Answers to Your Personal Injury, Workers Compensation, and Medical Malpractice Legal Questions
Your Questions Answered - Your Legal Options Explained
At KCAIA we know that it is essential for every injury victim to get good information about how to pursue their accident claim. Following an accident that causes serious injury to you or a loved one, there are often many unanswered questions.
Listed below are some of the most frequently asked questions we get from new clients. You can browse by category using the dropdown menu. Alternatively, for a quicker, more customized search, try typing your question into the search bar above.
Don't see what you are looking for? If you don't find the answers you need, contact us today for answers to your specific questions. Remember, the consultation is FREE and there is no obligation.
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How much does it cost for long-term care of a spinal cord injury?
One of the most devastating outcomes of a serious car or truck accident is a spinal cord injury (SCI) that leaves a victim paralyzed. This kind of catastrophic injury requires the assistance of an experienced personal injury attorney who understands the astronomical costs of such an injury and will fight to get the maximum compensation possible from all liable parties.
Many advances have been made in the care and assistance available to those suffering from an SCI, but they all come at a cost. Learn more about what you or your loved one will need to live your best life following an SCI caused by a car or truck accident.
Caring for an SCI Survivor
Every year, an estimated 17,000 people survive a spinal cord injury and require treatment and care. According to the National Spinal Cord Injury Statistical Center, the majority of these injuries—about 38 percent—are the result of motor vehicle accidents. While the treatment and follow-up care needed varies according to the severity of the injury, medical expenses can easily exceed $500,000 in the first year alone.
Victims and their families can expect to incur the following expenses:
- Emergency services. The medical care needed immediately after the accident may include an air ambulance, use of a specialized trauma center, and life-saving surgical procedures.
- Spinal surgery. Additional surgeries may be required for spinal stabilization, spinal fusion, and respiratory care.
- Rehabilitation. Most SCI victims require a period of rehabilitation to regain some function or to learn to use assistive devices.
- Long-term care. Severe cases may require moving to an assisted living facility or bringing in home healthcare workers.
- Medical equipment. Wheelchairs, respirators, and other assistive devices will be necessary for almost all SCI victims.
- Medications. Antibiotics to fight infection and painkillers will be required by many patients as they recover or for the rest of their lives.
An attorney experienced with catastrophic injuries such as an SCI knows that the cost of the initial medical interventions is only a small part of what will be needed to make the victim “whole.” That is why an attorney may wait until the prognosis is clear. Only at that point can he know what kind of a settlement he needs to try to negotiate.
Estimated Lifetime Costs of an SCI
According to the Christopher & Dana Reed Foundation, the average costs associated with an SCI vary greatly depending on the particular injury. Nearly half of all new SCI cases each year result in incomplete tetraplegia, an injury which affects all four limbs, but the ability of the spinal cord to convey messages to or from the brain is not completely lost and some sensation and movement is possible below the level of injury. Twenty percent of SCIs result in incomplete paraplegia, meaning functioning below the waist is affected.
The foundation estimates the following costs for each type of injury:
- Tetraplegia originating in the upper spine: $1,064,716 for the first year, $184,891 a year for each subsequent year.
- Tetraplegia originating below the neck: $769,351 for the first year, $113,423 a year for each subsequent year.
- Paraplegia: $518,904 for the first year, $68,739 a year for each subsequent year.
The lifetime expenses for a 25-year-old who suffers a high-level spinal cord injury can reach nearly $5 million. A 25-year-old whose SCI results in paraplegia can expect lifetime expenses exceeding $2 million. These figures don't account for the victim’s loss of ability to earn a living due to his or her injuries. These losses average an additional $72,000 per year.
A Catastrophic Injury Attorney Can Make Sure Your Needs Are Met
When you or a loved one suffers a spinal cord injury in a car or truck crash that was not the victim’s fault, you need an attorney who knows what your family requres to live the best possible life with partial or total paralysis. These negotiations can take time, but given the costs victims face, it'll be worth the wait. Contact us at Kansas City Accident Injury Attorneys to learn more about spinal cord injury claims.
How much motorcycle insurance should I carry?
The quick answer to this question is that you should carry as much liability, personal injury protection, and uninsured motorist coverage for your motorcycle as you can afford. Since many people hesitate to pay a lot for insurance coverage because they don’t intend to be injured in an accident, we'll explain why it's so important to carry the maximum coverage you can afford.
