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When Should Injured Workers Hire an Attorney?

Someone who gets injured at work and needs to file a workers’ compensation claim hopefully can rely on the system working smoothly to provide complete care and other benefits. One hopes that injured workers have access to good advice through their employers or a third-party claims administrator, and that everyone involved will try hard to ensure that the worker receives all the benefits that are owed under state law. Unfortunately, this isn’t always how things go. Like every kind of insurance, workers’ compensation often raises conflicts of interest, disputes about medical diagnoses or treatment plans, and other problems that a worker who isn’t represented by an attorney may struggle to overcome.

How an attorney facilitates workers’ comp claims

The role of a workers’ compensation attorney is to protect the client’s interests and ensure that all the benefits to which the worker is entitled are properly paid. Within the scope of that work there are a number of important things an attorney can do for the client:

  • Ensure that claims paperwork is completed correctly and on time.
  • Monitor the medical evaluation process to verify that the client isn’t railroaded into accepting an incorrect or incomplete diagnosis.
  • Raise and resolve concerns with how coverage is being provided.
  • Keep track of important records that may be vital if the claims process needs to be taken into a dispute resolution proceeding or litigation.
  • Advise the client on when and how to dispute insurer decisions.

When should you hire an attorney?

Whether an individual needs the help of an attorney is really a question that needs to be answered after taking stock of all the facts of the individual’s case. It never hurts to reach out to an attorney who offers free consultations to determine if representation is necessary. Broadly speaking, the help of an attorney is more important if complicating factors are present. Some examples of these include:

  • Severe injuries. An attorney’s help can make a huge difference for someone who has suffered a serious injury that will involve significant health care expenses, long periods off work, or some form of disability. Such injuries cost workers a lot of time, money, and stress. Ensuring that workers’ compensation benefits cover everything the worker needs takes planning and close oversight. In part this is because high-cost claims often end up in disputes as insurers look for ways to limit their financial exposure.
  • Wrongfully denied claims. Someone who feels they’ve had their claim wrongfully turned down may need to file an appeal. Although an attorney isn’t necessarily required to make an appeal, the chances of an appeal succeeding gets significantly better if an attorney is involved, especially if the attorney has been involved from early in the process.
  • Medical disputes. Many types of injury are subject to a wide variety of medical diagnoses. A strained back could be diagnosed as a muscular problem or as a slipped disc. A headache might be diagnosed as a concussion or as a more severe type of head trauma. Insurers know this and will use the medical examination process to find ways to restrict their exposure. An attorney can make sure the client knows how to exercise important rights like the option for seeking a second opinion.

The law firm of Greenman Goldberg Raby Martinez has represented clients in workers’ compensation cases for over 45 years. We provide personal, caring service to each and every client. For a free attorney consultation about your case call us at 702-388-4476 or through our contacts page.

Workers’ Comp for Employees of Temporary Staffing Firms

The number of temporary staffing firms is constantly growing as businesses look for ways to manage employee costs by outsourcing work to temporary staff. Temporary workers are found in virtually every industry, including dangerous professions like construction, transportation, and health care. Like other employers in Nevada, a temporary staffing firm is required to carry workers’ compensation insurance that protects its staff members in the event that they are injured while working at a client site.

Understanding when workers’ compensation applies

Nevada’s workers’ compensation system provides that employees are insured against injuries that arise out of or in the course of employment. Generally speaking “the course of employment” captures any time for which an employee is compensated. A worker often is also covered during times when they are doing something that the employer has asked them to do. Personal time is not within the scope of workers’ compensation. Critically, a normal commute usually is not covered. However, because a temporary worker is often asked to commute to a location other than their firm’s office, those trips may be covered for some workers.

Workers’ compensation is a kind of no-fault insurance. This means that the insurer is not allowed to base its coverage decisions on who was responsible for causing the worker’s injury. It’s important to remember that a temporary worker is employed by the staffing firm, not the client at whose site the work is done. The temp worker therefore falls under the staffing firm’s workers’ compensation coverage.

