Decoding workers Compensation: How does it work

Today we are going into uncharted territory! Meet Erica Mitchell, Workers Comp attorney and Marissa McKain, A workers Comp Director! They give us the insight into the inner workings of the Workers Comp world.

Episode Transcript

(00:00):
All right, buddy, welcome toanother edition Other Leadership Been Allowed Podcast with
your host Requality Rights. And youguys are in for a treat today because
y'all know I love to get thoserandom topics that people that are so taboo
that we just kind of know wedon't know. And today I promise you
when I say you're going to gobe like what workers comp. Let that
resonate workers Comp. That's what we'retalking about today. You don't have to

(00:21):
get the best. So I'm gonnalet them introduce themselves and we can get
this conversation going. Starting to myleft, Hey, that's me. I
am to his left, I'm Marissa. I am the Director of Workers Camp
at Bader Scott Injury Lawyers, andin my role, I oversee a team
of about forty five people and Ido that through accountability. So I do

(00:42):
a lot of reports and just makingsure we're all aligned with, you know,
our monthly, quarterly, and annualgoals. I do training and development
of our department. I also domaintaining the culture and I do that with
my sidekick, America. Yes,so my name is Erica Mitchell. I'm
the lead Workers Comp attorney. Wehave the largest claimants practice in the States,

(01:02):
so that's something that we're really proudof. My job there is pretty
much a joke, and I callmyself the department Mom. So pretty much
any legal needs, any business needs, any marketing needs, I'm typically involved
in those. So consulting on cases, talking to clients, developing training programs,
hiring and recruiting attorneys, so prettymuch everything. All right, So

(01:25):
let's get down to brass taks.What is workers compensation? Yes? What
is it? Exactly? Yes?I love this question. Okay, So
workers compas an insurance program. It'sjust like we have to have insurance on
our cars in case we get anaccidents. Companies that have more than three
employees have to have insurance in placeto cover their employees if they get hurt
at work. What that insurance coversis three types of benefits, medical treatment,

(01:49):
payment for your lost time from work, and then an additional payment for
permanent damage to the body part thatyou injured. So kind of the main
thing that I always like to stressto clients and just explaining to people just
initially is that it's an insurance program. So think how you would prepare an
insurance claim, submit medical documentation,determine if you're eligible for benefits. Workers

(02:10):
comp is very similar. You onlyhave to show that you're at work doing
something work related and you had aphysical injury, and then essentially you're covered
by that workers comp insurance policy.So typically attorneys will get involved if one
of two things is happening. Onethe insurance company has denied your claim,
because then you have to file what'scalled a hearing request, which is essentially

(02:30):
a lawsuit to force the insurance companyto pay the benefits that you are owed.
Then the other reason is if youwant to settle your claim. Determining
the value of all of those benefitsis something that requires experience in the industry.
I worked for insurance companies for mostof my career a fifteen years and
workers comp, so I know I'vebeen in those rooms and I've been the

(02:52):
one telling the insurance companies how muchto pay for claims. So in terms
of the settlement, it's always recommendedto have an expert because, as you
can imagine, insurance companies are notthe most giving. They don't like it
when I can I stay cheap,They're like, but I'm like, y'all
make money is you collect premiums andthen you don't have to pay out.

(03:13):
So UM, that's just the waythe business works. So they will always
you know, offer you with alow settlement, try to deny your benefits
if they think they have a reason. Maybe they don't. UM, So
that's where we'll typically get involved inthings. But it's initially an insurance program.
So think, for example, ifyou're a worker who doesn't have a
medical insurance or you don't have shortterm disability insurance. Workers comp insurance is

(03:36):
something that the law of the stateof Georgia mandates that they have to cover
you, UM, so that you'renot kind of out there, you know,
with no medical treatment, no incomewhile you're healing from your injury.
So it was this, like isit tiered for each company? They can
pick a tier of insurance. Carinsurance, you know, we can tear
it. I don't I have collision. But so is it like tiered for
comp that's a great question. Sothere's no tiers. UM. It's unlike

(04:01):
personal injury claims, for example,where you have to prove negligence, so
you have to prove somebody did somethingwrong. You know that person didn't have
the right away and they hit meor that sort of thing. In workers
comp you don't have to get intothat at all, and so kind of
the trade off of that is becauseyou don't have to get into that,
it's easier for you to get benefits. Or that's the idea behind it.

(04:23):
And plus, we don't want employeesin court for a year trying to prove
that, you know, my employerwas in some way negligent when I,
you know, was a delivery driverand I lifted that fifty found box and
you know, herniated some discs inmy back. It's not necessarily a negligence
thing. I mean, you probablylifted the box within your training. You

(04:43):
didn't do anything wrong. The boxmay have been heavy, you might have
slipped and you know, I mean, anything could happen. So what we
don't want is in that time foryou know, employees, that's a huge
that's a huge hit when you havea work injury. You know, if
you're if you're you know, bluecollar labor level worker and you need to
use your body, having that typeof injuries is severely impactful to your life.

