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Reasons Long-Term Disability Benefits Can Be Denied

Posted by on Jun 9, 2017 in Long-Term Disability | 0 comments

Long term disability due either to illness or injury can have a devastating effect on the financial life of a struggling family. Quite too often the disability benefit applied for by many individuals get turned down by their insurance provider. The usual reason for such denial is strictly technical, though, and not because of ineligibility. Technical reason may be improper filing of an application, missing a signature or skipping a box when filling out a claims form – these errors often happen because disability insurance policies are long and complex documents that many applicants find confusing.

However, there are also reported instances when applicants are judged not qualified or, if approved, are awarded small payments. If long term benefits are meant to compensate for salary losses, then even being awarded a small amount would never suffice for medical treatment, much more to support a family’s daily needs.

Many insurance providers resort to finding faults in applications aggressively and then deny claims or award small benefits to ensure increase in their profit. Besides using the guise of technical or paperwork issues, these providers also resort to other tactics to make denials appear legitimate, tactics like, misclassification of injuries, undue termination of a policy or delay in the approval and/or release of cash benefits.

Legal experts call denials of benefit as “insurance bad faith,” which is a breach of the contract that providers, themselves, made and signed with the policy holder. If an insurance company, though, denies any long term disability benefits claim, then the applicant must be allowed to a full and fair examination of the denied claim, as well as to appeal the decision.

An appeal is a formal petition that asks for a re-assessment of an unfavorable decision (like a denial, termination or reduction of benefits) made by an insurer.

According to a long-term disability claim lawyer, the usual reasons why long-term disability benefits can be denied include:

  • Inadequate Medical Support: Medical records can help prove how severe your injury or disability is, as well as the impact on your ability to work. If your claim is missing important information, the insurance company may deny your claim due to a lack of evidence.
  • Definition of Disability: Each long-term insurance policy may have a unique disability definition. Some policies have guidelines which are much stricter than others, and certain medical conditions may even be excluded. It’s important to understand what your policy allows, and what criteria must be met in order to qualify.
  • Social Media Investigation: Insurance companies can also deny your claim if they find examples of behavior where you appear to be able to perform activities despite your illness or injury. A common source used by the insurance companies includes searching your social media accounts to show that your condition is not as limiting as you claim.

If you have been denied your long-term disability benefits, you owe it to yourself and your family to get the legal advice you need to ensure your appeal is accepted. A long-term disability lawyer knows what it takes and he/she may be able to help you understand your legal options.

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Power Morcellator Lawsuits

Posted by on Mar 11, 2017 in Medical | 0 comments

The Unintended, though Deadly Consequences of Power Morcellators, the Basis of Power Morcellator Lawsuits

According to the National Institutes of Health, hysterectomy is one surgical procedure that many women in the United States will undergo in their lifetime. Presently, there are 600,000 hysterectomies performed in the U.S. every year, making it the second most common surgery after Caesarean section.

Hysterectomy is a surgical procedure wherein a woman’s uterus or womb is removed. This is done for various reasons, such as to eliminate/remove or treat chronic pelvic pain, uterine fibroids or myomas (benign tumors growing in the uterus), tissues that cause cancer (like cervical cancer, ovarian cancer or cancer of the uterus), vaginal bleeding, uterine infections, adenomyosis, uterine prolapse and endometriosis.

There are different ways of performing hysterectomy. There is:

  • Abdominal Hysterectomy – which is an open surgery that requires a 5-7 inches vertical or horizontal incision in the abdomen);
  • Laparoscopic Hysterectomy – also known as minimally invasive surgery wherein four minimal (0.5-1cm) incisions are made. These incisions are passage ways for the laparoscope (a small camera that will allow a doctor to see inside the body and guide him/her in cutting the uterus into small pieces), the power morcellator (a surgical device used to cut the uterus or fibroids into small pieces), and other surgical tools;
  • Vaginal Hysterectomy – wherein the uterus or fibroids are cut and removed from within the vagina instead of through the abdomen); and,
  • Laparoscopically Assisted Vaginal Hysterectomy or LAVH – a procedure that makes use of a laparoscope to guide the cutting and removal of the uterus through the vagina.

The introduction of the power morcellator in the 1990s gave doctors a device that could enable them to perform hysterectomies or myomectomy (removal of uterine fibroid), easier, faster, with lesser chances of complications, with less pain and blood loss, and through very tiny cuts that heal much faster, compared to the 5 – 7-inch abdominal incisions required in traditional (or open surgery) hysterectomies.