Staffing firms often face workers’ compensation challenges

The inherent complexity of a staffing firm’s risk profile means they can have a hard time finding insurance. Many firms get insured through a professional employer organization, or PEO. A PEO is essentially a service company that takes on components of an employer’s human resources functions, such as payroll and insurance administration. A PEO may offer temporary staffing firms with a way to secure workers’ compensation coverage under a plan that groups together all of the PEO’s clients.

The presence of a PEO in the chain of authority can add a layer of administrative challenges to a worker who is injured on the job. Ideally a claim process goes smoothly and with adequate support from the insurer to resolve technical hiccups without interrupting the injured worker’s treatment. But if administration of the claim is handled by a PEO, the worker may have no relationship with the individuals handling the claim and may need additional help to resolve problems.

The law firm of Greenman Goldberg Raby Martinez has represented clients in workers compensation cases for over 45 years. We can help temporary workers get the workers’ compensation coverage to which they are entitled. For a free attorney consultation about your claim, call us today at 702-388-4476 or through our contacts page.

How Medical History Can Shape a Workers’ Comp Claim

Nevada’s workers’ compensation insurance system is designed to ensure that everyone who works for an employer in the state is protected in the event of an injury on the job. Benefits are provided to qualified workers without regard to fault: an injury is covered regardless of whether the worker, the employer, or someone else can be blamed for causing it. The lack of a fault analysis doesn’t stop insurers from looking for ways to deny or limit an injured worker’s coverage. One way they may try to do that is by arguing that the injury existed prior to the work-related event that gave rise to the claim.

To be covered by workers’ compensation insurance an injury must “arise out of or in the course of employment.” Generally speaking this means that if a worker is injured while doing work-related activities, especially if the worker is “on the clock” and getting paid for the time that covers the injury event, the injury will be covered. In some types of injury, the cause may have arisen at work, but the scope of the injury only became clear later. Cancer arising after exposure to carcinogens at the workplace is a good example of a work-related illness that may be slow to develop and that would require the worker to establish a causal link to the employer in order to receive coverage.

Causation can become a barrier to coverage if the source of a particular injury can be traced to something that is not work-related. If a claim is for an injury that could be described as a “pre-existing condition” the insurer may refuse to cover it. For example, a worker who hurt his knee while skiing may have a more difficult time getting coverage for an injury to the same knee while on the job. The insurer’s argument will be that the injury did not “arise out of or in the course of employment” but was in fact the personal problem of the worker.

For a worker in such a circumstance the important thing is to document the ways in which an existing condition was made worse by the accident at work. Being clear with doctors about the details of the injury is important at every stage. So is keeping a record. In the case of the skier, if a doctor was consulted after the skiing accident the doctor will have records related to the scope and severity of the injury at that time. The accident at work may have worsened the condition in ways that can be medically measured, and to that extent the worker may be entitled to coverage.

If an insurer denies a claim that has a legitimate basis in a work-related injury the worker may need to consult with an attorney to make a successful appeal. An attorney can help the client organize facts, complete paperwork, and anticipate common insurer arguments. The attorney can also help the client navigate the medical examination process that will be used to determine the scope of coverage.

The law firm of Greenman Goldberg Raby Martinez has represented clients in workers’ compensation cases for over 45 years. We can help you understand how your preexisting conditions may affect your coverage for a work-related injury. For a free attorney consultation about your case call us at 702-388-4476 or through our contacts page.

Avoiding Unethical Lawyers in Nevada

For many people, suffering an injury is the first time in their lives when they need to talk to a lawyer. Driving through Las Vegas it’s hard to miss the billboards from attorneys who promise quick results and huge payouts for injured clients. For every “billboard” law firm there are dozens of others vying for new clients. Adding to the confusion are outfits that prey on the desperate circumstances of people who have been injured by offering pre-settlement loans, sometimes at high interest rates. All of this, combined with the stress and challenges of recovering from an injury, can be confusing. Having the help of an ethical law firm is essential for clients who are trying to make sense of it all.