(05:08):
So we try to resolve those differently. In the world recognizes that,
but again they're straight offs so they'restraight off. Nothing is easy, so
the trade off is not a perfectsystem. Yes, so the tradeoff is
um There are no tiers of insurancecoverage, but the law caps your benefits.
So in terms of, for example, your medical treatment, this is

(05:30):
how they control coross. So withyour medical treatment, typically the company has
to follow certain rules. It's calleda panel of physicians. It's a list
of doctors that you can treat with. If they don't follow those rules,
you can treat anywhere you want,which is helpful. Most people like autonomy
and choice and their medical providers.And again you can imagine the who the

(05:53):
insurance picks to be on their list. Of course to be conservative, yes,
very conservative providers. Yes, theyget that ability to kind of limit
think in network and not and notwork doctors like how your private insurance would
work or your healthcare would work.And then in terms of the income benefits,
you're only eligible for two thirds ofwhat you were making before you got

(06:15):
hurt at work. And then yes, and then if you were injured after
July one of last year of twentytwenty two, you're eligible for up to
seven hundred and twenty five per weekin benefits and that's the max benefits.
So if you're you know, atruck driver making one hundred and ten and
you get hurt, it's two thirdsmax. Seven twenty five. Doesn't matter
if you were getting paid fifteen hundreddollars a week, well, so that's

(06:38):
just across the board. Yeah,correct up to seven twenty five. So
that's it actually hurts higher wage earnersmore so if you were earning two thousand
a week, now the maximum you'regonna get from the insurance company is seven
twenty five. So you can seewhere that can hurt a lot of injured
workers and their families because their billsdo not stop at seven twenty five.

(07:00):
And you know, but we docome in and we make sure that we
maximize. We work the claims upto make sure that they're pro getting the
all of the medical treatment that they'vebeen requested or recommended, and we make
sure that they get the payments thatthey're entitled to. So we do strategies
and we have plans of actions.You know. The secret sauce for US,
I think is all of our attorneysand our legal staff. They are

(07:23):
very well trained, they're very skilledto maximize and it's one thing We're very
client centric business at Beater Scott,so everything we do is with the client
in mind. Every process that wecome up with, every change that we
come up with, every role thatwe create, is always how would this
make the client's experience better? Sothe two thirds that's law, So there's

(07:46):
no correct debating that, there's nogoing to correct. That's at two thirds
and it's probably one of the biggestthings that we have to explain to the
clients. And it's not Better Scottand then you go to another law firm.
It is the law. It's that'sit. That's the maximum amount that
you're able to get up to thatamount, and that's two thirds because they
don't pay one hundred percent, allright. So in the workplace, I

(08:09):
know there's a lot of documentation thathas to be posters that people see it.
What if aldly posted as it pertainsto workers, calm okay. So
initially a few things. It's oneyou want to have that panel of physicians
posted and you want to make surethat it's valid. So there's some laws
in terms of the type of doctorsand the number of doctors that you have
on that list. That's the listthat if an employee reports an injury or

(08:33):
they have an accident, You're supposedto present them that list and let them
choose a doctor. Is that sothere's no preferred physician, Like if I
get hurt, I can't go tomy physician to get that panel. Or
if that panel doesn't adhere to thelegal requirements, then you can treat with
whoever you want. So if Ineed a specialist, I still need to

(08:54):
confer to that list for its possiblecorrect Now, at Better Scott, we
pride in our training of our staff. So one of the things that we
do is we make sure that wetrain our legal assistance as a claimants attorney
to try to invalidate the panels wedo have. The there's criterias, like
you know, they have to beat least six doctors. There has to

(09:15):
be no more than two occupational clinicson that list, at least an orthosurgeon.
Now, at a glance, thatpanel might look valid because it has
Oh I see six doctors, OhI see, you know, an orthosurgeon.
But we have our staff actually godive deeper and call them or make
sure that they're one at the samelocation, or that they are still accepting

(09:37):
workers com So if we can invalidatethat panel, meaning we can knock a
doctor off, and now there's onlyfive and the law allows that there has
to be six, we can goback to the insurance company and say we
have invalidated this panel the physician.So now we get to control medical We
want our client to go to doctorX, y Z, and they have
to approve that because they're the onesthat made the error of an invalid panel,

(10:01):
and we are so good at thatthat that creates and sets the case
up for success. It increases thecompensation for the client because not only are
they going to get better medical treatment, not less concerned, they're gonna actually
the doctors are gonna actually doctor,They're actually going to provide and recommend what
that injured person needs and as suchas a medical treatment. But then it

(10:24):
also will probably you know, gettheir clients workers comp checks started things like
that nature. So that's why ourfirm stands out above the rest because we
take the time to make sure thatwe are doing the proper skill set to
make sure that we can compensate ormaximize the compensation for our clients. And
that's important. I didn't know youcan do that. So yeah, that's

(10:46):
that's good stuff. Okay, whatelse should be like posted the Disabila rights.
It's just a list of information interms of kind of how the frame
causes works, and what your rightsare entitled to. It's just a set
form that you post literally called theworkers Count Bill of Rights. Okay,
like you could google it and putit up. You could google a panel
too, but you have to knowhow to you have to know how to

(11:09):
figure it out for in the firsttwenty minutes. Now I already found us
if I had no idea, allright, so that's what we're here for,
I know. So we're gonna shift. Yeah, I just hurt myself
at my job. Okay, wheredo I start? What do I do?
What cab batter Scott injury lawyers?Yeah, eighty eight m And then

(11:31):
but if you don't have time becauseyou're severely injured, because obviously that happens
as well. I mean really thefirst point of contact is if you get
injured at work, is you've gotto address your physical needs. You know,
your your body, you get oneof them. So if you need
medical treatment, you need to getyour medical treatment. You should you know,
go to the emergency room if it'ssomething that requires emergency room treatment.