According to a power morcellator lawsuit attorney, “morcellators are particularly well-suited to remove certain noncancerous growths during a laparoscopic surgical procedure, as these devices can help break down non-cancerous tumors and tissues into smaller pieces. However, if a patient does have cancerous tumors or growths, it can spread this cancerous tissue. As such, the unintended consequences associated with the use of morcellators can be devastating and may include:

  • Cancer growth, particularly Metastatic leiomyosarcoma, Uterine cancer, Uterine sarcoma, and Endometrial stromal sarcoma;
  • The abnormal growth of tissue; and,
  • Direct harm to healthy tissue” (http://www.williamskherkher.com/practice-areas/defective-pharmaceuticals/morcellators/)

Since 1995 the FDA has approved the use of power morcellator from different manufacturing firms, including those from Ethicon, Johnson & Johnson’s power morcellator manufacturing division. Cases of women diagnosed with leiomyosarcoma, a type of deadly cancer resulting from the spread of uterine sarcoma, have already been reported and lawsuits have also been filed against manufacturers of the device used on them.

Filing a morcellator lawsuit would definitely be the right of women injured by power morcellators as these legal actions can enable them to receive compensation (from the manufacturers or other parties responsible) that will cover medical treatment, pain and suffering and other damages that the court will recognize.

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Equipment Malfunction

Posted by on Mar 10, 2017 in Personal Injury | 0 comments

Operators Lacking in Experience is never an Excuse in the event of Equipment Malfunction

Construction is progress, and progress requires fast action; but, as construction firms face the challenge of erecting taller and more complex edifices, many workers are forced to render longer work periods, resulting in fatigue which, in turn, often compromises safety in the workplace.

Heavy machinery is a must in construction areas as this help the construction industry accomplish more at a much faster rate. Heavy machinery may include cranes, road rollers, crawlers, excavators, caterpillar, loaders, forklifts, concrete mixer, and bulldozers. Due to their huge sizes, however, any of these can cause a disabling or fatal injury if operated wrongly or by an untrained and careless worker.

Recognizing the risks of accidents and injuries that employees, but most especially construction workers, are exposed to everyday the US Congress established in 1970 the Occupational Safety and Health Act (or OSH Act) which, in turn, gave rise to the Occupational Safety and Health Administration (OSHA).

OSHA’s task is to ensure the safety of all working men and women through the creation and maintenance of a safe and healthy working environment; it is charged to set and enforce standards that will keep the workplace, as much as possible, free from accident-causing injuries.

It is clear, however, that having an accident-free working environment is quite impossible for, despite OSHA’s work, state laws and employers’ efforts, the US Department of Labor still received reports of as many as 4,585 fatal work-related accidents for the year 2013.

Records from the Department of Labor also shows that being struck by an object and getting caught in or between objects are among the top causes of deaths in construction sites (falls is number one) and that more than half of all construction site accidents involve employees who are in their first year of employment.

The law firm Clawson & Staubes, LLC: Injury Group points out that “Construction workers frequently have to operate motor vehicles and heavy machinery while working on construction sites. Additionally, heavy machinery often involves coordination by multiple contractors and subcontractors involved in the use, rental, maintenance, and operation of on-site equipment. Understanding the duties and responsibilities of each contractor or subcontractor requires expertise.”

This is why operators of heavy machinery lacking in experience cannot be an acceptable reason for an accident, especially since OSHA also mandates that all employees should receive training about their job. Though workers, who get hurt in an accident or develop an occupational illness, may claim financial benefits through their employer-sponsored Workers’ Compensation Insurance benefit, this is never an excuse for any employer or anyone in the construction workplace to be negligent of his/her responsibility in helping keep the work area safe for everyone.

Consulting with a highly-skilled construction accident lawyer or personal injury lawyer may help injured victims understand their legal rights and the best legal action they may be able to pursue.

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Motorists and Bicyclists

Posted by on Mar 9, 2017 in Bicycles Law | 0 comments

Motorists and Bicyclists have Equal Rights on the Road

The National Highway Traffic Safety Administration persuades every road user, especially motorists, to respect the rights of bicyclists on the road, as this is the best way to make a safe transportation environment. Legally speaking, bicycles have the same rights on the road as any other type of motor vehicle. Sadly, though, many drivers have refused bikers the space they need on the road, resulting in significant numbers in severely injured and dead bicyclists.

According to the website of LaMarca & Landry, P.C., there were about 51,000 injured and as many as 600 killed bicyclists in 2009 alone. These numbers have continued to increase in recent years, showing the great danger bikers are exposed to once they start to ride on US roads. And despite the bike lanes on busy city roads, many drivers still refuse to acknowledge the right of bikers on the road, rendering car and bicycle collision a common road site every day.

The most common causes of collision between motor vehicles and bicycles are:

  • Motor vehicle drivers directly and abruptly turning in front of cyclists;
  • Drivers, from parking areas or driveways, driving into traffic and cutting cyclists’ right of way;
  • Drivers failing to slow down at intersections;
  • Drivers running a stop sign or traffic light;
  • Drivers not taking time to double-check for incoming cyclists; and,
  • Reckless driving due to negligence or alcohol influence,

Despite the number of bicycle accidents, riding a bike should never be a seen as a dangerous means of transportation or leisure activity. If only to keep away from the dangers that city roads present, many bicyclists have decided to ride along paths where they’ll be safer and enjoy more.