Avoiding an unethical lawyer can be a simple matter of instinct. Sometimes an attorney will offer something that sounds too good to be true. But it’s always a good idea to do a little research and analysis before working with an attorney, especially if the attorney isn’t one that was recommended by a trusted friend. There are a number of ways to examine whether an attorney is ethical:

  • A clean bar profile. A simple step is to search for the attorney on the Nevada State Bar Association’s website. Every licensed attorney’s status and disciplinary history is available on the site for the public to examine. If an attorney has been censured by the bar for unethical behavior, that should serve as a red flag.
  • Willingness to provide free, substantive consultations. Free initial consultations are a staple of personal injury practice. An initial consultation serves numerous purposes, the most important being to help the client get a feel for the options available for their case. A consultation also helps both the client and the law firm decide if the firm is the right fit for what the client needs. An attorney who doesn’t provide free consultations may be a good lawyer who simply has a different business model, but for many injured clients the free initial consultation is key part of their process of evaluating a potential attorney. Clients shouldn’t have to pay for this step.
  • Clarity about process or fees. An ethical attorney will be up-front with new clients about how the case will be handled by the firm and how the firm will be paid. The attorney should provide a clear, written statement of how fees and expenses will be paid. If the client will be asked to assume certain costs, such as the fees for expert witnesses, that should be stated at the outset of the engagement. A lawyer who draws in clients with promises of low fees and huge awards, but who springs inflated expenses on the client at the end of the process, is not acting in an ethical manner.
  • Putting the client first. An attorney’s obligation is to provide rigorous, passionate representation of the whole client. Among other things, this means that the relationship between the attorney needs to be about more than just money. The attorney needs to be a careful, thoughtful listener. Many law firms operate as “litigation shops,” which try to earn money for their partners by doing high volume, low quality work. Clients of these types of firms may have difficulty getting personal attention from their attorneys, who are busy chasing down new clients rather than serving the needs of their existing ones.

The law firm of Greenman Goldberg Raby Martinez has represented clients in personal injury cases for over 45 years. We are proud of our long tradition of thoughtful, caring service to each and every client. If you have been injured and you have questions about how to pursue a case, please contact us today for a free attorney consultation. We’re available at 702-388-4476 or through our website.

What Out-of-Pocket Costs Can a Workers’ Comp Claimant Face?

Getting injured while on the job in Nevada entitles workers to insurance coverage under their insurers’ workers’ compensation program. Once a valid claim is started, the insurer will pay for a range of important expenses associated with the worker’s medical care. In some cases, though, an injured worker may need to pay some costs.

Nevada’s workers’ compensation system provides a broad basket of benefits to covered workers:

  • Medical bills for treatment that is reasonable, necessary, and authorized.
  • Wage replacement (up to defined maximums).
  • Mileage reimbursement for travel to and from doctors’ appointments.
  • Vocational rehabilitation for workers who can no longer continue their prior profession.
  • Benefits such as funeral expenses and special payments to heirs in the event that the worker dies as a result of work-related injuries.

All of these benefits are subject to important limitations. Each have caps limiting how much an insurer will pay. Each may also come with strings attached. For example, by accepting certain fringe benefits the worker may sign away his or her right to reopen a claim. On top of these limits, insurers work hard to find ways to limit their financial exposure for each claim.

The potential for disputes with the insurer is perhaps the most important source of potential out-of-pocket costs for an employee. The “bargain” of the workers’ compensation system is that in exchange for obligatory, no-fault insurance coverage an employee cannot sue the employer except in rare cases of gross negligence or intentional injury. This limitation can put the employee in a difficult position if the insurer or employer doesn’t provide the kind of coverage that the worker is entitled to.

As a consequence, injured workers may need to hire an independent attorney to assist them with their case. An ethical attorney will examine a potential client’s case and provide an analysis of the kind of value the attorney can add to the client’s claim. By hiring an attorney the client may be able to greatly improve the outcome of the workers’ compensation process.

Of course, once coverage limits are reached any further costs must be borne by the injured worker. One goal of a workers’ compensation attorney is to ensure that only relevant costs are allocated to a particular category under a policy, so coverage limits aren’t reached in an artificial manner. There are other, rarer kinds of out-of-pocket expenses that may be necessary to resolve disputes with insurers. A dispute may require payment of administrative fees to obtain hearings. There may be costs associated with elective medical exams that are necessary to refute a questionable diagnosis by an insurer-designated physician.

The law firm of Greenman Goldberg Raby Martinez has represented clients in workers’ compensation cases for over 45 years. For a free attorney consultation about your case call us at 702-388-4476 or through our contacts page.

