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Four Reasons Why a Workers’ Comp Claim Might be Denied

Having a workers’ compensation claim denied can be a shocking and frustrating experience. For many working people, workers’ comp is the best or only available resource for getting care for an injury or illness that happened on the job. When someone can’t keep working or needs long-term care, denied coverage can have profound personal consequences. Here are some of the common reasons why an insurer will deny a claim.
  • The injury or illness is not eligible for benefits.
To be eligible for workers’ compensation coverage, an individual must have been injured or contracted a disease in the course and scope of employment. Workers’ comp is a no-fault form of insurance, which means that an insurer cannot base decisions about whether to approve a claim on the degree to which the employee or someone else is responsible for the injury or disease. But insurers do look closely at the circumstances of the claim to verify that the individual who makes it was in fact working at the time of the injury. Cases involving denied claims have included employees who are injured while commuting, on a lunch break, or between shifts. But the dividing line between work and not-work is not always clear, and sometimes a dispute can arise when, for example, an employee is injured on the way to an employer-provided break room.
  • Missed deadlines and incomplete paperwork.
The insurance adjusters who evaluate the merits of claims are paid to review every detail for breaches of legal requirements. When claim paperwork is submitted late, or required pieces are missing, an insurer may have an excuse for denying an otherwise valid claim. For example, an accident at work needs to be reported to the employer within seven days.
  • Suspicious discrepancies.
Insurers are passionate about guarding against fraud. If they think that a claim is based on misinformation, they will be quick to deny it. Workers can find themselves facing a denied claim if information they provide in their paperwork doesn’t match third-party records, such as those provided by the employer or the physician who conducts the initial evaluation. Injured workers are also getting into trouble by posting contradictory information to social media accounts.
  • Evidence of drugs or alcohol use.
A workers’ compensation insurer can deny an employee’s claims if it finds evidence that the employee was drunk or under the influence of a controlled substance at the time of the workplace injury. This includes recreational marijuana use. An employee can only overcome the denial of a claim on the basis of drugs or alcohol use by showing through clear and convincing evidence that the substance was not a factor in the employee’s injury. Although the facts of an injury may support the employee’s argument, the process will be significantly more complicated as a consequence of drug or alcohol use at work. For over 45 years the law firm of Greenman Goldberg Raby Martinez has represented Las Vegas clients in workers’ compensation claims disputes. We can help you resolve your questions about workers’ compensation coverage and fight back against an insurer that refuses to give you the coverage you deserve. Call us today for a free attorney consultation at 702-388-4476 or send us a request through our site.

Is Lead Poisoning Still with Us?

It’s tempting to think of lead poisoning as a problem that’s largely of a bygone era, when paint in old buildings caused widespread problems for children. But the truth is that the problem is still ongoing and may even be getting worse. Lead poisoning can have serious, long-lasting effects, especially on growing children. Someone who is affected by lead poisoning may have grounds for filing a lawsuit.

The sources and risks of lead poisoning

Despite regulatory efforts to reduce or eliminate lead from historical sources like lead and other construction materials, it remains present in a wide variety of items. A huge variety of products have been found to contain lead, from ceramic tile to cosmetics. Many products that are imported from overseas, including toys and food products, may contain significantly higher doses of lead than would be allowed under U.S. regulations. Part of the challenge of lead poisoning comes from the fact that even very small amounts in a person’s blood stream can be extremely toxic. It can cause a wide range of serious medical problems. In children lead poisoning can be especially serious, leading to developmental problems, cognitive issues, pain, and even seizures. Adults may experience high blood pressure, mood disorders, and memory problems, among other things.