According to Philadelphia car accident lawyers, in the state of Philadelphia, specifically, “1.1% of all auto accidents in 2014 involved bicycles, which also accounted for 1.6% of all car accident related deaths. Children ages 5-14 were the most susceptible to death and injury while riding a bicycle, though bike riders between the ages of 15-19 accounted for 15.5% of all bike injuries as well. Bicycle accidents occurred most frequently during daylight hours, though 17.3% of all personal injuries involving bicycles occurred when it was dark out. The majority of bicycle versus car accidents occurred at 4-way intersections.”

As explained by a Georgetown personal injury attorney, “a bicycle collision involving an automobile can be incredibly dangerous. In the event of an accident, the massive weight and force of a moving vehicle against a bike that offers no protection from impact is likely to result in serious injury for the cyclist. Although drivers are legally required to share the road with bicycles and exercise caution in consideration of smaller vehicles, collisions resulting from a driver’s negligence occur regularly. These accidents can be caused by a driver who veered into the bike lane, failed to check for oncoming bicycles when turning right, or otherwise acted inattentively when cyclists were present. While cyclists and drivers are both legally required to obey the rules of the road, damages from a collision are often greater for a cyclist, necessitating a greater duty of care on the part of the driver.
Injuries that can result from a bike collision can include: head or brain trauma; spinal cord injuries; lacerations, scrapes, bruises; broken bones; and, facial injuries.

The type of injury sustained will depend on the speed of the automobile, whether a helmet was used, and the degree of impact. If a cyclist was negligent in a collision by riding on the wrong side of the road, running stop signs, turning abruptly into traffic, or ignoring traffic laws, they may be unable to recover damages”; however, if the one at fault in the accident was the driver of the motor vehicle, the negligent or reckless driver at fault ought to be made to answer to the injury he/she has caused. With the help of a determined and knowledgeable personal injury lawyer, though, obtaining the compensation that the victim legally deserves is closer to possible than never.

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When a Bicyclist is Injured in an Accident

Posted by on Feb 28, 2017 in Bike Injury | 0 comments

Many individuals ride a bike to go to work or for morning exercise. This is one way to keep them selves fit and healthy, as well as to enjoy the many other benefits of bicycles. However, like motorcycle riders, bicyclists should know that they too face higher risks of crash-related injuries and death compared to motor vehicle occupants.

In 2013, 900 bicyclists died, while an estimated 494,000 were rushed to emergency department due to accidents. In 2014, with the Educational Pedestrian and Bicycle Safety programs introduced by the National Highway Traffic Safety Administration (NHTSA), the number of fatal bicycle accidents went down by 20% to 720.

Separate studies conducted by the Centers for Disease Control and Prevention (CDC) and the Governors Highway Safety Association (GHSA) reveal the following facts:

  • Adolescents and young adults whose ages range from 15 to 29 and adults 45 years and older are the
    most common victims in fatal bicycle accidents.
  • Children aged between 5 and 14 and those between 15 and 24 years old have the highest rates of non-
    fatal bicycle-related injuries.
  • The top two cities where the highest number of male cyclists get killed every year (in accidents involving bicycles and motor vehicles) are California and Florida. Add Illinois, New York, Michigan and Texas and all six cities account for 54% of all cycling fatalities from 2010 to 2012 which total to
    2,023 (621 in 2010; ;680 in 2011; and, 722 in 2012).
  • Two major contributing factors to bicyclist deaths are failure to wear a helmet and alcohol-impairment.

The most common causes of accidents between cars and bicycles include: cars that fail to yield to bicycles, distracted drivers, swerving drivers, drunk drivers, cars that fail to utilize their side or rear-view mirrors, and cars that fail to use turn signals.

Many states implement the bicycle helmet law for children and adults for the added safety a helmet can provide, which is reduced risk of head and brain injuries in the event of a crash. Despite wearing a helmet or being extra careful, however, some motor vehicle drivers are not concerned with the safety of bicycle riders, thus, they do not bother to check for the possible presence of one when they are driving.

Personal Injury lawyers, such as those from the Mazin & Associates, PC law firm, say, “Cars and vehicles are a valuable asset for independent individuals. They enable people to travel, earn wages, engage in social activities, and have the freedom of going wherever they please. However, car accidents happen far too frequently, resulting in expensive car repairs, lost wages, and even death or serious injury. When a car accident is the fault of one specific party, it is greatly unfair to expect the innocent party to waste their time and resources dealing with the situation, especially in the event of a wrongful death.”

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