(11:52):
If it's not something that acquires anemergency room treatment, you report it to
your HR manager or your supervised andthey should be trained in the procedures.
Unfortunately, even just as somebody who'sdone defense work for years, not everybody
is trained. So the main thingthat's always you want to report your injury
to your supervisors, get some sortof initial medical treatment if it's you know,

(12:16):
emergency room, if you've need ifyou've broken your arm, or so
if your car accident. Obviously thepriority is to get you treatment. I've
had clients before that have called mein there in the hospital and I just
assure them that there's waiting periods.We have time right now. I want
you to focus on getting better andgetting to a place and then the benefits
are there. So as long asyou report to your boss within thirty days

(12:39):
or somebody in your organization, that'sthe main thing. And then the focus
is to kind of get that medicaltreatment. If it's not an emergency medical
treatment, then you should go throughthe panel process with your employer. They
should show you a list, sendyou somewhere for you to start. Most
people start at an urgent care clinic. A lot of times. You know,

(13:00):
if you go and you say,you know, I was lifting my
back, my back hurts, it'snot an emergency. I know. Sometimes
lumbar strains can be very painful,but you're not gonna die like a literal
medical emergency. You know. Yougo to an urgent care typically, what
they'll do is you'll treat with themfor a little while. If your injury
is more severe, you won't getbetter, you'll be referred to an orthopedist,

(13:22):
and then again have to refer backto that list if that's a valid
list. So the first thing isjust always to report it and then focus
on medical treatment. And that medicaltreatment, especially those initial visits, really
set the tone for the rest ofyour claim. So when you go into
those initial visits, you want tomake sure that you're very specific about how

(13:43):
the accident occurred, and that you'revery specific about any any physical pain or
limitation that you are experiencing as aresult of that accident. Okay, so
let me ask this statement wise,when I get hurt, should I writing
statement that I have or when Igo to the doctor, They're going to
take one automatically because it's a workit could possibly be a claim. So

(14:05):
typically what will happen depending on again, if it's an emergency room treatment,
you're just going to go. Ifit's something that doesn't require emergency room treatment,
you're report it to your supervisor orHR professional. They should have some
sort of process in place where theyshow you the panel. They could get
a written statement from you, geta written statement from many witnesses that are

(14:28):
have and then what the employer issupposed to do. Just like when you
get in a car accident, youexchange insurance information and you got to report
it. They're supposed to call itin and report it to their insurance company.
Once they call it into their insurancecompany, the insurance company has twenty
one days from the time they knowabout it to investigate your claim. So

(14:48):
in terms of kind of you knowwhat kind of happens in the beginning because
they have an opportunity to do thattwenty one days of investigation. The main
thing is always report your accident assoon as possible. There's a thirty notice
period, so you have to doit within thirty days, so try to
do that as soon as possible.And then when you're going in for that
medical treatment. Just be as clearand specific as you can, because,

(15:11):
like I said, that kind ofsets the tone. So that's really the
only things that you need to doin the initial process. And then of
course, typically do recommend reaching outto an attorney at least within those first
couple of weeks after you were injured, to get an idea. Every claim
is different, you know, toget an idea of what should be happening.

(15:31):
If you know you're getting resistance orsomething that sounds like the insurance company
is getting ready to deny your claim, or if it's a serious injury,
or if frankly, you just don'twant to deal with the insurance company.
Again, it's an insurance process,so that means you know, documentation,
specific types of evidence. We areexperienced and know what insurance adjusters and that

(15:56):
sort of thing are looking for toget those benefits started for you as soon
as possible. So once you kindof get through, like I said,
make sure you do your notice,make sure you get the medical tight.
Then you know, it's always agood idea to definitely reach out to council
kind of see what's coming down thepipe, because all injuries are just different,
you know, I've had injuries wherea client was a truck driver.

(16:18):
They got hurt in Texas, theywere hospitalized, they had to get transportation
back home. They are concerned abouttheir bills. They need to be clear
on you know, they've got aneurology referral because they have headaches now because
they hit their head on the steeringwheel. They've got an orthopedic referral because
their neck has been disrupted, orthey broke a wrist, or sprain to

(16:40):
knee, or just anything can happen. So when it gets a little complicated
like that, you always want tomake sure that you've just got that process
because it can be a really cumbersomeprocess, you know. I mean,
like you said, you've learned alot about workers comp with in the first
twenty minutes. I mean most ofus, most of us don't know how
it works. And I think alot of times to the way that it's

(17:02):
presented. It's presented like it's apublic benefit. So it's not like Social
security, it's not like unemployment.It's literally private insurance. Now again their
cost focused. So so you knowthat delay, you know, it's have
you've ever dealt with anyone who hashad to obtain medical treatment, like through

(17:22):
the VA, there can be longdelays and getting a surgery scheduled, or
you have to wait for referrals tobe approved, or even if you have
like an HMO plan. So thinkworkers comp plans are similar. You know,
they start you out in urgent carein hopes honestly that you get better.
And sometimes people do you know,you maybe just tweaked your back.

(17:42):
It's fine, you need a littlephysical therapy, you can get some medge,
you can go back to work andyou're good. That's always the best
case scenario. Even as people thatrepresent injured workers, I tell clients often
that you know, the idea isthat you improve with the medical treatment and
then you're able to go back towork. A myriad of things can happen.

