Evaluations by an AGREED MEDICAL EVALUATOR (AME) or a PANEL QUALIFIED MEDICAL EVALUATOR (PQME)  have become more complex than ever. It is very important the initial questionnaire is completed accurately. If you are unable to complete the answers to the questions and need assistance, it is really important to write on the questionnaire itself if you had help. For example,  you could note by your signature line “also completed by _____” and have whoever helped you sign next to your name. The doctors make assumptions about you and your case based upon your answers. If you tell an AME or a PQME that you love your job when he/she asks if your job is stressful, then they will assume you are not under any stress at work. If the physician  makes the wrong assumption, you will get less settlement or even worse, your case could be wiped out completely. So, if you need help with the questionnaire or are unsure if it has been completed accurately, please call our office. The legal assistant assigned to your case would be more than happy to help you.

Child support obligations continue whether you are working or not. It is really, really important to go back to Court for a modification if you lose your job or become disabled. The calculation for support is based upon your current earnings. If you are making less money, you will probably owe less in support.  The Court will recognize the date you file the paperwork as the date set for the modification for your support. Failure to timely go back to court, when your income changes, will result in owing more money that you have the ability to pay.

The District Attorney is entitled to file a lien for unpaid child support, including any interest and penalties due, against your workers’ compensation claim. The District Attorney for each County in which you have a support obligation, will file a lien. It does not matter where the divorce was filed. Often the divorce occurred in one County and the child support obligation occurred in another.  Child support is County specific. So contacting the District Attorney in the County in which you currently live, about a child support obligation in Los Angeles, is not helpful.

The amount to be repaid out of the workers’ compensation claim goes back to the date of injury. You may owe more support prior to the date of injury, but you are only required to pay off the amount outstanding since the date of injury.

The law requires the child support lien to be paid out of your workers’ compensation claim. It is your responsibility to know how much you owe. Having the exact payoff amount before your case settles, make the settlement process easier and faster.

By Lisa Ivancich

Keep in mind that if a neighbor, friend, or acquaintance asks you to help out around his or her home and is willing to pay you for it, you a most likely not entitled to workers’ compensation benefits if you become injured.

According to Labor Code Section 3352 you are exempt from Workers’ Compensation Benefits if you are employed for fewer than 52 hours or earn less than $100 within 90 days of the calendar year while working in a home-related or personal services type job.

So the next time Mrs. Smith asks you to hang her Christmas Tree Lights for $50 and you fall off the ladder, look to your private insurance for coverage.

How Large A Portion?

Ouch! You have just suffered an injury while at work, and therefore may file a workers’ compensation claim.  You are in your mid-40’s and the injury is to your back.  You had noticed your back hurting a bit before the injury (probably from just getting older) but it was nowhere near the pain that you are now experiencing since the work injury.  Not to mention you had that old embarrassing lower back injury that you suffered during a picnic whiffleball game a few months ago, which you have since pretty much fully recovered from.  But what should these other aches and pains have to do with your new injury?  After all, if it wasn’t for the new work injury, you would still be able to work!

That is absolutely true.  However, when it comes time to determine the amount of Permanent Disability associated with your back injury, the doctor will attempt to determine just that:  how much of the disability was caused by the work injury and not other contributing factors.  This is called apportionment in workers’ compensation.

The doctor will attempt to apportion your Permanent Disability.  Using the example above, the doctor could determine that 80% of your disability is a result of your work injury, while 10% is due to “degenerative changes” (the back pain you noticed before) and 10% to your whiffleball-related injury.  This is when you say, “But that isn’t fair!  If it wasn’t for the work injury I wouldn’t have any noticeable disability!”  You’re right, but that is just the way the law and the labor code are written at the moment, and we’re stuck with it.

Insurance companies are also beginning to try to apportion an injured worker’s inability to get back to work after the injury to other factors besides the injury itself.  Again, you will correctly shout from the rooftop that “but if it wasn’t for my work injury I would still have my job!”  However, insurance companies are increasingly making the argument that not all of someone’s inability to find a job is related to the work injury.  They put forward that the economic climate is even preventing healthy people from finding work, that the injured worker may not be looking at all available jobs, that the job the injured worker was employed in is now more and more rare for anyone who is looking for work, injured or not.  Simply put, they are looking for other things to blame your inability to find a job on than your work-related injury.

Rodman J Martin