Insurance Laws and Fault Differ by State
At Kansas City Accident Injury Attorneys, we're proud to serve the residents of both Kansas and Missouri in their motorcycle accident claims. However, residents should understand that laws regarding fault in motor vehicle crashes as well as insurance requirements differ according to the state in which your vehicle is registered. We'll discuss the laws and your options in each state individually.
Motorcycle Insurance Requirements in Kansas
Kansas is one of a dozen states that follows a no-fault car and motorcycle insurance system. Under this system, it doesn’t matter who is at fault in an accident—a motorcycle rider’s insurance policy will cover his or her medical expenses. That's why it's especially important to carry adequate insurance to cover the injuries and recovery that could result from a motorcycle crash. Under Kansas law, motorcycle owners are required to carry certain minimum coverages for personal protection (or no-fault), liability, and uninsured motorist coverage.
Personal Injury Protection (PIP)
The first coverage tapped after your motorcycle crash is your PIP coverage. The minimum amount you're required to carry by law includes the following:
- $4,500/person for medical expenses
- $900/month for one year for disability/loss of income
- $25/day for in-home services
- $2,000 for funeral, burial, or cremation expense
- $4,500 for rehabilitation expense
- Survivor Benefits: Disability/loss of income up to $900/month for one year
Injuries resulting from a motorcycle crash can be catastrophic and require thousands of dollars in medical care and years of recovery and rehabilitation. Keep in mind these minimum coverages will clearly not be enough to get you through your accident recovery
Even though Kansas is a no fault state, if you suffer serious bodily injury, you may sue the other driver for coverage once you have used up your personal injury protection coverage. Under Kansas law, a serious injury is one that causes permanent disfigurement; fracture of weight-bearing bone; compound, comminuted, compressed, or displaced fracture of any bone; permanent injury; or permanent loss of a body function.
Every driver in Kansas is required to carry liability insurance in the following amounts:
- $25,000/person for bodily injury
- $50,000/accident for bodily injury
- $10,000/accident for property damage
The victim of a motorcycle accident can suffer injuries requiring more than $25,000 in medical care, so if the at-fault driver is carrying the minimum coverage, you'll be even more reliant upon your PIP coverage.
Uninsured/Underinsured Motorist Coverage
If the at-fault driver in your motorcycle crash is uninsured, your uninsured motorist coverage will pay for medical expenses. Minimum coverage in Kansas is as follows:
Motorcycle Insurance Requirements in Missouri
Unlike Kansas, Missouri is a fault state, which means once fault is determined and assigned to a driver in an accident, that driver’s insurance company is responsible for paying the medical costs of the victims. Fault can be shared in Missouri as well, so if it's determined that each driver contributed in some way to the crash, they'll each be responsible for some percentage of the damages. Minimum insurance requirements in Missouri, like Kansas, will likely also be inadequate to cover catastrophic injuries resulting from a motorcycle crash.
In Missouri, you must carry the following minimum coverage amounts to pay the victim of the crash for his or her medical expenses if you're determined to be at fault in an accident:
- $25,000/person for bodily injury
- $50,000/accident for bodily injury
- $10,000/accident for property
As the victim of a negligent driver who is carrying the state minimum, you won't be able to collect nearly enough to cover your medical costs. This is why the state also requires drivers to carry uninsured motorist insurance.
Uninsured Motorist Coverage
If your medical costs exceed the liability coverage of the at-fault driver, you will have additional coverage from you own uninsured or underinsured motorist coverage.
State minimums are as follows:
- $25,000/person for bodily injury
- $50,000/accident for bodily injury
This additional amount will help, but still inadequate to pay all of your expenses if you suffer a spinal cord injury or traumatic brain injury.
How Much Insurance Should You Carry?
Insurance laws in Kansas and Missouri are the same for car owners as they are motorcycles owners, despite the potential for much greater injuries in a motorcycle crash. Determining how much insurance you should carry above your state’s minimum depends in large part on what you can afford.
However, knowing that a serious motorcycle accident can lead to permanent and catastrophic injury, it's not difficult to calculate what you may need. In a no-fault state like Kansas, if you have excellent health insurance coverage, you may not need to increase your PIP coverage. Most insurers recommend carrying liability insurance of $150,000 per person/$300,000 per accident to protect other assets such as your home if you are at fault in an accident. The bottom line is to discuss all of your options with your insurance agent and purchase the maximum amount you can afford.
