival at the ER and a few X-Rays Sherry was diagnosed with "whiplash" and "soft tissue injuries". Sherry contacted my firm and though she was only diagnosed with a whiplash, when I heard of the extent of damage done to her car, I agreed to accept her case.

Over the next several months, as Sherry started receiving medical care it became abundantly clear that what was wrong with Sherry was more than just a "whiplash". The injuries she received in the car wreck eventually required Sherry to undergo multiple neck surgeries by some of the finest orthopaedic surgeons in Atlanta.

Her medical care lasted over 2 years. As we prepared for trial and went through the discovery process it was abundantly clear that the original "whiplash" diagnosis was only the tip of the iceberg. Once the insurance company for the at-fault party became aware of the damage their client had caused Sherry, they became extremely anxious to settle the claim, avoid a jury trial, and pay FULL value. This claim eventually did settled prior to trial for a very large six figure number.

Had Sherry settled quickly for some low number offered her in a "bum's rush" offer after she was originally diagnosed with a whiplash, she would have slammed the door on her ability to receive FULL value for her Georgia personal injury claim.

CONCLUSION

In Georgia you have two (2) years before the statute of limitations expires in a personal injury action. There is no RUSH to settle your claim early. Early on, the most important thing is to get a proper diagnosis and proper medical care for your injuries. After that, it will be time to settle your claim for the FULL value.

GOING BACK TO WORK AFTER A GEORGIA WORKERS COMPENSATION INJURY

Going Back To Work

Sometimes I will receive a call saying I'm currently receiving a weekly income check from workers compensation because of my job injury. My doctor told me I can work on modified duty yesterday and miraculously the employer (or the insurance company adjuster) called me today and told me to show up for work tomorrow (some even have the nerve to incorrectly say, if you don't go back to work tomorrow, your benefits will be cut off).

There is a formal process put in place by the Georgia Legislature that the insurance company needs to follow before you go back to work. This procedure was put in place in order to protect you from unscrupulous employers and insurance companies and has certain safeguards built into it that protect you in case you try to go back to work and and can't do it. By forcing you back to the job without going through the correct formal process, you can seriously jeopardize your ability to continuing to receive all the benefits you are entitled to.

Do not risk making your injury worse by going back to work doing things that may end up hurting you even more.

If you have been receiving a weekly income check through workers compensation and your employer or the insurance company is trying to rush you back while you are still on restrictions, call The Keener Law Firm, 770-955-3000.

GEORGIA WORKERS COMPENSATION CLAIMS

If you have had a work related injury you are entitled to certain benefits.

Income Benefits - Equal to 2/3 of the average of the 13 weeks of income you were making prior to your date of injury.

Medical Benefits - no co-pay and no deductable. The catch is you have to choose a doctor from the panel of doctors provided by your employer. However, if your employer does not have a valid posted panel of doctors, you can choose whomever you wish as your authorized treating physician.

If you have been injured on the job the first thing you need to do is tell your supervisor.

When you see a doctor about your job injury, be sure he understands you were hurt at work. Lots of what you tell your doctor is placed in his medical notes. We want to insure that your medical records actually reflect the fact that you were injured on the job and that you have a Georgia Workers Compensation claim.

Your primary doctor is called your ATP (that stands for Authorized Treating Physician). He is allowed to provide you with all the medical care you need to provide a cure or relief form your injury. Your authorized treating physician can send you to any other doctor he feels will help you . That doctor can also provide you with all of the medical care you need but he is not allowed to refere you further.

If you need to see additional doctors, the prescription for the new doctor, must come through the authorized treating doctor.

For more detailed information you can see my web site at KeenerLaw.com. I also have a web site dedicated to Georgia Workers Compensation cases. It's called Georgia-Workers-Compensation-Lawyer.com. There you will find a lot of helpful information about filing your claim, selecting the right doctors and making sure your eventual settlement is for the full value of your case.

There are also videos you can check out. Try: http://youtube.com/watch?v=IYFzmTgfwPs for my frequently asked questions (FAQ) number 1.

Also check out http://youtube.com/watch?v=IYFzmTgfwPs for my frequently asked questions (FAQ) number 2.

If I can be of help, let me know.

Russell Keener