Liability for lead poisoning

For someone who has been affected by lead poisoning and wants to pursue legal action to recover compensation for its related costs, a preliminary challenge is often to identify the source of the lead. Exposure to even small amounts of lead can cause significant problems. Tracing the source can require extensive, expert analysis of the environment where the affected person lives. The presence of lead paint in an old rental property might offer a clear-cut case. But finding the lead in, say, a particular toy may require considerably more work. The theories that a plaintiff might use to recover compensation for lead poisoning will vary according to the lead’s source. A tenant who lives in a building with undisclosed lead paint might have a good case for premises liability against the landlord. The parents of a child poisoned by a toy could have a strong case of products liability against the manufacturer, importer, and marketer of the toy. In each case, the plaintiff can seek compensation for medical treatment as well as remedial care to help the affected individual improve their quality of life.

GGRM handles lead poisoning litigation in Las Vegas

For over 45 years the law firm of Greenman Goldberg Raby Martinez has represented Las Vegas clients in cases involving personal injury, premises liability, and products liability. If you or a loved one has suffered from lead poisoning, please reach out to us today for a free attorney consultation about your legal options. Call us at 702-388-4476 or send us a request through our site.

Seeking Workers’ Compensation Coverage for Depression

Work-related depression is a problem that is hiding in plain sight. Whether resulting from the stress of the job, loneliness, or alienation, depression is an authentic and serious problem for working people. Evidence that employers are aware of this problem can be seen in the rise of employer-provided “help lines” that provide employees with no-cost, anonymous counseling services to address depression and other issues. When an employee suffers from depression that is linked to work, the employer’s workers’ compensation program may offer a source of financial assistance for treatment and recovery. Despite the well-understood link between the stresses of work and clinical depression, the employee who makes a workers’ compensation claim likely will need help making an effective case for coverage. Workers’ compensation programs often are designed to address relatively easily understood workplace injuries, like broken bones and strained ligaments. Mental health issues pose special challenges for insurers, who will look for ways to avoid financial responsibility for an employee’s treatment. The most likely argument that an insurer will make to deny coverage is that the illness was not work related. To be covered by workers’ compensation a disease must have arisen out of or in the course of employment. If the disease can be traced to a cause that is not work-related, coverage will not apply. A conventional injury, like carpal tunnel from a non-ergonomic desk layout, tends to have a clear causal link to the employee’s job. The claimant must be ready to show that depression was caused by the job. Proving the link between depression and work can involve several sources of evidence. An important one will be the employee’s mental health professional, such as a psychiatrist or counselor. An expert’s evaluation of the underlying sources of depression can be vitally important in cases where causes beyond work can have played a secondary role. Other sources of evidence might include other employees as well as confirmation from family and friends who have observed the ways that the employee’s work have affected his or her mood. Depression can result from ongoing stresses, but it can also be the consequence of a specific event. Here the case for workers’ compensation can be clearer. A worker who has seen a number of long-time colleagues laid off may experience specific emotional responses to those events. A worker who has suffered a physical injury at work may experience depression caused by medication or simply by a loss of mobility or career prospects. A workers’ compensation attorney works with clients to improve claims outcomes. For more than 45 years the law firm of Greenman Goldberg Raby Martinez has helped injured workers get the coverage they need to get back to full health after suffering an injury on the job. For a free attorney consultation, contact us at 702-388-4476 or through our contact page.

