Archive for the Insurance Coverage Category

Sometimes disabled workers injure another body part while going to physical therapy. When this happens, the doctrine of “compensable consequences” comes into play, according to Herndon workplace injury lawyer Doug Landau.

What is a “Compensable Consequence ?”

If an injured worker sustains a second injury or condition because of the original accidental injury (or its treatment), the costs of care may be covered under the workers compensation law of Virginia.

If an injured worker sustains a second injury or condition because of the original accidental injury (or its treatment), the costs of care may be covered under the workers compensation law of Virginia.

A “Compensable Consequence” is a consequence of the original injury or the treatment of the original injury that may be found “compensable” but the Virginia Workers Compensation Commission added to the original AWARD Order. In other words, if someone has a complication as the result of pushing too hard in physical therapy or occupational therapy, or has something go wrong during a surgery to fix, repair or help a comp injury, then the complication or infection can also be covered by Workers Comp. If the complication or infection is completely unrelated, then it goes under the family’s Health Insurance.

There is a doctrine in Virginia Workers’ Compensation called the “Doctrine of Compensable Consequences.” The doctrine holds that medical consequences and sequelae that flow from the primary injury are compensable, i.e. covered by workers’ compensation. Compensable consequences include injuries sustained not as an immediate result of the original injury, but as a result of some intermediate event which was itself a result of the original injury. See the case of Amoco Foam Prods. Co. v. Johnson, 26 Va. App.26 (1997). When the primary injury is shown to have arisen out of and in the course of the employment, every natural consequence that flows from the injury likewise arises out of the employment, unless it is the result of an independent intervening cause attributable to the injured employee’s own intentional conduct.

The Virginia Workers Compensation Commission has also held that exacerbations of a claimant’s condition resulting from medications taken to treat an industrial injury, pain killer, corrective or exploratory surgery, etc., are compensable under the doctrine of compensable consequences. Cubbage v. Wangler, 74 O.W.C. 204 (1995). At the Herndon law firm ABRAMS LANDAU, Ltd., we have won cases for injured workers who developed a second injury or condition due to: their favoring one arm over the other; having the wrong leg operated on; getting an infection that caused a heart attack after surgery on their foot.

If you or someone you know or care for has been injured at work and there are complications or new conditions that have developed, and there are questions about what laws apply, e-mail or call us at ABRAMS LANDAU, Ltd. (703-796-9555) at once.

Police Car

In the state of Maryland, police officers are immune from liability in car crashes.

A question came across the desk of Herndon car accident attorney Doug Landau regarding a crash that was cased by a police officer, driving a police car, in the state of Maryland.  The specific question was whether damages can be recovered when a police officer causes a crash.  And a related question, is there insurance coverage in this situation?

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Experienced auto accident lawyer Landau notes the difference between a motorist who is uninsured vs. one who is immune.

In the state of Maryland, which is a mandatory liability insurance state, it is illegal for a motorist to be (more…)

The details in this case are hard to believe.  It would stand to reason that if a person is legally blind, a claim for Social Security disability benefits would be a slam dunk. But in this case, that is not what happened.

Instead, in the case of this 59-year old, wage earning Georgia woman whose own doctor diagnosed her as legally blind, her benefits were turned down – not only at the initial level, but also then again on the “Reconsideration level.”  It was only when Herndon Disability Attorney Doug Landau of ABRAMS LANDAU Ltd. took her case to court in Washington, D.C. that she finally (more…)

Approximately 85-90% of all auto claims paid out are for property damage and not personal injury.  Thankfully, this means that in most auto accidents the only thing hurt is a vehicle and not a person.  But it also means that insurance carriers do everything they can to minimize the dollar amount they pay on out property damage claims.  By either authorizing only replacement parts that are not from the car or truck manufacturer; sending claimants to their approved body shops, or just plain “nickel and diming” the case, they save millions of dollars each year over hundreds of thousands of car crash claims.

