Author Archives: elevine

Realities of time associated with Wisc and Section 32 Agreements

The type of workers’ compensation settlement you get can affect how fast you get your payments

As we have discussed throughout our blog; payment of the agreement is subject to various delays and legal formalities. The quickest  way to modify your benefits has become the WISC settlement. These formal written agreements must be approved by a Law Judge before the carrier can be compelled to make appropriate payments pursuant to the agreements.The normal time, post signing of the written WISC agreement for a hearing,  is less then three weeks after all parties to the agreement have signed same. The procedure starts with a request for a hearing by one of the parties and has been running within two weeks of the request with payment following the written publication of the agreement by the Workers’ Compensation Board. The publication of the approved agreement usually takes a week to ten days post hearing.

A more detailed settlement is usually done by way of a Section 32 Agreement. This procedure has many delays to wit: formal writing of the agreement and the signing of same by all the parties. Occasionally when individual beneficiaries are on Medicare or Medicare eligible a formal application and review has to be conducted by vendors for the Insurance Company and then reviewed by the CMS unit responsible for Medicare cases. This has now been taking approximately 4 weeks for the Vendors review and and additional 4-6 weeks for CMS approval when no glitches develop. Once the CMS approval document is issued by CMS then hearings are generally set by the compensation board  and held within 5-7 weeks post filing. Once the Judge approves the agreement at a hearing a decision is published within 2-3 weeks and payment is made by the carrier within 10 days of the published decision date.

As stated throughout our blogs,  these blogs are both written for educational and informational purposes and not formal legal discussion of your specific case. Individual delays sometimes occur depending on the specifics of the instant claim. It is always best to contact your attorney for full and formal discussion of your claim and benefits associated with same.

Practice remains the same.

We handle your workers’ compensation case from start to finish

The firm continues to be a ground level litigation firm handling court appearances and trial work from start to finish. The reality is that Workers’ Compensation has devolved into settlement negotiations or long fought litigation. We try to negotiate good results without jeopardizing our clients benefits. We believe the assistance of veteran trial attorneys will help in this new era of Compensation and Civil Litigation.

Additional thoughts legal Services

Over the last many years we have been working with individual attorneys assisting us with complex Negligence cases. We are now reviewing additional routes for handling lighter cases with visiting attorneys. We’ll let you know how this develops. I am investigating my options.

Recent changes to Workers’ Compensation Practice and court locales

The Workers’ Compensation Board has changed recently

It’s been some time since I was able to write to this blog. My daughter got married, my wife and I took a vacation. I hired two different attorneys and now continue serving my clients with three attorneys on staff and a few associates at various hearing locations; we’re now back on the beam.

As previously stated we continue to provide legal services in the fields of New York State Workers’ Compensation, Federal Social Security Disability and Negligence. Veterans’ disability claims are presently on hold as you may have noticed,  there appears to be an extensive back up in that system and efficiency seems delayed.

The Workers’ Compensation Board has gone through some recent geographical changes. The Riverhead hearing point has been closed. Cases previously assigned to Riverhead are now being heard in Hauppauge. Claimants are given the right once they evidence a hardship to attend their hearing via phone. Wisc Settlements and Section 32 Agreements once written and filed can also be approved by a law judge with the claimant attending by phone. This practice is subject to a case by case and judge by judge decision. It further appears that claimants who live along the western border of Suffolk County will be having their hearings held in the WCB Hearing Point located in Hempstead. This is also subject to telephone appearances upon judicial prior approval. It is always best to attend your hearing / case in person.

The medical treatment guidelines professed by others to exist as a means to expedite treatment has proven a cog in the system which required correction permitting some chronic care with stated limits. It is always best to have your doctors thoroughly review the Medical Treatment Guidelines posted by the Workers’ Compensation Board and to follow them explicitly.  The forms C4 Auth should be used as detailed by the treatment guidelines where applicable. If additional treatment beyond that which is stated in the “Guidelines” is required; your doctors will have to file MG 2 forms with explanations why the treatment desired or requested is medically necessary and they must document in detail why the present form of treatment is showing improvements but further care is necessary. Most of the health providers seem to be able to comply with the Guidelines or document why additional treatment should be approved. Regrettably, some insurance carriers have elected to refrain from being required to give prior approval to treatments listed under the guidelines.This has proved to be a vexing condition for the health providers who may not provide treatment unless and until it is sanctioned by the guidelines or a variance has been approved by a law judge. All of these obstacles continue to thwart the professed intention of the act which has always been to promote quick and early treatment to injured workers allowing them to successfully return to their respective places of employment. We hope the WCB comes to regain this philosophy.

New paths for Eliot Levine and Associates.

We are in the beginning sages of opening a new section of the practice to cover disabled veterans who are denied Veterans Disability Benefits. I am presently reading up on the appeals process and will begin to canvas for additional support staff to interface with the Northport VA and to do supplemental tasks in the office rounding out the provision of disability representation for my clients before the associated agencies. We will now provide legal assistance in the fields of New York State Workers’ Compensation Law, Federal Social Security Disability Law, Negligence and Veterans Disability.  We will continue to work in various associations paralleling legal services with affiliated legal providers.