(18:03):
You know, you are supposed tocome in. They put you on
a light duty job, meaning ajob where you're physically not required to do
anything because of your injury. Likeif you've injured your back, they may
say no lifting over five pounds,or you can't do delivery driving, you
have to work in an office.The company has to offer you a job
that fits those limitations that you nowhave because of the work injury. Typically

(18:27):
those are jobs that are below theskill level that the injured worker already has.
You know, there's just every allof a sudden, all the employers
turn into doctors. They know howlong you should hear what exactly you could
do? Right? Yes? Yes, yeah, yeah, yes, So
things you know, kind of startto happen. I explain to people that

(18:49):
it's a little bit like marriage anddivorce. You know, you get in
a relationship, something happens, maybeyou're able to recover of it, and
sometimes maybe you're not. And inworkers comp situations, you know, sometimes
there's um as. You can imaginesome things that kind of happen if you
know the employer they already have arelationship with the client that's already a certain
way, or like I said,all of a sudden, everybody's a worker's

(19:11):
medical expert, and they can tellthat that person is faking. And you
know, my uncle had three Turneyeighted discs and he was doing backflips at
the family last. We hear itall the time, all the time,
all the time. And then,like I said, it really will really
be a job that's beneath your skilllevel. I mean, if you're a
like a high earning fifteen hundred ortwo thousand dollars a year, you know,

(19:33):
delivery driver with commission or mileage commissions, and then all of a sudden,
you know, you're used to drivingaround and then they put you in
an office to stay full pail papersand it's not good offering that job,
Like you have to say, thenyou are obligated to attempt the job.
That's another thing for us that asgood attorneys, we know, okay,

(19:53):
we want them, you know,under the law to continue, we have
to work still within the law regardless. But there's strategies and there's plans of
actions that the insurance company is notgoing to tell the clients, like you
have to attempt the job for atleast a certain number of hours or days,
and that if you can't do that, then we'll send you back to
the doctor. You'll explain that tothe doctor, and then the doctor may

(20:15):
either take you back completely off ofwork or they'll increase your restrictions because you're
just having a hard time doing eventhat job within the restrictions. So there's
strategies and there's plans of actions thatour attorneys and our legal assistants are skilled
to do to make sure and thebigger thing with our clients is we explain

(20:37):
the process at every turn because that'swhat they want. They want information.
With information, they know what's happening, they know what's next, they know,
you know what their options are.And I think that's extremely important.
So we make sure and we prideourselves to make sure that we are communicating
every update, what our plan ofaction is, what the strategy is.

(20:57):
We make sure that the client whenyou go to the doctor, especially with
men, you know, they justsay I have pain. No, you
have to be detailed. I havepain. I cannot sit long periods of
time, I can't stand long periodsof time. I can't you know,
if it's a shoulder injury, Ican't do overhead reaching. You know,
I have numbness and tingling down mylegs. All of these things have to

(21:18):
be told to the doctor in orderfor the doctor to do the proper diagnosis,
recommend the right you know, diagnostictesting and all that helps your case.
So let me ask. I'm gonnaask you, so what does I
call you guys? What does theintake process like? Like? What are
you going to ask me when Icall you guys? What does the intake
process look like. We want toknow one. We're empathetic to what happened.
So when you first call in andyou say, hey, I was

(21:40):
just in a you know, anaccident on my job, they'll ask,
you know, basic questions. Nameyou know, employer information, how did
the accident happen, what were thebody parts that were injured? Who were
the witnesses? Some basic information.That's the onboarding and we tell our new
prospect we call them sees prospect clients. We tell them that we are the

(22:02):
right people for the job you calledus, and we're here to help you.
This is all of our attorneys arehere to help you move through this
claim. We're in it side byside with you. Will explain the process,
and we'll go ahead and make surethat you get all of the medical
treatment that you're entitled to, anyincome benefits that or your weekly workers comp
checks that you're entitled to, andwe will make sure that we maximize the

(22:25):
case value. So at the endof all of this, you feel better
or as best as you can,and then you will be able to move
forward, you and your family,because you got to remember, this is
not just the injured person. Thisaffects their spouse, their partners, their
children. We have clients all thetime that you know, in the beginning,
they're like, I can't feed mythree year old because I don't have

(22:47):
any checks because they stop, youknow, I stopped working. What do
I do? Well, We're goingto make sure that we get your checks
started. We're going to make sureyou get that proper treatment because they're hurting
number one. And then of coursethey have the financial hardship. So that's
what we do as a law firmand as a team and as our attorneys
and our legal staff, we makesure that we take care of them.
So the very very basic information,once it's pushed out of you know,

(23:08):
and we signed the client up,then it's pushed over to our department,
whether that's a work department or aPI department, because we also have that.
But once it's pushed over to ourdepartment, we assign a case investigator.
So the case investigator will do aneven more deep dive. They'll verify
the information, they'll verify that youremployer has insurance, they'll verify you know,

(23:29):
your pay stubs and your driver's life. They'll fall a claim with the
state board and then we'll assign thelegal team, and then the attorney and
the legal assistant and fall clerks medicalrecords. Because we work in pods and
we work as teams, they allwork together to move the case forward.
So does workers Cops start day onethat I'm hired or is there like a
times So, yes, it doesstart day one that you're hired. There

(23:52):
is no time frame, so ifit's your first day on the job,
again, the only thing you haveto prove is that you were at work
doing something are related and you hada physical injury. If that happened,
you've been there for five years,you've been there for thirty days. You
are walking in on your first dayand you slip and fall in the lobby,
you're covered. So any employee thatis with the company. The only

(24:14):
requirement is that the company has tohave three or more employees in order for
them to be required to have insurance. But the insurance is there, so
most companies already haven't in place,and you're covered. You don't have to
be specifically listed in the policy.But I did want to add one thing
that I think is really important,especially when choosing an attorney for a worker's
comp claim, is just to keepin mind that the workers practice is probably