Getting Back to Work After a Serious Hand Injury

Hand injuries can be crippling, and for anyone who works with their hands—most people—such injuries can have serious career consequences. If the injury happened at work, workers’ compensation insurance should cover not just medical costs, but rehabilitation and potentially some retraining as well. For people who suffer hand injuries outside of work, the path can be more difficult.

Recovering from hand injuries is a long process

The hand is enormously complex, and injuries to it can be just as complicated. Even an invisible injury like a torn tendon or carpal tunnel can have long-term consequences. But broken bones and amputations are common as well. One of the challenges of recovering from a major hand injury is that many factors can cause recovery to go more slowly than anticipated, or not be as successful as hoped. Many types of injuries lead to chronic conditions that limit the injured hand’s functions and affect an individual’s ability to work.

Workers’ comp and hand injuries

Because workers’ compensation is a no-fault insurance system, workers who are injured on the job need to meet a fairly low threshold to get coverage for an injury. By law an employer is required to provide workers’ compensation insurance to all of its employees and qualified contractors. For an injury to be covered it must have arisen out of and in the course of the worker’s employment. Hand injuries on the job are no different from other types of work-related injury as far as coverage is concerned.

Lasting hand injuries often force people to change the kind of work they do. Workers’ compensation may cover retraining programs where a doctor has imposed permanent work restrictions related to the injury and the employer has not offered permanent light duty work. The success of a retraining program depends on many factors, only some of which are within the worker’s control. But it can offer a way to change careers in response to an injury that otherwise could leave the worker unemployed for the long term.

Injuries outside of work

One hopes that an individual who causes his or her own hand injury has insurance to cover the injury and its consequences. Of course, as we all know many people lack such insurance, and for them the cost of such injuries can be enormous.

Someone who suffers a hand injury as a consequence of another person’s negligence may have the option of filing a personal injury lawsuit to recover whatever costs an insurer won’t cover. Quite often these include things like job retraining, prosthetics, and physical therapy. Unlike workers’ compensation insurance, a lawsuit can also recover compensation for pain, mental anguish, and other forms of damage that a hand injury often brings.

GGRM is a Las Vegas workers’ comp and personal injury law firm

If you have suffered a serious hand injury and you think you have not received fair compensation, whether from the responsible employer or from a person who caused the injury, it’s important to talk to an attorney right away. The law firm of Greenman Goldberg Raby Martinez has represented clients in personal injury and workers’ compensation cases for over 45 years. For a free attorney consultation about your case, call us today at 702-388-4476 or through our contacts page.

Proving Causation of Work-Related Cancers

Cancer affects much more than just a patient’s physical health. It also can have profound consequences for the sufferer’s financial wellbeing. One hopes that cancer victims always have the benefit of thorough insurance coverage, but that isn’t always the case. When cancer can be traced to a cause that was work-related, a patient can sometimes seek benefits under the workers’ compensation insurance policy of the employer responsible.

For cancer to be covered by an employer’s workers’ compensation insurance the patient must be ready to prove that the disease arose “out of or in the course of employment.” For most types of injury the link between an injury and employment is established early in the process, usually at the first visit to a doctor. But unlike a broken arm suffered at a work site, cancer can be slow to develop and its cause may be difficult to trace.

There are three threshold matters that the patient must establish (or be prepared to establish) to ensure that coverage will not be denied:

  1. Exposure to a carcinogen at work. Proving exposure to a carcinogenic material at work can be easier in some situations than in others. If the patient worked at a chemical plant and was routinely exposed to substances that are well known to cause cancer, the case will be relatively easy to build. But if the patient’s exposure was in an isolated event, where the presence of carcinogens wasn’t known, proving the link may be more difficult. The passage of time can complicate proof as well.
  2. A causal relationship between the carcinogen and the patient’s specific cancer type. The patient’s doctor can help draw a connection between the work-related exposure to a carcinogen and the patient’s cancer. If a dispute arises with the workers’ compensation insurance provider, additional expert testimony and other scientific evidence might be required to prove causation.
  3. No intervening cause. Although a patient doesn’t need to prove that his or her cancer didn’t come from a source other than work, the insurer will almost certainly argue that it might have. This has been the insurer’s argument in cases involving secondhand smoke exposure at casinos. Because casino workers can be exposed to cigarette smoke other than at work, insurers have successfully denied coverage for their lung cancers.

