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EP 37: Takeaways - Chris Miranda & Workers' Compensation Claims

Clarke Speaks shares his takeaways from the conversation with Chris Miranda, a Senior Workers’ Compensation Paralegal at Speaks Law Firm.

Hi, and welcome back, I'd like to talk to you for a few minutes about my takeaways from my conversation with Chris Miranda, Chris Moran, if you'll remember, as, you know, very experienced paralegal has worked in, in New York and in North Carolina on workers compensation claims, some of them, you know, really catastrophic claims. And he talked about his experience that experience in those kinds of situations, the first thing that I thought was interesting about what Chris said was, he talked about a lot of people seem to think that fault is a part of the analysis. You know, they hear about negligence, and they hear about fault, and they hear about, you know, liability and all that sort of thing. And it's important to draw the distinction between liability, which is, which is an injury caused by someone else's negligence. And workers compensation, which is an injury that's compensable, by virtue of your employment status, and these things are not necessarily not related. And so workers compensation does is not followed is not a component of the workers compensation analysis. So it's important to recognize that we see that and when a lot of people contact us about these kinds of claims. And they'll say, Well, you know, I want you to know, it wasn't our fault, it wasn't my fault because of this or that, or, or whatever. And that may ultimately be relevant. But you know, if there's a third party claim, if there's a liability claim, but in workers compensation claims, it's generally not a part of the analysis. The second thing that I thought was really interesting about what Chris said Is he talked about the adjusters particularly in catastrophic cases, and he talked about how, in the in the lawyers in catastrophic cases, he talked about those people is not necessarily being bad guys. He talked about those people as being in and also being, especially in catastrophic paid cases, it's a small group of people, we see the same insurance companies, the same insurance adjusters, the same insurance defense lawyers in in catastrophic cases. That's not to say that there aren't some people that some lawyers or companies or agents that might not be a part of that sort of relatively small group, but we seem to tend to see the same people over and over again, in these catastrophic cases. And that's why one of another one of the reasons why credibility is so important, and professionalism is so important. And in being the kind of person and firm that does what they say they're going to do. And that's important in terms of our ability to communicate with these professionals and, and maximizing the recovery in these kinds of cases. The third thing that I thought was really important about what Chris said was, he talked about when we talked about catastrophic cases, how insurance companies and adjusters and defense lawyers deal with these cases, because ultimately, at the end of the day, their responsibility, their objective is to reduce and minimize the exposure for the company for the insurance company, and for the employer. And that, unfortunately, comes at the expense of the employee. And so our position is exactly the opposite, we want to maximize the benefit to the employee. So we are on opposite sides of the fence, even if they are not necessarily bad people. And a lot of what comes the way they do it in these catastrophic cases is it's there's no denying that the person was hurt at work, there's no denying that is compensable, there's no denying that it's covered. So they'll start out providing good care. And they'll start out providing the care that a person needs after a catastrophic injury. However, over time, what we see is they'll gradually start peeling back and taken away this and taken away that and taken away this, and in what they're trying to do is they're trying to reduce the amount of benefits the cost that the insurance company is required to, to pay. And so at certain times, that may make sense, it might make sense as a person recovers and gets better and their body heals and their mind heals, that they might require fewer and fewer professional and medical services. But we want to be very careful about that. We want to be very careful about the removal of those kinds of services, particularly where if someone needs those services, or if someone's being rushed back to work, or if if if a functional capacity exam is saying that a person is capable of going back to work when really they're, they're not capable of going back to work. So those are some of the different ways where in these catastrophic cases that these arguments take place over some of these different issues, and they can have a huge impact on the value of a claim. So hope that's helpful. And thank you for joining us.

Transcript

Hi, and welcome back, I'd like to talk to you for a few minutes about my takeaways from my conversation with Chris Miranda, Chris Moran, if you'll remember, as, you know, very experienced paralegal has worked in, in New York and in North Carolina on workers compensation claims, some of them, you know, really catastrophic claims. And he talked about his experience that experience in those kinds of situations, the first thing that I thought was interesting about what Chris said was, he talked about a lot of people seem to think that fault is a part of the analysis. You know, they hear about negligence, and they hear about fault, and they hear about, you know, liability and all that sort of thing. And it's important to draw the distinction between liability, which is, which is an injury caused by someone else's negligence. And workers compensation, which is an injury that's compensable, by virtue of your employment status, and these things are not necessarily not related. And so workers compensation does is not followed is not a component of the workers compensation analysis. So it's important to recognize that we see that and when a lot of people contact us about these kinds of claims. And they'll say, Well, you know, I want you to know, it wasn't our fault, it wasn't my fault because of this or that, or, or whatever. And that may ultimately be relevant. But you know, if there's a third party claim, if there's a liability claim, but in workers compensation claims, it's generally not a part of the analysis. The second thing that I thought was really interesting about what Chris said Is he talked about the adjusters particularly in catastrophic cases, and he talked about how, in the in the lawyers in catastrophic cases, he talked about those people is not necessarily being bad guys. He talked about those people as being in and also being, especially in catastrophic paid cases, it's a small group of people, we see the same insurance companies, the same insurance adjusters, the same insurance defense lawyers in in catastrophic cases. That's not to say that there aren't some people that some lawyers or companies or agents that might not be a part of that sort of relatively small group, but we seem to tend to see the same people over and over again, in these catastrophic cases. And that's why one of another one of the reasons why credibility is so important, and professionalism is so important. And in being the kind of person and firm that does what they say they're going to do. And that's important in terms of our ability to communicate with these professionals and, and maximizing the recovery in these kinds of cases. The third thing that I thought was really important about what Chris said was, he talked about when we talked about catastrophic cases, how insurance companies and adjusters and defense lawyers deal with these cases, because ultimately, at the end of the day, their responsibility, their objective is to reduce and minimize the exposure for the company for the insurance company, and for the employer. And that, unfortunately, comes at the expense of the employee. And so our position is exactly the opposite, we want to maximize the benefit to the employee. So we are on opposite sides of the fence, even if they are not necessarily bad people. And a lot of what comes the way they do it in these catastrophic cases is it's there's no denying that the person was hurt at work, there's no denying that is compensable, there's no denying that it's covered. So they'll start out providing good care. And they'll start out providing the care that a person needs after a catastrophic injury. However, over time, what we see is they'll gradually start peeling back and taken away this and taken away that and taken away this, and in what they're trying to do is they're trying to reduce the amount of benefits the cost that the insurance company is required to, to pay. And so at certain times, that may make sense, it might make sense as a person recovers and gets better and their body heals and their mind heals, that they might require fewer and fewer professional and medical services. But we want to be very careful about that. We want to be very careful about the removal of those kinds of services, particularly where if someone needs those services, or if someone's being rushed back to work, or if if if a functional capacity exam is saying that a person is capable of going back to work when really they're, they're not capable of going back to work. So those are some of the different ways where in these catastrophic cases that these arguments take place over some of these different issues, and they can have a huge impact on the value of a claim. So hope that's helpful. And thank you for joining us.

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Speaks Law Firm is recognized by National Attorney ranking services for excellence in the fields of auto injury and workers’ compensation in North Carolina.
Copyright © 2024. Speaks Law Firm. All Rights Reserved.
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