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Herndon injury lawyer Doug Landau recommends that automobile owners be aware of this natural bias that exists in an insurance company’s underwriting process.  If you are involved in an auto accident in which there is property damage, make sure your insurance company is giving you a fair payout to cover the cost of repairs or vehicle replacement.  Get a “second opinion,” in writing, as to the full extent of the damage to your property after a collision.  Your local body shop, service station and the dealership that sold you the car or truck may all be able to assist, especially if they are going to get to do the repair work !

Doug knows all too well, however, that some auto accidents do result in personal injury.  If you or someone you know has been injured as the result of a car, truck, bicycle or motorcycle crash and there are questions about your insurance coverage, e-mail or call us at ABRAMS LANDAU, Ltd. (703-796-9555).

 

Tall dogs, fuzzy dogs, dogs that fit into purses and all of them are called man’s best friend. Fortunately, that is true of most house dogs, but sometimes we are sadly reminded that dogs are animals and are not rational. For this reason insurance companies are charging higher rates to cover dogs or just not covering some breeds. The cost of coverage has gone up about 6.4 percent and dog incidents cover about 25% of home owner claims it is a substantial consideration for insurance companies. This is why many of them are not even covering certain breeds (rottweilers, dobermans, pittbulls, etc…) and dropping coverage on animals if they have any history of violence. One reason for the change in insurance practices is medical costs have risen and dog attacks can cause both physical and mental wounds which the victim should seek medical help them heal.

As stated by Doug Landau, an experienced attorney in canine attacks, In some car accidents, the injured plaintiff never sees the defendant trucker or hit and run motorist. But in dog attack cases, the innocent victim feels the teeth, claws and grabbing, sees the dog, hears the sounds of the attack, and can even smell and sometimes taste the dog’s saliva on her face. These are nightmarish experiences for anyone. The results the Landau Law Shop has had throughout the East Coast suggest that juries and judges take these harms and losses very seriously.

If you have questions regarding dog attacks please contact us at The Herndon Law Shop.

When workers are injured performing tasks their employers have trained them to do, the “safety net” of workers compensation is supposed to provide for their medical care, medications and a portion of their wage loss. This is especially true when they are on their employer’s premises helping co-workers save others from imminent harm. Courage in the face of a tornado’s 200 mph winds is something to be respected and honored. The EF-5 tornado that struck Joplin, Missouri was among the nation’s worst ever. It killed 162 people and destroyed more than 7,000 homes. A Joplin Social Worker’s heroic acts have resulted in permanent injuries, disability from work and a denial from the workers compensation insurance company. (more…)

PCIP helping those with pre-existing conditions get insuranceOn May 31, 2011 the Department of Health and Human Services (HHS) announced that steps were taken toward making it easier to enroll in the Pre-Existing Condition Insurance Plan (PCIP). In 18 states the premiums could drop up to 40% and eligibility will be less stringent in 23 of the states plus Washington DC.  PCIP is under the  Affordable Care Act and was created to span the gap until 2014. When at that time insurance companies cannot deny coverage due to pre-existing conditions.  This offers relief to those claimants waiting to hear if their Social Security claims are approved or those in the 24 month waiting period for Medicare cash benefits.  Both these groups and others who are pressed by major medical considerations can now consider PCIP a reasonable option for their medical expenses.

Sounds like something you are interested in? This should get you started:
To get started you will need show the administrator the following three items. To enrol you will need a letter from either a Medical Doctor, Physicians Assistant, or a Nurse Practitioner from within the last 12 months.  You must be able to prove you are either an American Citizen or a legal resident.  Lastly, you must have been without insurance for 6 months before you qualify for the program. You should know that the program is not based on income and your premiums should not be higher based solely on your pre-existing condition.

For more information please reference PCIP’s Website, and if you are in a situation where your have sustained injury and would like assistance with a legal claim, please call our Herndon Virginia Law Shop today at 703-796-9555 or e-mail us.