(24:37):
more dynamic than most other areas oflaw. In most other areas of law,
even in personal injury, you're justlooking at what happened in the past,
and you're trying to get evidence onwhat happened in the past. So
of course we have you know,if for some reason the insurance company has
denied the claim and we have togo through witnesses or they say this condition

(24:59):
is pre existing. Of course,there's things that matter that happened in the
past. But the thing that's differentabout workers comp is that your claim can
change at any time. What doyou mean, so with the way the
benefits work, So think you choosethe doctor from the list, or you
choose whoever you want. That doctorwill give an opinion on what your work

(25:21):
status is. Your work status willbe one of three things they'll say in
relation to the accident or the injurybecause you've had this physical injury. Either
you cannot do any work at all, meaning you're completely out of work.
You can go back to work,but there are things that you can't do,
which is what we call light dutyor restrictions, meaning limitations or restrictions
on what you can perform or fullduty, meaning you don't have any limitations

(25:47):
as far as the work injury goes. Yeah, maybe you had a little
bit of pain, but you're goodto go back and do your regular job.
So based upon that determines if you'reeligible for those weekly benefits. Now,
every time you go to a doctorand workers comp doctors, you know
you're following up every thirty to fortyfive days or so. So you could

(26:07):
go to an appointment. Doctor couldsay you're on no work, continue physical
therapy, see how you get betternext time. If you're not better,
we might recommend an MRI. Yougo to that appointment forty five days later,
the doctor could say, yeah,I know you're still having a little
bit of pain, but I thinkyou're fine. I'm gonna relea shoot back
to full duty. I don't thinkyou need an MRI. I think you're

(26:29):
done. And it happens like that, and then they have ten days to
cut off your benefits if you're receivingthem, so you have to have an
attorney. That one is anticipating whatthe insurance company's moves are going to be
and the doctors and the doctors we'revery familiar with the doct knowing the strategy.
You know, you have to knowthat, Okay, you've been out
of work for a few months,you've had the MRI. They've recommended injections

(26:55):
like epidural injections or something like that. Maybe you don't need surgery, or
maybe you need physical therapy. Theinsurance company, all they're thinking about is
how to get you off benefits.They want to stop paying for medical treatment,
they want to stop paying for thoseweekly benefits, and then they're hoping
you don't have any permanent damage toyour body that you have to pay for.
So they're very involved in the kindof day to day process and the

(27:15):
handling of the claim, unlike likea personal injury claim with us, because
you're working within that system of insurancealready, and so they're paying for the
medical insurance. That means every timesomething needs to prove it has to be
personally looked at by the adjuster that'sreviewing their case. They may have five
hundred two a thousand files on theirdesk, so they will miss physical therapy

(27:38):
referrals or there will just be delays. It could take three months for them
to get you an appointment with anorthopedist, So you really need an attorney
that knows, you know, kindof this is what we're up against.
I've dealt with this insurance company before, I've belt with this attorney before.
I know they're going to deny everythingor they're gonna want to, you know,

(27:59):
look at every repiece of medical recordsand talk to all the doctors and
make sure you don't have you know, we kind of know how they're going
to maneuver, because, like Isaid, it's just a very dynamic practice
area and things can just change rapidly. You know, you've got a client
that may be out of work forthree months, the insurance company hasn't started
their benefits, and they should havewhere in the process of getting it in

(28:22):
front of a judge to force themto do it. Unfortunately, at that
point is always when I tell clientsall the time, the most aggressive thing
we do takes the most time.So we try to make sure that we
can, like Mrsis said, fasttrack you to those benefits. You know,
I don't want to if an adjustersends over a denial and they say,

(28:44):
well, I don't have any medicalevidence that this happened, you could
have an attorney that doesn't really lookat that or doesn't have a staff that's
experienced enough. They just see adenial, They file a hearing request.
You have your deposition in two months, then you have a media perhaps in
another three months, and then youmay have to go to court in nine

(29:04):
or twelve months after your injury.Whereas our philosophy is always we're going to
try to do what we can atevery step of the way they get you
those benefits. We're not gonna wait. If we can get access to a
medical record and we can send itto them and we can resolve a dispute,
then we're gonna do that. Ifthe adjusters like, well, I
pulled what's called an ISO claim searchreport, because again their job is to

(29:27):
cut benefits off, so they willrun background checks. They'll see how many
insurance claims you have. Oh,I see that you had a motor vehicle
accident two years ago. I thinkthis ankle injury is related to that.
They haven't got any records, andthey can say no, or they can
stay it's still under investigation. Butwhat we can do is we can say,

(29:48):
okay, well, I'll ask myclient about that accident. Did you
go to the emergency room. Wasit just an insurance claim like for property
damage, and really try to workwith them because otherwise your kind of kicked
off into this later timeline. Butagain, it's just so important to make
sure that somebody is really with youevery step of the way. You know
a lot of times, you know, people will get into situations. Obviously,

(30:12):
I have clients if their claim isdenied, they're on light duty,
meaning they can do some type ofwork according to the doctors, and they're
waiting for a light duty job orfor the company to start benefits or whatever
it is. And in the meantime, they have to get work. You
know, they got families, theygot to eat, you know it.
Just the benefits are coming, butthey're not coming tomorrow kind of situation.