Regardless of Your Coverage, We Can Help With Your Accident Claim
As a motorcyclist, the system often works against you. We understand that. If you're the victim of a crash that was someone else’s fault, contact our motorcycle crash attorneys today. We'll seek maximum damages, no matter what kind of insurance the other driver carries.
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Does my employer have to accommodate my disability when I return to work after a workplace injury?
Many types of workplace injuries can lead to permanent impairments that will change or limit the things a victim can do when he eventually returns to work. Depending on your disability category, you may or may not be able to return to work, but if you do, you may need some assistance.
Whether there is a physical limitation, such as an inability to stand for long periods of time, or a sensory impairment, such as hearing or vision loss, the employee isentitled to accommodations for his new limitations whether he returns to his original place of employment or gets a new job. Workers are protected under both workers’ compensation law and the Americans with Disabilities Act (ADA).
Debilitating Workplace Injuries
Even seemingly minor workplace injuries can change the types of tasks an employee can be expected to complete when returning to work. For example, a grocery store cashier suffering from carpal tunnel syndrome may not be able to continue to work at the check-out.
Here are the five most common workplace injuries and how they can affect job performance:
- Overexertion injuries. Injuries related to job duties such as lifting, carrying, holding, pushing, and throwing are the most commonly reported in workers’ compensation filings. When a worker suffers an injury from repeatedly performing one or more of these tasks, he may not be able to continue the same tasks when he returns to work after recovery.
- Slipping/tripping. Slipping on a wet floor or tripping over something placed on the floor leads to a large number of on-the-job injuries each year. When a worker trips and falls, he can suffer muscle strains, broken bones, and head injuries that could require a change in duty upon return to work.
- Falling from heights. These accidents are common in construction and manufacturing jobs and may cause serious injuries such as traumatic brain injury, spinal cord damage, and broken bones. Workers returning to the job after suffering this type of fall might not be able to continue doing platform or scaffolding work due to physical limitations and a traumatic fear of heights.
- Reaction injuries. When a worker trips or slips, but manages to brace himself and prevent a fall, he can suffer from muscle strains and body trauma that could require physical therapy and avoidance of hazardous environments in the future.
- Falling object injuries. Workers in many industries can be injured by objects falling from shelves or platforms above them. These accidents often lead to head injuries, and returning workers need to protect themselves from re-injury by avoiding the environment or wearing protective gear.
When you recover sufficiently from a workplace injury and your workers’ comp doctor declares that you are fit to return to work, don't hesitate to request changes to your duties or work environment in order to accommodate any disabilities you suffer. In fact, you're given the right to do this by the ADA.
How the ADA Helps Injured Workers
While workers’ comp law doesn't require an employer to hold your job open for you while you recover from a workplace injury, the employer may be compelled to under the Family and Medical Leave Act. Stay in touch with your supervisor while you're recovering and make your desire to return to work clear.
When you return to work following a disabling workplace injury, you employer may not deny you a job based on your disability, and is required to help if you request specific reasonable accommodations, such as the following:
- Restructuring a job
- Modifying work schedules
- Acquiring or modifying equipment
- Providing qualified readers or interpreters
- Appropriately modifying examinations, training, or other programs
- Reassignment to a vacant position for which you're qualified
If an employer isn't willing to accommodate your disability, you may have a case for discrimination.
Our Attorneys Will Support Your Workers’ Comp Claim
If you're struggling to get the workers’ comp benefits you're entitled to following a workplace injury, contact Kansas City Accident Injury Attorneys today. We'll help you support your claim so you get the medical care and time to heal you need now. Call us at (888) 348-2616.
How can seatbelt use in the workplace save lives?
Many of us are careful to safely secure our children in their seats when we drive around town, and even wear seatbelts in the family car ourselves to be good role models. However, a new study indicates that these safety precautions do not always transfer to the workplace and may contribute to the high number of workplace fatalities caused by car accidents each year. One solution may be company policies that mandate seatbelt use.
In 2014, the most recent year for which statistics are available, the Bureau of Labor Statistics (BLS) reports there were 4,281 fatal workplace injuries. While workplace fatalities have dropped by nearly 1,000 over the last ten years, 2014’s number is five percent higher than 2013, a trend we don't want to see continue.