It does not matter who is behind the wheel, reasonable transportation expenses are reimbursed by the Virginia Workers Compensation Insurance Companies when such travel is in connection with medical care that satisfies the “three Rs” (Reasonable, Related and by Referral).  A call to the Herndon law Firm ABRAMS LANDAU repeated this often heard question.  In order to be reimbursed for trips to the doctor, physical therapist, hospital, radiologist, etc., it does not matter if:

  • Your daughter, son, wife or parents drove you,
  • You took a cab because you could not drive,
  • An old friend gave you a lift in his vintage mustang,
  • You hopped the local bus (or two) and then the Metro,
  • A car service was required because there is no public transit nearby,
  • The Medical services building charges you for parking,
  • There are toll roads along the way to the therapist’s office,

As long as you have the receipts for the taxi, bus, subway, parking, tolls and other travel related expenses.  If you go to a health care provider for treatment, then such expenditures may be covered under your Workers Compensation Award.  For use of your own car (whether or not you were driving, as many ABRAMS LANDAU client cannot drive themselves to their medical appointments because of the severity of their injuries), mapquest or the mileage on the odometer can be summated for payment.  In cases where the injured or disabled worker cannot drive and has no one to take them, cab fare or car service may be reasonable under the circumstances.  In some permanent total disability cases, the insurance companies have paid for car service, limousines and taxi cabs to shuttle our clients to their necessary medical appointments.  Bottom line: keep the receipts and good written records for full reimbursement !

There are some aspects of Virginia workers compensation law that are just plain frustrating.  In the wake of a workplace accident that results in some sort of injury, it is natural to believe that you might have legal recourse against your employer—just like you would against anyone who is potentially responsible for causing you to sustain an injury. After all, isn’t the threat or litigation supposed to incentivize safe work environments and practices? While litigation may seem like the natural response, many employees injured on the job are actually surprised to find that oftentimes, that door is closed to them. Why is it, exactly, that employers seem to receive this special protection?  The brief answer to that question is (more…)

With the price of gasoline, parking and tolls rising and injured workers and their families traveling to doctors, physical therapy and testing appointments, there is a significant cost to just getting to and from health care facilities.   However, there are solutions to these expenses according to the workplace injury team at the Landau Law Shop. “I am going broke going to the doctors, physical therapy and the testing center !”  “I spent over a thousand dollars in tolls, parking and gas; doesn’t that count for anything ?”  “My wife’s car is falling apart and we cannot afford to fix it up to take me to my appointments safely !”

Doug Landau of the Herndon law firm ABRAMS LANDAU has heard all of these statements.  However, there are solutions.  Landau points out that there is a mileage reimbursement rate for Virginia Workers Compensation claimants, set forth below, that reimburses injured workers and their families for travel associated with their medical care.

YEAR            Reimbursement rate per mile
2010                   $.505
2009                  $.505
2005                  $.27 eff 10/1 $.325

Not every injured worker is transported by cab, ambulance or limousine paid for by the workers comp insurer.  Most injured workers get around by car or public transportation.  The insurance company can be ordered to pay for (more…)

Douglas K.W. Landau is admitted to practice in DC, VA, CT, FL, and NJ. Abrams Landau services clients in Washington DC, Pennsylvania, PA, Maryland, MD, Virginia, VA (including Northern Virginia, Fairfax county, Loudoun county, Herndon, Reston, and more), Connecticut, CT, Georgia, GA, Florida, FL, New Hampshire, NH, New York, NY, New Jersey, NJ, Maine, Massachusetts, MA, Rhode Island, RI, North Carolina, NC, and South Carolina, SC.

Information disseminated on this website is intended for informational purposes only and is not legal advice. This information is not intended to create an attorney-client or similar relationship. Please do not send us confidential information. Past successes cannot be an assurance of future success. Whether you need legal services and which lawyer you select are important decisions that should not be based solely upon this website. Please contact: Abrams Landau Ltd. at (703) 796-9555.