| Insurance Carrier Conflict of Interest |
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| In the arena of workers' compensation and subrogation, the employee may be significantly impacted by the workers' compensation carrier's conflict of interest. The most negative impact would be found in those states denying the injured employee the right to maintain an action against the third party who actually caused his injury. Essentially, the carrier's principle conflict would arise when it is not only the employer's workers' compensation carrier but also the liability carrier for the third party. When this happens, the carrier's interest in paying as little as possible for the claim may be in competition with the employee's right to receive the best recovery possible.More... |
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| "Residual Functional Capacity" in Social Security Disability Evaluation |
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| As a correlative step in its disability evaluation, the Social Security Administration examines an individual's residual functional capacity (RFC). The nature of the individual's impairment(s) will determine to what degree his ability to work is impacted. The bedrock of the RFC assessment is what is the most that an individual can do; not the least. An individual's RFC is that remaining functionality that the individual has despite the limitations caused by his impairment. An RFC assessment is made based on all the evidence, which may include the individual's own account of his limitations, observations by physicians, psychologists, friends, neighbors, and the like, work attempt records, and the individual's medical records.More... |
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| Mental and Nervous Injury |
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| Generally, a worker's injury that occurs in the course of his employment is compensable even though it is a mental or nervous injury as opposed to a physical one. With causation and "arising out of the employment" issues dispensed with, the majority of states find that a mental condition, which causes a physical injury, is compensable. For example, a worker is frightened by a sudden event or accident and immediately thereafter suffers a heart attack. Compensability is no less viable when the mental stimulus is sustained over a period of time. For example, an employee who over the course of months is so pressured by the demands of his employer and his position that, even though relatively young, he suffers a heart attack.More... |
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| Supplemental Security Income and Homeless Individuals |
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| The "homeless" status of an individual does not affect his eligibility for Supplemental Security Income (SSI) benefits. Homeless individuals have the same right to apply for SSI benefits as anyone else. To obtain his benefits, a homeless individual may pick up his payments at a local Social Security office, have the payments mailed to a third party, have the funds automatically deposited into a personal bank account, or have the payments sent to a representative payee who will act in the individual's best interests.More... |
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| Subrogation |
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| Subrogation is a tool used by employers or their workers' compensation insurance carriers to seek reimbursement from a third party for the amounts paid to an injured worker. The employer's position is that the third party who caused the employee's injury should rightfully bear the burden of compensating the injured worker. In various forms, each state provides for subrogation. Some states have instituted no limits on an employer's right to seek reimbursement, others allow both the employer and the employee to maintain actions against the third party, and still others give either the employer or the employee priority in filing an action against the third party.More... |
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