Another potential problem for slow-developing cancers can be employers who have since gone out of business. Patients in this situation shouldn’t entirely give up hope. Even though the business may no longer exist under its old name, it may still exist under another, been merged with another business, or been bought out. A crucial question will be whether the current legal entity that owns the business has responsibility for lingering obligations to former employees.

Nevada provides a special benefit for firefighters who contract cancer, even after retirement. NRS 617.453 can simplify the process of seeking benefits for firefighters who are exposed to carcinogens during their careers. The law provides a specific list of carcinogens and their known related cancer types. Provided the firefighter can show exposure to a carcinogen that the statutory list links to the firefighter’s cancer, there will be a presumption that the cancer is work-related.

For over 45 years the law firm of Greenman Goldberg Raby Martinez has served clients with challenging workers’ compensation cases. If you think your cancer may be work-related but you aren’t sure how to go about making a claim against your employer, please reach out to us today for a free attorney consultation. Call us at 702-388-4476 or send us a request through our site.

Can a Nevada Workers’ Comp Claim be Reopened?

In an ideal world every injury would have a predictable, consistent path to recovery, or at the very least a clearly defined range of potential harms. Of course, we don’t live in a perfect world. An injury can be misdiagnosed or underdiagnosed at preliminary medical appointments, or its treatment can lead to unexpected complications that require additional medical care or expensive drugs that weren’t part of the original plan. For someone who is receiving care under a workers’ compensation claim, these kinds of complications can require a claim to be reopened.

“Reopening” a workers’ compensation claim can be necessary if an insurer has formally indicated that its financial obligations with respect to it have been fulfilled—that is, the claim has been closed. Closing claims is one of the ways insurers manage the predictability of their costs: by closing a claim, the insurer knows with certainty how much it had to pay, and how much it needs to pass on to the employer. Reopening a claim therefore necessarily involves a degree of paperwork.

Nevada law sets out specific procedures for when and how a workers’ compensation claim may be reopened. The specific procedure depends on how long the claim has been closed. For claims that have been closed less than one year, the insurer is only required to reopen the claim if:

  1. Medical evidence demonstrates that an objective change in the claimant’s medical condition has taken place.
  2. There is clear and convincing evidence that the claimant’s change in circumstances was primarily caused by the injury covered by the original claim.

A claim must be reopened within one year of being closed if the claimant wasn’t forced off of work for at least five days, and didn’t receive benefits for permanent partial disability. In other words, for relatively minor injuries workers have a shorter timeframe to reopen their claims.

To reopen a claim that has been closed for a year or more, the claimant must show three things:

  1. A change of circumstances (complications during recovery, discovery of previously undiagnosed problems, and so on) warrants an increase or rearrangement of compensation.
  2. The primary cause of the change of circumstances was the injury covered by the original claim.
  3. The claimant’s doctor has provided a certificate attesting to the change of circumstances.

Any effort to reopen a claim must be grounded in an assertion that the reopened claim remains completely related to the original claim. That is to say, the ongoing circumstances of the worker’s condition must relate to a job-related injury. If circumstances that were unrelated to the original claim have since intervened, the insurer will deny the request to reopen the claim.

If an insurer denies a request to reopen a claim it may be necessary to sue. It is always a good idea to consult with an attorney before starting the process of reopening a claim to reduce the likelihood that a request will be denied and to have a plan for contesting a denial. The law firm of Greenman Goldberg Raby Martinez has represented clients in workers’ compensation cases for over 45 years. For a free attorney consultation about your case call us at 702-388-4476 or through our contacts page.