Roadway Debris Poses a Serious Risk to Motorized Scooters

Motorized scooters are taking America’s streets by storm. Seen as quick, flexible ways to get around town, they offer a fun alternative to walking, riding a bike, or catching a bus. On the other hand, scooters are also being blamed for a significant rise in injuries, including serious head wounds. One of the major sources of risk for scooter riders is roadway debris. The question for riders who are injured due to roadway debris is whether they have any legal recourse to recover compensation. Motorized scooters generally fall within the scope of Nevada’s rules governing mopeds. In many regards, a moped is treated like any other vehicle under Nevada’s traffic safety laws. Scooter riders therefore have a variety of basic obligations while they ride on public streets: obey traffic signals, take reasonable precautions to prevent accidents, and stay under the speed limit. Likewise, other drivers and pedestrians have a general obligation to use reasonable care to avoid accidents with moped riders. Roadway debris poses an interesting challenge for people who get hurt in accidents that it causes. Who is to blame for the debris being there? Answering that question is not always straightforward. Here are a few scenarios to consider:
  • A piece of equipment falls off the back of a truck, and a few minutes later the scooter rider falls while trying to avoid it. In this scenario, the owner and/or driver of the truck may bear liability for failing to properly secure the equipment, provided they can be identified.
  • An unresolved pothole leaves extensive gravel and other debris in the roadway. Such scenarios raise a number of questions. Which entity was responsible for maintaining the road? If the entity was a public agency, it may have protection against lawsuits under Nevada’s sovereign immunity law. On the other hand, if the agency failed to reasonably address a serious hazard of which it was aware, it may have committed negligence that would fall outside the sovereign immunity shield. Different standards apply to privately maintained roads.
  • Garbage blows onto the roadway from an adjacent property. Here again there will be tricky factual issues to resolve. Who was responsible for containing the garbage? What steps did they take to secure it, and what caused it to get loose?
For those who rent scooters from one of the several rental companies popping up around Las Vegas, it’s important to bear in mind that the rental contract probably includes some form of liability waiver, making a lawsuit against the rental company more difficult. Riders also should bear in mind that in any lawsuit their behavior as riders will be scrutinized. In general, a rider whose reckless behavior contributed to the accident should expect to have his or her chances of recovery reduced to some degree.

GGRM is a Las Vegas accident law firm

For more than 45 years the law firm of Greenman Goldberg Raby Martinez has represented clients in personal injury and accident cases. We can help you examine your legal options if you have been injured in a scooter accident. For a free attorney consultation, contact us today at 702-388-4476 or through our contact page.

Lawsuits After Deaths During Childbirth

Despite all the significant advances medicine has made in improving outcomes for mothers and their babies during childbirth, complications still happen. Over the last several decades the rate of maternal deaths in child birth have risen significantly in the United States. Birth and its immediate aftermath are also dangerous for the child. The United States lags behind other developed nations, a problem that has gained significant attention in recent years. For those who are grieving the loss of a mother or child in childbirth, a lawsuit may offer a means of recovering compensation for the devastating impacts that such a death can cause. Childbirth involves a range of common complications that pose risks to mother and child even under perfect medical supervision. But some deaths during childbirth could have been prevented if a hospital’s staff had followed proper procedures, correctly interpreted warning signs, or had the appropriate training or equipment. When the death of a child or mother can be traced to negligence on the part of a hospital or its staff, a lawsuit for professional negligence may be warranted. Professional negligence is a specialized form of negligence that applies to cases involving licensed professionals, like nurses, doctors, surgeons, and so on. A professional negligence suit asserts that the defendant, or defendants, failed to use reasonable care, skill, or knowledge ordinarily used under similar circumstances by a similarly trained and experienced professional. NRS 41A.015. To bring a professional negligence suit the plaintiff must obtain a sworn affidavit from a qualified expert witness who supports the plaintiff’s argument that the defendant behaved negligently. A professional negligence claim can be accompanied by a wrongful death claim. Wrongful death is a cause of action available to the legal heirs of a person who has died: a surviving spouse, parent, surviving children, among others. Wrongful death can also be pursued by the legal representative of the deceased, such as an estate attorney. A wrongful death claim can seek compensation for funeral expenses as well as other special forms of damages, such as the plaintiff’s grief, loss of companionship, and the pain and suffering of the deceased. The estate may also pursue ‘survival’ claims for damages the person who has died suffered while they were still alive, including any penalties or punitive and exemplary damages which the person who died would have recovered if they had lived and damages for pain, suffering or disfigurement and loss of probable support, companionship, society, comfort and consortium. The law firm of Greenman Goldberg Raby Martinez provides caring, compassionate counsel to clients in personal injury, professional negligence, and other cases in Las Vegas. We gladly provide free attorney consultations to new clients who wish to explore their legal options. Call us at 702-388-4476 or through our contacts page.