There are many causes of fatal workplace injury, including falls from heights, being struck by an object, and even homicide, but the leading cause of fatal injuries at work is transportation incidents. This type of injury results in 41 percent of all work injuries resulting in death.
Transportation incidents are broken down as follows:
- Roadway collisions with another vehicle (31 percent)
- Other roadway incidents (28 percent)
- Pedestrian vehicular incidents (16 percent)
- Non-roadway incidents (13 percent)
- Aircraft incidents (7 percent)
- Rail vehicle incidents (3 percent)
- Water vehicle incidents (3 percent)
- Other (1 percent)
In 2014, 379 workers were killed in multiple-fatality incidents, 64 percent of which were caused by transportation incidents. Clearly, motor vehicles are a dangerous workplace hazard.
Seatbelt Use Among Workers
According to the Centers for Disease Control and Prevention (CDC), workers’ compensation costs for serious, nonfatal injuries among work-related roadway incidents involving motorized land vehicles were estimated at $2.96 billion. Add this to the high rate of worker fatality due to motor vehicle accidents, and this becomes an issue that clearly needs to be addressed.
As the CDC points out, a proven and well-documented method to reduce injuries to motor vehicle occupants is the use of seatbelts. Statistics from the National Highway Traffic Safety Administration show that use of lap/shoulder seat belts reduces the risk for fatal injuries to front seat occupants of cars by 45 percent and the risk to light truck occupants by 60 percent.
However, a recent survey of driving behavior found a significant lack of seatbelt use by workers in particular occupations. Not surprisingly, the workers who report the lowest seatbelt use are the workers who are most at risk for suffering a fatal workplace injury. According to the survey, workers in construction and extraction; farming, fishing, and forestry; and installation, maintenance, and repair reported the lowest use of seatbelts while at work.
The BLS report indicates that construction workers suffered the most fatal injuries at work, followed by transportation and warehouse workers, and forestry, fishing, and hunting personnel. This link between self-reported seatbelt use and worker fatality is no coincidence. Not wearing a seatbelt at work is risky, and employers can make a difference.
How to Protect Workers From Transportation Incidents
The CDC report further found that workers in states that have a primary seatbelt law—meaning you can be pulled over and ticketed for not wearing a seatbelt—report a higher rate of seatbelt use than workers in states with a secondary seatbelt law. Only 10.4 percent of workers in states with a primary seatbelt law report not wearing one while at work; by comparison, 23.6 percent of workers in states with secondary seatbelt laws do not wear them. This finding indicates that workers will wear seatbelts more often if they are required to do so. The CDC recommends that employers—particularly those whose employees use motor vehicles as part of their job duties—develop a policy that requires seatbelt use by their workers and enforce the requirement.
What Role Workers' Comp Plays
If you're injured in a motor vehicle accident while performing your job duties—even if the accident is your fault—you may be eligible to receive workers’ compensation to cover your medical bills and time away from work. If an immediate family member is killed in a motor vehicle accident at work, you could be eligible for workers' comp survivor benefits. Call Kansas City Accident Injury Attorneys for assistance with your worker’s comp claim in Kansas or Missouri. We're here to help.
What happens if I get in a car accident in another state?
Americans put more miles on their cars than drivers in every other country in the world. In fact, we travel by car 40 percent further than Canadians and 60 percent further than Australians each year. Many of those miles are logged in interstate travel, as vacations and family visits often have us crossing state lines in our cars. While some traffic laws differ from state to state, it’s generally a seamless transition between states on interstate highways. But what happens when you're injured in a car accident in another state? Which state’s laws are you governed by—your own or the state you're in? Who should you call for help?
Insurance Coverage in Out-of-State Accidents
The first thing to be aware of is when you get in an accident, your car insurance will cover you no matter what state you're in. Most auto policies provide coverage in any state in the U.S., plus any territory or possession of the U.S. and any province or territory of Canada. However, many policies don't cover travel to Mexico or Central America, so be sure to understand your policy limits before traveling to these areas.
Suing for Injury Compensation
Unfortunately, not every accident is straightforward. If you or your passengers were injured in a crash that was the fault of another driver, you may have to sue to get compensation for your injuries. When the accident occurs in another state, you may be confused about how and where to file a lawsuit, as issues of jurisdiction are in question.