Common Construction Site Injuries

Construction workers have some of the most dangerous jobs in the country. They and their employers need to take safety very seriously to keep injuries to a minimum. Ideally a safety program has a flawless record, but accidents can and do still happen. Some of the common sources of injury at construction sites include:

  • Injuries from equipment. Because of the powerful forces involved, accidents involving tools and heavy machinery can cause particularly serious injuries, like amputations. The risk of injury is greater if equipment isn’t properly maintained, or is modified to remove safety features.
  • Trip hazards are commonplace at construction sites. So are projects that are high off the ground. Falls from scaffolding, or into holes, are frequent events.
  • Injuries from vehicles. With heavy trucks, bulldozers, and other large vehicles moving around a job site, there’s always a risk that someone could be struck, run over, or crushed. A worker wearing hearing protection might not hear the warning signal of a backing truck. Vehicles might slip on loose or muddy ground.
  • Falling objects. Even a relatively small item dropped from significant height can pose a serious danger to people below. Hard hats help, but a hammer dropped on an unprotected shoulder can cause long-term problems.
  • Heat-related injuries. In Nevada we often experience weather that is hot enough to pose a significant health danger to people who are doing strenuous work outdoors. Heat exhaustion, heat stroke, and other serious complications can result if workers aren’t provided with adequate hydration and opportunities to cool down.
  • Long-term diseases. Illnesses caused by exposure to dust, toxic substances, and carcinogens can be slow to develop and difficult to tie back to a particular job. For example, workers may be exposed to materials like asbestos during a demolition job. The consequence could be respiratory disease or even cancer.

A worker who is injured while on the job at a construction site is entitled to workers’ compensation coverage. Workers’ compensation is a no-fault system, meaning that coverage applies regardless of who was responsible for the injury. In most circumstances, an employer that has legally required workers’ compensation coverage is shielded from being sued for personal injuries. That doesn’t mean, however, that an injured worker doesn’t need the help of an attorney. A workers’ compensation claim can involve complicated nuances. Insurers often try to limit the scope of the coverage they will provide.

A workers’ compensation attorney acts as the workers’ advocate, protecting the worker’s interests in the face of potentially adversarial insurance adjusters. The law firm of Greenman Goldberg Raby Martinez has represented clients in personal injury and workers’ compensation cases for over 45 years. We are standing by to help workers who have been injured at construction sites in Las Vegas and surrounding areas. For a free attorney consultation about your case, call us today at 702-388-4476 or through our contacts page.

Seeking Compensation for Child Care After an Injury

Parents and other guardians of children can find that caring for a child after a serious injury is significantly harder than it was before the injury occurred. Routine tasks like lifting, driving, doing laundry, or cooking may no longer be possible while recovering from the injury. As a consequence, it may be necessary to hire outside help. Plaintiffs in this circumstance sometimes wonder if they can include the cost of child care in their personal injury lawsuit claims.

Nevada law allows plaintiffs in personal injury cases to include “replacement services” in the scope of the damages that are demanded in a lawsuit. Replacement services essentially covers things that the injured person used to do for themselves, but now must hire an outside person to do. This includes cooking and cleaning, and also includes taking care of children.

Replacement services are a form of economic damage, because they can be tied to real-world numbers. The actual cost of hiring a nanny or housekeeper, hiring a driver to take the kids to school, or hiring someone to cook can be proven with actual invoices or, if the plaintiff hasn’t been able to afford such services before the lawsuit begins, with reference to estimates or averages taken from services available in the plaintiff’s community.

As with other forms of damage, the cost of replacement services must be proven with reasonable certainty to be recoverable. Making a full accounting of the cost of child care will require consideration of a range of factors that include the anticipated likelihood of the plaintiff’s recovery to resume providing child care, and the age of the children involved (i.e., how long replacement services will be needed).

Although parents may seek to recover the highest possible compensation for child care services, courts may place some limits on what can be recovered. For example, a court may consider it unreasonable to provide plaintiffs with sufficient compensation to allow for a full-time, professional caregiver if the plaintiff’s circumstances would allow for a less expensive alternative. If prior to the injury the plaintiff shared child care responsibilities with another adult, the defendant may only be held liable for replacing the plaintiff’s services alone.

For more than 45 years the law firm of Greenman Goldberg Raby Martinez has helped clients in the Las Vegas area recover compensation for personal injuries. We are proud of our long history of providing caring, thoughtful service to each client. We work hard to take every part of a client’s life into consideration as we develop our cases. Please call us today for a free attorney consultation at 702-388-4476 or reach us through our contact page.