(30:33):
And so it's also working with themmaking sure that you know, we're protecting
all of those interests because our motivationreally when they say the workers compensation system,
I always explain to people that compensationmeans money. Yes, we don't
get justice, can't shut the employerdown, We can't get your supervisor fired
because they were mean. We can'tdo any when we can, we would

(30:57):
love to do. I want tosue john because he was rude to me
this morning, and we're like,you said, you're faking it. Yeah,
yeah, we're empathetic to that,but we still have to work within
the law and make sure that everythingthat you're entitled to, we will go
after them for that. I can'tget Johnny fired, but we're going to

(31:18):
make sure that the insurance company youknow, pays for that surgery that you've
been recommended. Make sure you're gettingpaid all those weekly workers comp checks at
the maximum amp that you're supposed tobe paid, which is two thirds of
your weekly salary. And then alsomake sure that there's an impairment rating at
the end of permanent damage to thatbody part, because that body part is
not ever going to be the same. For example, if it's a shoulder

(31:41):
injury, I used to be ableto pick this table up, and now
because of you know, my rangeof motion, my strength, I am
unable to do that, and thatis a disability and that is one of
the benefits that workers paid. Soas a whole, we tell our clients
we want to make sure that uswe make sure that all of your benefits
are entitled. We get you mileage, we get your prescriptions, paid for,

(32:05):
we get we make sure that everythingand these are some of the things
that the insurance Unfortunately they don't tellyou. They can reimburse you mileage when
you go to the doctor. They'llpay for that medication that the doctor you
know just ordered for you. Andyou just went and spent thirty dollars on
that fight dollar parking that I justpaid to park. Get your medical building
to go. I'll get the fightout of that fight dollar could pay for
some gas, a sandwich, abeer, a snicker. Well, I

(32:30):
mean it's important because it's important tomaximize everything. Well, because I tell
clients the unfortunate part about workers compass. Even when they're doing everything that they're
supposed to do legally, it's notenough, correct, it's doctor, so
you don't really want to treat withit's two thirds of what you were getting
paid already, so you're already ina hole. Which is typically how we
get to the settlement conversation. WheneverI sign up clients, I always let

(32:52):
them know what our options are.Settlement or requires you to resign from the
company that you're working for that yougot injured. A lot of times people
don't want to do that because youknow, the injury may not be that
severe, but unfortunately, if youwork for you know, I'm not going
to name names. You work fora national delivery carrier and you're, you
know, thirty five years old,and you make fifteen hundred dollars a week

(33:14):
with commissions, and you get extrabump during holidays, and you cause,
you know, you getting an accidentthat's not your fault and like a motor
vehicle accident or something, and itcauses severe damage to your back and you
have permanent I can't lift anything overtwenty five or thirty five pounds. That's
it. That's a major now inhibitorfor you to perform your job. And

(33:35):
so unfortunately, at that point,because of this injury, what you're looking
at is really you probably need tochange careers or figure out what your next
step is. I love kind ofthis current I might be kind of a
little in my own head about this, but I really like the current move
of kind of just the job industryanyway, with newer generations of workers and

(33:59):
employee and I think kind of themindset of you know, you can work
at a company for twenty twenty fiveyears, you can retire. They give
you a pension and a watch.I mean where that's golong. Yes,
so you may have so you mayhave a short period of time where you're
able to do this physical job ata high earning rate. But then perhaps
I always say settle for a newbeginning. Sometimes you just need to cash

(34:21):
out all those benefits because and reallywhat our job is to make sure kind
of like a bell curve, ifyou're settling, we want to settle at
the highest point because when you're cashingout those benefits. Again, compensation,
it's a monetary system. That isthe way that the law compensates you.
And because that compensation system is solimited, we're always looking for ways to

(34:43):
maximize it. But again in maximizingthat, and especially when you're talking about,
you know, changing industries or becomingan entrepreneur, I've had a lot
of cases with truck drivers who've workedfor national companies and then they really want
to be owner operators, which youknow, you can buy your own um,
you know, rigg or whatever andhire another driver, start a transportation

(35:06):
company, start your own long carefor you were injured at a long new
season, you're injured at a constructioncompany, and now you can't but you
can get the jobs and the bidsand then you hire on. So it's
really um those are kind of mymy favorite cases to work on because it
really is helping people, um,you know, workers come. Sometimes it's

(35:27):
not that exciting, it's insurance,but you really really just to be honest,
I love the fight. Yeah,personnel, the fight. Yeah.
You can look at me and say, I like the fight. Yes,
I know, I know. I'mlike, it's all about our clients,
yes, yeah, part of thereason, but it's really advocating so they
can get as much out of thisbecause, like I said, sometimes,

(35:47):
you know, it's it's really challengingto not have your medical in your career
decisions in your own hands. Andthe longer that you're in the workers' comp
system, the longer that you don'thave that entire moment too. You know,
you will sometimes I'll have clients andthey'll be upset. They'll feel like,
you know, they're just getting pressuredto settle, somebody staring money at
them, and it's explaining to themthat we can do the fighting to get

(36:12):
you to stay in the system,and we can continue to fight with you
through the system. But probably what'sin the best interest of you is to
just cash out and get out ofit. So then you can because for
as long as you're in the system, that they have to provide medical treatment
for four hundred weeks after your accident, so you think seven or eight years
with a worker's comp doctor. Themeantime, they're going to be doing what