In general, you can and should file a suit in the state in which the defendant lives, as states have personal jurisdiction over all their residents. This means that if you're from Illinois but are injured in a crash while driving through Kansas and the driver who caused the crash is a Kansas resident, you'll have to file suit in Kansas. You'll also be subject to the procedural laws, including statute of limitations, of the state in which the accident occurred. For these reasons, your best course of action is to hire an experienced local law firm to handle your case.
The Advantages of Using a Local Law Firm
While you may have a trusted attorney back home, if you find yourself in an out-of-state legal situation—including an injury car accident—you'll likely get the best results by hiring a law firm based in the state where the accident occurred. A local attorney will be more familiar with state traffic laws, statutes of limitations, and procedural considerations and may also have personal connections with certain insurance adjusters, defense attorneys, and judges in the area—something the attorney where you live isn't likely to have. A local attorney will also be able to handle the legal side of things while you recover at home.
No Matter Where Your Accident Occurs, Do These Things
Whether your accident occurred out of state or close to home, you must take certain steps immediately following the crash to protect yourself and your claim, including the following:
- Call 911. Get emergency medical care if you need it and get the police to the scene of the accident.
- Contact your insurance company. Remember: most auto policies cover you in every state and U.S. territory. Even if you are eventually awarded a settlement from the at-fault driver, you will need to report the damages to your own insurance company.
- File a police report. Make sure the responding officer gets your version of events and contact information for those involved and potential witnesses.
- Take pictures. If possible, take pictures of the crash scene before anything is moved. You may need these in court later on.
- Call an attorney. Find a local car accident and personal injury law firm and call it as soon as you're able to following your accident.
Kansas City Accident Injury Attorneys Should Be Your First Call
If you're involved in an accident while visiting Kansas or Missouri, make us your first call. Not only do we practice in two states already, but we also have experience working with out-of-state plaintiffs and will give your case the attention it deserves. Contact us onlilne or call us directly at 816.471.5111 to schedule your free consultation. .
Which smartphone apps are the most effective at stopping distracted driving?
Most of us readily admit that we have a hard time disconnecting from our smartphones. According to data from the Pew Research Center, two-thirds of American adults now own smartphones and 46 percent of them say they could not live without them. We know it’s dangerous to use a phone while driving, but most of us are guilty of a glance at a stop light or a quick reply to an important text. Even these seemingly harmless acts can have tragic consequences. That's why mobile phone companies and cellular providers have created various apps to prevent texting and driving. One of these apps may be the solution for you or someone you love.
Why Use an App?
It may seem ridiculous to develop an app to prevent hazardous phone use while driving, but the reality is that many of us now depend on our phones for key aspects of driving, so simply turning off the phone isn't an option. Whether using a music streaming service to provide tunes for the road or a navigation app to avoid traffic back-ups, we want our phones on and connected while we're driving.
However, problems arise when we allow ourselves to be tempted by an incoming call, a social media notification, or an important text. The best new apps and services work to block the distractions while still allowing other uses for the phone.
Which Apps Work Best?
Every major cellular provider offers a service to prevent distracted driving, but some are better than others. If the app is not fairly automatic, most of us will either forget to activate it when we're driving or choose not to for shorter trips, which totally defeats the purpose of the technology.
Offerings from some major brands include:
- DriveMode. AT&T’s free app is available for iPhone and Android devices. It earns high marks for starting automatically as soon as the car exceeds 15 miles per hour. Text alerts, phone calls, and social media notifications are blocked, but you can set up the app to send an auto-response until you're available again. You'll still be able to interact with navigation and music apps, even as distracting messages are blocked. DriveMode is available to users on other carriers as well.
- Apps from other carriers. Sprint, T-Mobile, and Verizon offer similar apps, but none are available for iPhone. For Android users, Sprint’s Drive First app is similar to DriveMode. T-Mobile charges customers $4.99 for its DriveSmart app, and Verizon’s Driving Mode only blocks texts, not other possible distractions, and has to be turned on manually every time you get in the car.
- SafeDrive. Available for iPhone and Android, this app turns staying off your phone into a game. You earn points for every trip you take without touching your phone and you can redeem your points at some gas stations and retailers.
- Screen Free Driving. An app designed for iPhone, this program actually scolds you when you touch your phone while driving. You will receive messages such as “Hang up and drive” and “Eyes on the road, Chief” whenever you touch your phone. This app launches automatically when you start driving.
