Investigation

A MTA WORKER IS BOTH A HERO….AND AN INJURED WORKER: INJURED WORKER IN THE NEWS, #55

Posted on August 18, 2022 by Edward Singer

Mr. Anthony Wilson, an MTA Worker, is both a hero and an Injured Worker. It was reported that “[l]ast week, Nelson was cleaning the Pelham Bay subway station in the Bronx when police allege 49-year-old Alexander Wright began to harass customers. Nelson stepped in to protect them, but the suspect quickly turned his rage toward Nelson, breaking his collarbone and nose.” KESQ.COM

This fact pattern may involve many unique issues. This article will discuss two important issues that come up with these type of events; the injury investigation and the Injured Worker’s high profile work injury celebrity status.

Why Would High Profile Claim Like This Be Investigated?

In California, any assault claim has the possibility of an insurance company defense of initial physical aggressor. The initial physical aggressor rule could bar an Injured Worker’s claim. Therefore, it is worthy of inquiry by the insurance company. In other words, there will be an investigation as to whether the Injured Worker made the first physical contact.

Labor Code Section 5402, allows insurance companies 90 days to investigate claims. “If liability is not rejected within 90 days after the date the claim form is filed under Section 5401, the injury shall be presumed compensable under this division.” Thus, the Insurance Company will got out and get witness statements and see if the incident was caught on tape before accepting the claim.

Why Is The Injured Worker’s Celebrity Status A Problem?

An Injured Worker who becomes a celebrity as a result of their injury creates a problem.

When an Injured Worker is in a high profile worker’ compensation case, they may be on television or interviewed for news articles. These television reports or interviews may reveal information concerning the Injured Worker’s injuries and their physical activity level. Additionally, in interviews, Injured Workers may try to make a positive and uplifting impression rather than be accurate concerning their complaints. This information can be used to impeach the Injured Worker. Also, it could be sent to examining or evaluating physicians.

What if I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

DID JOURNALIST DEVELOP WORK- RELATED PTSD? INJURED WORKER IN THE NEWS # 32

Posted on April 25, 2022 by Edward Singer

A Washington Post Journalist on a MSNBC Meet the Press TV Broadcast revealed that“online harassment targeting her and her family caused her to experience “severe PTSD” and contemplate suicide in the recent past.” “The MSNBC coverage aimed to detail brutal harassment faced by female journalists — noting data that showed 73% reported experiencing online attacks while doing their jobs.”It is reported that, after the broadcast, she has faced “even worse” treatment the segment. She reported “If your segment or story on ‘online harassment’ leads to even worse online harassment for your subjects, you f—ed up royally and should learn how to cover these things properly before ever talking about them again.” nypost.comThis fact pattern is interesting with respect to the issue employer notification of injury. Also, it is important with respect to issues of causation and apportionment.

Can This Journalist’s Television Interview Constitute Notice of Claim?

Possibly. First, if the interview connected the PTSD to her job, it could constitute a connection of the PTSD to her work duties. Second, her employer would have had watched the program. If she had expressed connection, ie my job gave me PTSD, and her boss watched the program, there would be notice of a claimed injury for which her employer should notify their workers’ compensation carrier and provide the journalist a claim form.

This action is based upon Labor Code Section 5402, which provides “(a) Knowledge of an injury, obtained from any source, on the part of an employer, his or her managing agent, superintendent, foreman, or other person in authority, or knowledge of the assertion of a claim of injury sufficient to afford opportunity to the employer to make an investigation into the facts, is equivalent to service under Section 5400.”

Why Is Notice of Injury Important?

Under Labor Code Section 5402(b) “If liability is not rejected within 90 days after the date the claim form is filed under Section 5401 , the injury shall be presumed compensable under this division. The presumption of this subdivision is rebuttable only by evidence discovered subsequent to the 90-day period.”

If The Journalist Didn’t Really Have PTSD, Would It Matter?

No. Notice of claimed injury is about a “claimed” injury. It is not about an actual injury. Thus, a “claimed injury” whether actual or not is the basis for which a claims’ file should be opened. At that point, it is the Workers’ Compensation Carrier which must investigate.

What If I Need Advice?If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

A QUESTIONABLE AMPUTATION WORK INJURY? INJURED WORKERS IN THE NEWS, #13

Posted on January 24, 2022 by Edward Singer

A story comes out of Maine in which a Man was found carrying a severed arm. He had severed it allegedly while operating a ban saw. The man worked at a store. The police department “ have not determined how the man lost his arm, beyond describing the gory amputation as a ‘workplace incident.’ From the story’s facts, there were no witnesses to the accident that were interviewed. dailymail.com

For the purposes of this blog post, the assumption will be given that there is some uncertainty as to how the accident happened.

Will The Workers’ Compensation Carrier Accept This Type of Claim Immediately?

No. Given the paucity of the hypothetical’s facts, the Insurance Company would likely wish to investigate the claim to determine whether there was a work injury. They would want to talk to the Injured Worker as well as his co-workers.

Are There Any Times Limits to the Investigation?

Yes. Labor Code Section 5402(b) provides for a 90 day period for an Insurance Carrier to investigate a clam.

Can The Injured Worker Get Medical Care During the Period of Investigation?

Yes. Labor Code Section 5402(c) provides for up to $10,000.00, of medical care to be provided up to the date of the carrier’s determination.

Are There Any Special Benefits That Applicant to Amputation Cases?

Yes. Labor Code Section 4656(c)(3) allows for 240 weeks of total temporary disability benefits as opposed to the 104 weeks which is provided for cases that are not afforded an exception.

What if I Need Advice?