(36:34):
trying to cut you off at everycorrect and then you're already at the two
thirds salaries. So yeah, they'resending you to doctors for second opinions,
they're denying surgeries, they're denying procedures. They're like, well, you've been
out of work for six months,we think you should be ready to go
back to your job by now.So even if you stay in the system,
you're not going to stay in thesystem and they're not gonna mess with
you. That's getting reduced as timegoes by because you always tell our client

(37:00):
there is a window of opportunity tosettle your case, and that is when
the maximum benefits. So that's whenyou're still treating and still being recommended,
whether that's injections, physical therapy,or whatever, that that's still medication or
medical treatment being referred. You're stillentitled whether you're getting it or not,
but you're still entitled to your incomebenefits and due to the medical records documentation

(37:22):
we have that there is a disabilityto that body part. So there's always
a window of opportunity that we tellour clients and you don't want to settle
too soon because we may not knowyet what's going on. I always explain
it like in a banana. Youknow, when the banana is still green,
it's not there yet. We don'tknow you haven't had an MRI yet,
We don't know what your actual medicalis. What if somewhere down there

(37:44):
you settle down and then you needa surgery later. So when the banana
is green, that's still when we'redoing that. You know, we don't
know what's going on. Get anMRI, get some treatment, get some
injections, and then as time goesby, you have that banana that is
yellow and it's the sweetest time,right, But that's why you're getting treatment.
You're getting your weekly workers context.But if you wait too long,

(38:05):
because there is still a maximum ofthe four hundred weeks, if you wait
too long, what happens to thebanana? It gets brown, and then
the value of the case goes downbecause they're considering, Okay, of the
four hundred weeks, we've already passedtwo hundred weeks, So it's there's always
that window of opportunity. When weas attorneys and legal staff and in all
of our staff at our attorney's office, at our law firm, we know

(38:29):
that window of opportunity. We knowwhen it's the best time because that's our
job. That is what we do, and we explain to the client,
this is the this is the bestopportunity for you to get the most money.
Now we can. We work foryou, so we're gonna do what
you want us to do. Soif you want to wait, but we
still again going back to every stepof the process, we explain everything,

(38:51):
what's next, what's the strategy.If we go A, this is what
you're going to get. If wedon't do A and we do B,
this is what that is. Ifyou wait and we wait for C,
this is what potentially it could be. And that I think is very valuable
to our clients because they understand now, with information, everybody can makes decisions
best for them and their family.So we make sure they have that information

(39:13):
and they're the ones that have tomake that decision for what's best for them
and their family. I was gonnasay, just unfortunately, claims don't get
better with time. You know,we'll have a lot of clients and let's
say, well, I just wantto be completely healed before I settle.
And the thing is that, remember, even when they're doing everything they're supposed
to do, it's not enough.They're not going to make you whole.
So to that end, a lotof times it's well, maybe settle right

(39:37):
after you have the surgery so youdon't have to worry about the logistics with
that. Insurance is going to payfor it. But the notion that,
like you don't want to stay init, unlike a personal injury claim,
you don't settle once you're at apoint where you don't you're back to full
duty work. Set is you don'thave any more benefits that they're owed,

(39:57):
you don't have any more medical treatment. And then ending on what you're permanent,
you know, damages and it couldbe zero there are some injuries words
zero. Um. You know,at that point your claim has no value
because workers' comp settlements are based uponwhat the insurance company has to pay in
the future because they've been paying allalong, and so they like to settle
out their claims because they're thinking,well, this company had to fire you

(40:22):
or terminate you because they don't havea light duty job that you can do
or they don't have I mean,those light duty jobs can't go on forever.
There's only so much stapling in theoffice sometimes that the companies have,
and they try, you know,and you're Once you're off of that,
then, like Marissa said, aftera year, your benefits are going to
drop. They can drop them toand the law allows them to do that.

(40:44):
So in terms of kind of wantingto stay in it, you really
want to kind of strike while theiron is hot, because if you stay
in it till you're completely healed,then it's you know, could be the
difference from okay, well right aftersurgery, they thought where you might be
out of work for another six monthsto a year. We don't have light
duty. We don't know how thesurgery or recovery is going to go.

(41:06):
You may need physical therapy, maybeyou just need meds. But we can
negotiate a settlement that makes sense.That could be, for example, you
know, fifty thousand dollars based uponthose things versus if we now wait until
your full duty completely healed, whatever, the settlement is probably gonna be less
than five thousand, probably less thantwenty five hundred, correct, So that

(41:27):
incentive to kind of drag it out. You know, there's once the insurance
company gets to the point to wherethey're like, oh, we don't have
to pay anything anymore. If they'renot paying for medical treatment and they're not
paying for your weekly benefits, there'sno exposure. You're not sticking it to
them, and they're no exposure andthey're not settling. They don't care.
It's not costing the money. Butif you're costing them money and it looks
like you're going to cost them moneyin the future. There that's where they

(41:51):
get what's called authority for them toresolve it. Because on the defense side,
the insurance company side, they're thinkinga good claim is a close claim
claim that we don't it's just becausenow it's just the risk is just going,
going, going, going. Andthey're on the other side, which
is what I used to do mostlyof trying to figure out how do we
get this person back to work?And sometimes it's not even always nefarious.