- Special apps for teen drivers. Teen distracted driving is a particular problem and many parents want a solution. One highly-rated app is tXt Blocker. At $7.99 per month, parents can shut a teen’s phone down completely when he or she is driving. You can also set up “No Cell Zones” to prevent texting at school or at work, and track your teen’s whereabouts and driving habits through the website.
Whichever app you choose, taking a proactive stance against texting and driving will protect you, your passengers, and other motorists on the road from tragic texting and driving crashes.
We See Too Many of These Cases
Recent data shows that distracted driving plays a part in one in four crashes, and too frequently, texting and driving are key factors in the car crash cases we see. If you know you'll be tempted to reply to a text while you are driving, we encourage you to try one of these apps. You could save a life!
Can information about a defendant’s insurance coverage be admitted in court?
When a personal injury case goes to trial, the main question is usually who's to blame for the accident and how much the victim should receive in compensation for their injuries and pain and suffering. It's up to the jury to listen to each side and make a determination of fault and monetary damages. While evidence from the crash scene, witness testimony, medical records, police testimony, and much more may be presented to the jury, one fact that cannot be brought up at all is whether the defendant is insured and how much insurance he carries. In both Kansas and Missouri, civil law forbids entering proof of liability insurance into evidence.
Why Insurance Coverage Is Inadmissible
When two parties involved in a car crash cannot come to an agreement over who's at fault and who should pay damages, the case may end up in court. In a personal injury trial, it's up to the jury to decide, based on the evidence presented, who's liable for the crash, how much harm has been caused, and how much the victim, or plaintiff, should receive in compensation. The court believes that the decision shouldn't be influenced by whether the defendant has liability insurance coverage or how much coverage he or she has.
The court goes to great lengths to prevent any mention of insurance during a personal injury trial. In fact, mention of insurance by anyone in the proceeding could lead to a mistrial. The concern is that juries will award higher amounts to the plaintiff if they know it will be covered by insurance, or won't award a large sum if they know the defendant has to pay out-of-pocket.
The court holds that these circumstances are irrelevant to the guilt or innocence of the defendant. It's well known, however, that juries speculate about the likelihood of the defendant having insurance and that the speculation may influence their decision. Defense attorneys may play to this bias by presenting information about the defendant’s occupation and lifestyle. Their hope is the jury assumes the defendant does not have insurance—or not much, anyway—and won't award a large sum of money.
All Kansas and Missouri Drivers Should Have Insurance
The reality is that most people who wind up in court over a car accident have at least some insurance. The plaintiff may even carry an uninsured motorist policy that pays out if the defendant cannot. Juries in both Kansas and Missouri will be aware of the minimum coverage requirements for each state and likely have these figures in mind.
Minimum auto insurance coverage in Kansas is as follows:
- $10,000 per accident in property damage
- $25,000 per person for bodily injury
- $50,000 per accident for bodily injury
- $25,000 per person for uninsured or underinsured motorist coverage
- $50,000 per accident for uninsured or underinsured motorist coverage
- $4,500 in personal injury protection
Missouri has similar minimum insurance requirements. Missouri drivers must carry the following:
- $10,000 per accident for property damage
- $25,000 per person for bodily injury
- $50,000 per accident for bodily injury
Anyone who has been in a car accident knows these minimum coverage amounts don't go very far to cover serious or catastrophic injuries. If a jury member is aware of these requirements and is led to believe that this is all the defendant has, he or she may be more likely to find in favor of the defendant, or to limit the amount of compensation awarded, despite the true financial needs of the plaintiff.
An Experienced Car Accident Attorney Will Protect You From These Tactics
As the injured victim, when you're represented by an experienced car accident attorney, the defense attorney will be less able to sway the jury by hinting at the defendant’s lack of insurance coverage. Never take on an injury case like this alone. Call the experienced car accident attorneys at Kansas City Accident Injury Attorneys today.
What is ERISA and how could it affect my car accident claim?
If you have health insurance through your employer, it is likely that your plan is governed by the Employee Retirement Income Securities Act (ERISA). This federal law sets minimum standards for voluntary pension and health care plans offered by private employers. The intent of the law is to protect individuals who subscribe to these plans, but due to recent Supreme Court decisions, it has also presented problems to subscribers who win settlements in personal injury cases. The laws that apply to this situation are complex, but we provide a general overview here.