Wifi upgrades

In an attempt to improve this blog we have modified our equipment by upgrading our system WiFi with Cisco larger router, Cisco extender and Apple TV effectively increasing bandwidth generating faster streaming. System works great and overcomes weak spots in building.

This now allows additional locations as base for continued client contact with multiple devices.

We’ll have to see if this generates interest in the rest of the Workers’ Compensation Blog.

Overlapping Issues

Your workplace injury may be eligible for multiple different types of claims

Very often similar facts patterns, which at first blush appear to be limited to a single Workers’ Compensation claim, may also be susceptible to legal interpretations which may lead to multidisciplinary issues that should be pursued in parallel areas of the law.

For example, while an injury caused in and out of the work place might suggest a Workers’ Compensation claim; if you are rendered unable to do any work in the national economy as a result of your injury and this keeps you out of work for a year or more, you may also be able to successfully pursue a Federal Social Security Disability claim. An outside worker who gets injured in the course of his or her employment while driving in a vehicle may be able to file for No Fault Benefits in the form of increased personal income benefits. In some cases a negligence case may also be brought against the  responsible party with adjustments from successful awards for benefits provided.  Sometimes,  individuals with long term disability benefit contracts are permitted to obtain LTD benefits from the same injury and continue to receive Social Security Benefits with limitations and relationships between said benefits. Some individuals carry retirement agreements which permit continuing  benefits from other areas of the law and continuation of your Workers’ Compensation Benefit. For a proper legal interpretation of your rights,  it is best to contact your legal representative and go over all possible implications associated with the fact pattern causing your injury and thereby permit a proper evaluation of your specific issues.

As stated throughout this blog, these blogs are only informational and / or educational and therefore do not create an attorney / client relationship. It  is therefore always suggested that you contact  your attorney for a full and meaningful discussion of your individual rights and responsibilities.

New Years Eve Blog

Keep on top of your workers’ compensation claim

Where do we go from here?  Over the past many months we have discussed Workers’ Compensation issues. We’re now ready for a full court press.
This means in addition to filing your claim and pursuing same you should be following up with your representative’s office by making in person appointments to keep them informed of any changes in your treatment needs and wage reduction issues. Our attorneys and staff will file for hearings to try to convince the compensation system to enforce its rules and regulations.
This has been an uphill battle. Insurance companies try to insulate themselves from active claimants. Keep records. See your health providers and make sure they file all necessary variance requests documenting why the treatment they desire is medically necessary and that treatments already made are beneficial. Ministerial calls to insurance companies regarding late payments and the like are ineffective for all. Congressional pressure for increased hearings and penalties for non compliance with the compensation requirements seems best.
Stay connected to your case and representative. This will prove beneficial for all. Have a Happy New Year from the Law Offices of Eliot Levine and Associates.

The changing perspective of Workers’ Compensation

In the few years since the advent of Governor Spitzers’ changes to the New York Workers’ Compensation Law; the name of the game, is no longer get hurt and receive benefits for life. The ever present reality is that injured workers should receive medical benefits and lost wages to compensate for the injury and move on with their lives. This is no more evident then the desire on all sides of the issue to settle claims in the form of wisc settlements or global sec 32 agreements finishing off entire claims. Compensation was never intended to be a life long indemnity payment. Now, movement to claim value as soon as medically practicable or possible is the goal of all responsible parties.

As  stated throughout these blogs, assistance from a workers compensation representative permits more advantageous results from a system designed to respond more quickly to participants who know what is required. Proliferation of form requirements and short statutory time periods have become the rule.  Failure to meet same can doom a claim or produce an unfavorable result. Form has taken precedence over substance. In such a world,  you are best off with representation from an individual, practised in the field.

See associated disclaimer provided throughout this blog.

Forest for the trees, did we miss anything?

Please remember: workers’ compensation is for injuries that occur as a result of your work

Along the way of this blog, I have been commenting upon fairly complex New York State Workers’ Compensation issues and may have just missed a basic understanding. To pursue a Workers’ Compensation case to a favorable result; requires that the incident happens or occurs as a result of the work experience. This means not that you discovered the condition while at work or that a condition prevents you from working, but that the specific condition must have occurred and developed out of the work environment and is a consequence of that event, in other words the condition must be related to and develop from the work experience itself. There are many fact situations that will permit connections over time but the connections themselves must exist before you can attempt to obtain causally related befits. You should ask yourself a basic question. Why should my employer be responsible for my treatment and lost time. Unrelated sick time or vacation time although paid by your employer pursuant to an agreement of sorts does not by itself require the Employer to be responsible under the WCL. If you can reasonable show the relation as a cause  not a temporal appearance at work; you should consider it compensation and seek representation to investigate and pursue you rights under the New York State Workers’ Compensation Law.

As repetitively stated, these blogs are informational and limited in scope. A true attorney client contact should be made to better understand your rights in a specific incidence. Please see our disclaimer through these blogs.

Eliot Levine

Eliot Levine and Associates
1455 Veterans Highway
Hauppauge, NY 11749
fas 631-234-5561