(42:14):
I mean, they're not all terrible. Sometimes it really is this person has
been out, we don't know whatto do with them, We would love
to have them back, or they'rejust not getting better. They've been to
all of these doctors. Is theresomething that we can do to get because
again the idea is you get betterso that you go back to work.
And then on the flip side ofthat, it is just also keeping in

(42:34):
mind that although people have injuries thatobviously impact their lives severely and can cause
you know, some permanent limitations thatthey could live with for the rest of
their lives, we also have tokeep in mind that just the body heals
and the body adapts, and that'sjust honest, that's not you know,
we don't need to make it seemlike people are worse off than they are.
I mean, the body is goingto heal. So it's really about,

(42:54):
like I said, it's such adynamic, ever changing practice that you
want an attorney who's in there everystep of the way with you so that
you know, you get you know, they say, we don't have light
duty anymore. You tell your attorneythey know exactly how to handle it.
They say, we're not authorizing thatphysical therapy because we already authorize ten visits
in our guidelines only say ten.Then you have an attorney that will go

(43:16):
back to the and there's no thereyeahgies. Yeah, and so there's a
process, but it's a very youknow, form based heavy base. You
know, we can get on conferencecalls and things. Um, so we
can love the face. Well,yeah, that's what we do. We

(43:36):
want to educate the community. BecauseI wanted to go back to you know,
starting am I covered on the day, this includes part time and miners.
Oh so if you start on thatsame day, this includes you know,
part time miners, adults that starton that day. I wanted to
make a note and come back tothat when appended in my brains, I
wanted to medicine it. That's importantbecause we get a lot of the cause

(43:58):
they're like, well, I'm onlypart time, or you know, my
sixteen year old kids started and hegot hurt, you know, with a
fire Greece or something like that,and like, absolutely, we can represent
them. Let's make sure that theyget taken care of. So it's extremely
important, um that we educate thecommunity. And I want to add to
that, as a Cuban from immigrantparents, we also want to make we
also educate that the community that wethe same benefits that are everyone is entitled

(44:23):
to is also available to undocumented workers. Really, I educate my community every
single day insurance, so John Smithwill get the same benefits that Jose Lopez
will get, absolutely the same,there is not a deviation and same medical
treatment, same checks, same disability, same settlement. Undocumented, it does

(44:47):
not matter. It does not matter. And that's part of my job.
Um. I know, Seth Baderand I we have gone out to a
lot of the consulates and we we'vespent weeks at different you know, uh,
community events, and we just educate. And because they don't know,
we found a lot of employers thatwill tell undocumented workers or you can't have

(45:07):
a worker's complaim because you're undocumented,or you're this, or you're that,
and that is a lie a lotpeople, there's a lot. I am
here to say that we represent everyoneand you're entitled to the exact same benefits.
Okay, last question, is thisprocess like the personal injury process,
like you guys get paid on theback end, or like when I call
you, I need to have money. No, we're also contingencies. We

(45:29):
either get We get paid in twoways. One twenty five percent of the
settlement, and that's the maximum attorneyfee. It's regulated also by the law.
Everybody charges twenty five percent, Sounlike personal injury, it could be
like up to forty percent. Workerscompass scrapped at twenty five. So we'll
get attorney's fees from the settlement ifwe negotiate a settlement, or if the

(45:52):
insurance company and the employer has behavedso badly in not providing benefits, then
the court will award us attorney's fees. Final thoughts anything you will leave it
to people? Oh, anything toleave with the people. Final thoughts,
Um call us get hurt at work? Ye? Carry on? Yes?

(46:15):
Yes? Or do you want meto say something else more inspirational? If
you will, I will. Iwill say. One of one of my
favorite things about working at Bader Scottis just we have the most diverse law
firm that I've ever been a partof, that I've ever seen. To
sit in the leadership rooms with youknow, Merissa, with the immigrant parents

(46:36):
and me being African American, alot of women, a lot of minorities,
a lot of English as a secondlanguage, just employees UM, and
it really is one of the hardestworking groups of people that I've ever come
across. Everybody is passionate UM.A lot of legal as systems that want
to be attorneys, a lot ofyou know, receptionists that want to be
legal assistants. We're all really reallyinvested in providing the best legal services that

(47:00):
we can. Absolutely, and forme, I've been at Better Scott now
for six years. I've been inthe workers' comp space for seventeen years.
That gives my age, yes butright, and I've worked out out the
law firms. But I want tosay at Better Scott, I believe the
secret sauce is you know, ourculture. Our team members are amazing.

(47:22):
We're all aligned, we all wantthe same thing to help people. Our
leadership team we have, all ofour departments have leaders so we collaborate all
day every day. We're diverse.We have the majority of the leadership and
executive team are women. So Ilove that. And this comes from the
owners. This is Seth Beata andLewis Scott. They are amazing. They're

(47:45):
completely invested in the firm and ourteams and our team members and our employees.
And that comes from the heart,so it comes from the top.
When it comes from the top,that is a huge difference. And we
really focus on growth and development.Like Erica said, we have a lot
of team members that are takeing thel side. We've got some I've got

(48:06):
one legal assistant now that's in lawschool and another one that is about to
start law school. So I'm prettyproud of the development and I'm excited to
be a part of that. Ilove being a mentor and a coach.
I do a lot of training,and you know, with Erica, we
run the department, but it's expiringto see how hard our team members work
and I think that's extremely important andthat carries on to our clients and it

(48:30):
takes you right back to the circle. We're client centric. Everything we do
is about our clients, all right. Our slogan is Accelerate to excellence.
Absolutely is always focused on excellence.Everybody wants to know how to answer the
client's questions, know how to providethe appropriate level of advocacy. We are
just really focused on being the best, all right, love it, love

(48:52):
it all right. There you haveit special thanks to our guests. Thank
you. We'll see you got thesame time, same place on a leadership.
Been our podcast with your host forCaldy Rice. Thank you, thank you,