ERISA Requirements That Protect You
While you may have never heard of ERISA, you can be sure that you have been affected by it—mostly for the better. Passed in 1974, ERISA requires that private insurers offer participants the following:
- Plan information, including plan features and funding
- Fiduciary responsibilities of plan trustees or managers
- A grievance and appeals process to get benefits
- The right to sue for benefits and breaches of fiduciary responsibilities
Several important amendments to ERISA have also been passed over the years that expand protections for health benefit recipients, including:
- Consolidated Omnibus Budget Reconciliation Act (COBRA). This amendment provides some workers and their families with the right to continue their health coverage for a certain amount of time following the loss of a job and other events.
- Health Insurance Portability and Accountability Act (HIPAA). This act provides protections for workers and their families who have preexisting health problems or who face discrimination in healthcare coverage based on their medical status.
Amendments have also been passed regarding mental health and the health of newborns and women. There is no doubt that ERISA is an important law that protects health plan subscribers. However, if you don’t read the fine print provided with your plan, ERISA could come back to haunt you if you win a car accident settlement.
How ERISA Can Affect a Personal Injury Settlement
When you are injured in a car accident and need medical care, your health insurance will generally cover those immediate expenses. If another party (or multiple parties) is responsible for your injuries, you may have cause to sue them or their insurers to recover monetary compensation for injuries, lost income, and pain and suffering. Plaintiffs who are successful in these claims usually end up with settlements that are much greater than the total of their medical bills. Heath insurance companies have the right to claim a portion of your settlement as reimbursement for the medical care they have already covered. This is called subrogation and is very common. Often, the insurer will place a lien on the settlement until they are reimbursed. This means you will not have access to your recovery until you pay back the insurance company.
However, when your health insurer does not place a lien and you fail to pay them back, ERISA gives them the right to make a claim against your settlement. Once this proceeding begins, you are in danger of losing not only what the health insurer covered, but your entire settlement.
This is where the law becomes complicated. Your insurer’s right to your settlement under ERISA depends on the language in your plan, whether the plan is self-funded or insured, overriding state laws, and many other factors.
What You Should Do to Avoid an ERISA Lien
The most important thing you can do is read and understand the language in your plan. ERISA law does not override what you have agreed to in your plan. If your plan requires repayment of medical benefits when you receive a settlement, then you must reimburse your insurer. If your plan limits what the insurance company can demand from your settlement, ERISA does not allow them to demand more.
People often end up with a lien against their claim because they didn’t understand their responsibilities. Recent Supreme Court rulings have given more weight to ERISA law and once a lien is placed, it is very difficult to negotiate, so it is important that you seek the advice of an attorney before a lien is placed. If you were injured in a car accident and you don’t understand your obligations to your health insurer, contact the attorneys at Kansas City Accident Injury Attorneys.
How could I lose my workers’ compensation benefits?
When a worker is injured on the job or becomes ill due to a workplace exposure, he is entitled to receive workers’ compensation benefits to cover the cost of medical care and lost wages while he is unable to work. The worker’s ability to perform job duties will be assessed by a doctor chosen by the employer or the employer’s workers’ comp insurer. Disabilities will be classified according to whether they are permanent or temporary and whether they are total or partial. A temporary disability is one from which the worker is expected to eventually recover and return to work. An injured worker should expect to continue receiving benefit payments until he or she returns to work. There are situations, however, that can cause a worker to lose his or her benefits.
Losing Workers’ Comp Benefits
If you are legitimately ill or injured and have followed your doctor’s and your employer’s instructions regarding your medical care and work status, you should not have to worry about suddenly being cut off from benefits. However, when an employer mistrusts your intentions, you may find yourself in danger of losing your benefits. If you engage in any of the following actions, or your employer believes you have done any of these things, workers’ comp payments could be terminated:
- You fail to follow through with medical treatment as ordered by a doctor. The intention of workers’ compensation is to provide income while you are recovering from injuries suffered in the workplace that prevent you from doing your job. In order to qualify for the benefits, you must make every effort to heal and return to work. If you don’t, you could lose benefits.
- You refuse to comply with an order to have a medical exam. If your employer suspects you have recovered enough to return to work, he may order you to submit to a medical exam. If you refuse, your benefits could be terminated.
- You are convicted of a crime and are put in jail. Prisoners are not eligible for worker’s comp benefits. If you are imprisoned, your benefits will cease, even if you have family members who rely on the benefits as well.
