A Simple Way to Reduce Medical Costs

A glaring difference between civil court and the workers comp appeals board is the seeming lack of judicial power of the work comp judges to see to it that the claim is resolved quickly.  For instance, in civil court, the moment a case is filed the parties are given a date to return to court, usually 6 months hence, so the court can inquire if the parties are ready for trial. Why do they do this? To keep litigants from dragging their feet and creating a court back log of cases. If the workers compensation appeals board set status conferences for six months post filing, litigants would  be under pressure to explain to the judge why their case should not be set for trial. After all, if the injured worker still needs treatment the work comp judge can award lifetime medical. In my years of experience, most injured workers opt for a cash settlement rather than keeping future medical rights open. If the parties (and doctors) knew that the judge would be pushing to set the case for trial in 6 months they would have a reason to have their evidence ready to go within that time frame. The way it is now, applicant attorneys are in no position to tell the doctors to write a final report on their clients. This is the norm in civil cases where the " policy limit" defines the amount of the medical billing and provides the attorney with authority to get the doctor to stop treating the injured party.  Applicant attorneys would be more vigilant to obtain their medical evidence quicker when a time limit is looming.  And doctors would have to explain why an extended period of treatment is necessary when the established medical literature is clear that maximum tissue healing occurs within 6 months and most treatment after that time is just palliative. Of course there is always the exception for cases requiring surgery. But for the majority of cases this would work well and result in speedier claim resolution and therefore reduced medical billing. 

From Claim "denied" to justice: Roberto Flores vs. Western Single Ply

This case settled in September 2009. Mr. Flores, a California resident was sent to Brownsville, Texas to work on a commercial roofing project. While working on July 31, 2007 he witnesses a concrete wall give way and fall crushing and killing two co-workers. Mr. Flores suffered post-traumatic stress disorder from witnessing this gruesome and traumatic event. Initially the insurance company denied Mr. Fløres claim for workers compensation benefits. Mr. Flores hired Jackson & jackson to assist him with his claim. Derek Jackson, one of the firms partners and lead trial attorneys was able to get Mr. Flores needed grief counseling. The insurance company finally made an offer to settle the claim for $10,000. Mr. Jackson rejected the offer and the matter was set for trial. On the day of trial Mr. Jackson was successful in obtaining a $70,000 cash settlement for Mr. Flores despite the fact that the claim was initially denied. Congratulations to Mr. Flores and Derek Jackson, Esq. Hard work and determination have resulted in a fair settlement. 

Loss of an eye, no big deal according to cal legislature

Our client Roberto Romero Torres was working as a gardner for Carl & Roberta Deutsch in Malibu.  While driving a lawn mower, an object flew up and hit him in the eye resulting in total loss of vision of one eye. Lucky for him that a high velocity eye injury gets special treatment entitling Mr. Torres to an extended period of time to collect temporary disability payments. Luckier still for the insurance company that such an injury does not commonly require an extended period of time for recovery. A special thanks goes out to Governor Schwarzenegger for work comp "reform" which limits  Mr. Torres to $16,453.17 for his total loss of vision in one eye. 

California Workers Compensation from the trenches

After 16 years working "in the trenches" as a work comp trial attorney representing injured workers and uninsured employers, I have a gained a few insights into the California Workers Compensation system, some good, much not good and some down right unjust. For those who are dealing with the comp system for the first time, for those who wonder what they should do if injured at work, and for those who make the laws that affect injured workers, this blog is for you. Here you will learn the realities of the system, how it actually functions and what happens as a case progresses from the first moments of an injury until the case is finally resolved by a workers compensation judge. Here you will learn what you can expect if you are injured at work and suggestions to make the system more efficient so that it works for all who depend on it to obtain justice and fairness.