Frequently Asked Questions
After a serious accident, it’s common for the injured to have concerns or questions relating to their situations and how they can properly obtain compensation. At Abdo & O’Brien, we work hard to make sure our clients receive the best possible resolution and the highest amount of compensation available. On this page, we’ve compiled some of the most commonly asked questions regarding personal injury, and if you find that you still have unanswered questions, do not hesitate to contact us!
Why do I need an attorney to help me with my workers' compensation case?
As in every other area of law, you have the option of representing yourself. However, it is very important to know that your employer and/ or its workers’ compensation insurance company will be represented by a law firm with expertise in defending against workers’ compensation cases.
Workers’ compensation insurance carriers, like any other type of business, exist to make a profit and that profit is increased by reducing the amount that the carrier pays out on workers’ compensation claims. For that reason, the interests of a workers’ compensation insurance carrier (meeting its legal obligations to an injured worker at the lowest possible cost) are not the same as those of an injured worker (obtaining the best possible medical care and the maximum compensation available under the law).
For this reason, obtaining the assistance of an attorney with skilled in the area of workers’ compensation law is very much in your best interest.
Why should I hire Abdo & O’Brien to represent me in my workers’ compensation case(s)?
As explained above, an injured worker who represents him or herself against the insurance carrier’s attorney will almost certainly be leaving “money on the table”, either in the form of medical treatment that was not authorized or, quite literally, less in the way of compensation for your lost wages and/ or permanent impairment.
NYS Workers’ Compensation, a type of Administrative Law, is a very complicated system which is almost completely unlike any other type of law. For that reason, it is extremely important that an injured worker selects a legal representative that has a great deal of experience handling workers’ compensation cases to a successful conclusion.
Alex Abdo, Esq. has been practicing workers’ compensation law since 2005 and he represented insurance companies and employers almost exclusively for the first eight years. The experience that Alex has gained by representing insurance carriers and employers on upwards of 10,000 cases can be put to work for you, allowing you to potentially avoid pitfalls that less skilled attorneys would not see coming.
What benefits does an established workers' compensation case provide me with?
Medical Benefits: An established workers’ compensation case allows an injured worker to receive lifetime medical treatment of the injuries that the case has been establish for. However, a workers’ compensation insurance carrier will frequently deny authorization for (or payment of) medical treatment either on the opinion of its medical consultant or on the basis that the disputed treatment falls outside of the Workers’ Compensation Board’s Medical Treatment Guidelines. At times the carrier’s basis for disputing the treatment is invalid either because the opinion of its medical consultant is not credible or because the carrier has misinterpreted the application of the Board’s Medical Treatment Guidelines.
Indemnity (money) Benefits: An established workers’ compensation case also allows an injured worker to receive indemnity (money) benefits when, because of the work-related injury, he or she is either entirely out of work or working with restrictions/ limitations (light-duty) at less than his or her average weekly wage (pre-injury wages).
An injured worker’s average weekly wage (also known as AWW) is the basis from which all indemnity benefits including awards for permanency (other than award for facial disfigurement/ scarring) are calculated. In general terms, the AWW is an injured worker’s gross (before tax) earnings during the 52-week period leading up to the date of injury (or date of disablement, if the case is established for an occupational disease).
The AWW it is determined based upon payroll information that is provided by your employer and filed by the workers’ compensation carrier with the Workers’ Compensation Board. The law provides for multiple ways to calculate an AWW, depending on things such as how many days you worked in the 52-week period leading up to the injury as well as whether your job was full time/ year-round or part time/ seasonal. Other factors which are very important to consider in calculating the AWW include:
Whether you worked for more than one employer at the time of the injury (concurrent employment);
Whether you were paid bonuses or received compensation for travel, lodging, etc.
Whether you were promoted and received a pay increase at some point during the 52-week period preceding the date of injury and/or
Whether you were less than 25 years old at the time of the injury (minor’s wage expectancy).
When an injured worker is out of work because of a work-related injury, his or her indemnity payments are based upon the of doctors’ opinions as to the injured worker’s degree of disability/level of impairment. As you have likely experienced (or will almost certainly experience), doctors frequently assess different “degrees of disability” (or percentages of impairment that are often expressed as a number out of 100%) and this is especially true when the carrier gets its own opinion from a consultant known as an “Independent Medical Examiner”.
It is important to understand that the NYS workers’ compensation law assesses an injured worker’s degree of disability based upon his or her ability to perform all types of employment rather than his or her specific type of employment. While this may seem silly, this law frequently results in situations where a judge must find that an individual who has always worked in a manual labor field (such as construction work) is not 100% disabled because he or she is theoretically able to work in a “sedentary” job, such as answering phones or using a computer (such as a receptionist) - even if the injured worker doesn’t have the skills to do that job.
If there is a difference in the medical opinions as to your degree of disability, the workers’ compensation insurance carrier will often seek to have your weekly indemnity payments reduced to the medical opinion that results in the lowest possible rate.
In all the above situations, if a negotiated resolution cannot be reached, the disputes are resolved through litigation in front of a workers’ compensation law judge. The litigation process routinely involves development of the record with medical and/or lay witness testimony, citation to relevant case law and the presentation of arguments to the judge either in the form of a written position paper or an in-person oral argument.
Drawing upon his experience in litigating thousands of workers’ compensation issues to successful conclusion, Alex can explain your options and provide his opinion on the likelihood of success for each, so that you can make an informed decision as to which option to select. Significantly, Alex is often able to get a excellent results for his clients without extensive litigation because of his extensive knowledge of the workers’ compensation system gained from his years of experience in representing both insurance carriers and injured workers.
What areas in New York does Abdo & O’Brien serve?
The Abdo & O’Brien office is based in Camillus allowing our dedicated staff to serve clients in the surrounding communities of Central New York.