- You have returned to work. If you are earning an income, even if it is not in your original line of work, your benefits may be terminated. Workers’ comp is meant to provide an income when you are not otherwise able to earn one. Returning to any type of work could cancel your benefits.
Even if you have jeopardized your benefits in one of these ways, your checks should not stop without warning. If your employer wants to begin the process of terminating your benefits, he will have to submit a request to be reviewed by a judge.
Petition to End Benefits
If your employer has submitted a request to terminate your benefits, you should receive a copy of the request. The request will be reviewed by a judge who will make the final decision about ending your benefits. Until the hearing takes place and a decision is made, you should continue to receive your worker’s comp checks. As soon as you receive notification that a request to terminate your benefits has been filed, you should contact an experienced workers’ compensation attorney. If your employer’s doctor has determined that you are fit to return to work, but your personal doctor disagrees, you will have to provide evidence of your ongoing disability to the judge. These cases can become complicated very quickly, so hiring an attorney is always a good idea.
Don’t Hesitate to Hire a Lawyer
Even a legitimate workers’ compensation claim can be overturned by a judge. If there is a chance that you will lose your benefits before you are physically able to return to work, you should contact a workers’ comp attorney as soon as possible. Kansas City Accident Injury Attorneys will work hard to document your injuries and demonstrate the legitimacy of your claim. Contact us at (888) 348-2616 to get started.
What do I have to prove to win my car accident claim?
When you are injured in a car crash caused by another driver’s negligence, you deserve to be compensated for your expenses. Some of these cases are clear-cut. The other driver admits fault—or cannot deny fault due to charges filed by the police or other undeniable evidence—and his insurance company pays the claim without question. Often, however, the at-fault driver or his insurance company denies he was at fault or claims that fault was shared by more than one party. In these cases, you will need to provide evidence showing that he was at fault and should be held accountable for your expenses. Because this is a civil claim, however, the burden of proof you must meet is lower than that of a criminal charge. We explain burden of proof here.
What Is Burden of Proof?
You may have heard the term “burden of proof” on a legal drama or in a detective novel, but you may not fully understand what it means. You have probably also heard the legal phrase, “Beyond a reasonable doubt.” In a criminal trial, the prosecutor must prove the accused’s guilt beyond a reasonable doubt. That is his burden of proof. If you look at the burden of proof in terms of percentage, beyond a reasonable doubt means that jurors are 99 percent sure of the accused’s guilt. This is a high burden to meet, as it should be when determining guilt in a criminal case. However, in a civil case, the burden of proof is much lower. In a car accident claim, for example, the burden of proof is on the injured party, who must show the other driver’s guilt beyond a preponderance of the evidence. This means that it is more likely than not that the other driver is negligent. In other words, the judge or jury must be convinced that the chance the plaintiff’s facts are true is at least 51 percent. This is a far lower standard than the 99 percent burden in a criminal trial, but it is still not always easy to meet.
Settlement vs. Trial
Many car accident cases can be settled out of court. If you are the injured victim of a car crash, your first move should be to secure an experienced car crash attorney, who will begin settlement negotiations with the other party’s insurance company. In order to get the maximum available compensation, your attorney will need to provide evidence of the other driver’s guilt, but this evidence does not have to be certified or verified at this point. Simple copies of police reports, witness statements, and photos of the scene of the crash can be shown to the insurance adjuster in an informal setting and may be enough to convince the insurance company to pay up. However, if your attorney cannot convince the adjuster to provide a reasonable settlement, he may have to take the case to trial. It is at this point that he will have to prove the other driver’s negligence rather than simply showing his negligence. He will do this by formally entering the proof he has gathered into evidence. This proof will include:
- Medical reports
- Police reports
- Witness statements
- Expert testimony
- Crash scene photos and diagrams
- Lost wages statements
With this evidence, your attorney must convince the judge or jury that there is a greater than 50 percent chance that the defendant caused you harm and should be held responsible. He will then have met his burden of proof and the court will find in your favor and award you the compensation you deserve.
Our Car Accident Attorneys Will Gather the Evidence
While beyond a preponderance of the evidence is a fairly low burden of proof, it is still not easy for an injured victim to gather the evidence and present it on his or her own. The car accident attorneys at Kansas City Accident Injury Attorneys have many years of experience presenting evidence in car crash cases and will do our best to gather the evidence you need to make your strongest case. Call our office at (888) 348-2616 to discuss your case today.