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What To Do After a Slip and Fall Accident?

By Personal Injury

“Slip and fall” is the term used in a personal injury case where a person slips or trips and is injured on someone else’s property.  This usually falls under a premises liability claim.  Slip and fall accidents usually occur on property owned or maintained by another person. The property owner may be held legally responsible in the case of your accident. Many dangerous conditions include poor lighting, a wet floor, changes in flooring and cracked public sidewalks.  A slip and fall cause might occur when someone slips and falls outside when there is ice, rain or snow or falls into a hidden pothole or drain hole.  

When a person gets injured in a slip and fall on someone else’s property, they must prove that the cause of the accident was a dangerous condition and that the owner knew of this condition previously.  A dangerous condition must present an unreasonable risk to a person on the property and it must have been a condition that the injured party should not have anticipated under the circumstances.  

In order to show that a property owner knew of a dangerous condition it must be proven that: 

  • The owner created the condition 
  • The owner knew the condition existed and negligently failed to fix it 
  • The condition existed for a length of time that the owner should have found and corrected it prior to the slip and fall incident 

For the property owner to be held liable, it must have been foreseeable that his negligence would create the danger that is at question.  There must be a responsible party whose negligence caused the injury.  

To be legally responsible for the injuries someone suffered from slipping, or falling on someone else’s property, the owner of a store, restaurant or other business must have caused the spill, worn spot, or dangerous surface or item.  They should have known of the dangerous surface because a “reasonable” person would have repaired if upon discovery or on the opposite end, they knew about the dangerous surface but did nothing about it.  If a slip and fall happens on a commercial property, there are often a number of people and entities that may be held responsible for the injuries.  

In a residential property, landlords may be held liable to tenants or third parties for slip and fall injuries on rental properties.  To hold a landlord responsible for an injury the tenant must show that the landlord had control over the situation that caused the slip and fall, repairing the condition would not have been unreasonably expensive or difficult, a serious injury was the foreseeable consequence of not fixing the condition and the landlord’s failure to take reasonable steps to avoid an accident cause the tenant’s slip and fall injury.  

Special rules apply when a slip and fall injury occurs on a property owned by a local, state or federal government entity.  There are very specific and stringent notice requirements and broad immunity provisions that sometimes guard government objects from liability for injuries that occur on their property.  If you are injured on government property, call your attorney immediately so they can give you the proper information you may need for your lawsuit. 

Slip and fall accidents can be very pricey and if the fall was caused by another person or business, filing a lawsuit may be the only way you can recover medical expenses, loss wages and money for pain and suffering.  Call your attorney as soon as possible since there are time limits where you can file a personal injury lawsuit.  

What You Should Do Immediately After a Slip and Fall Accident? 

  • Get medical attention as soon as possible – This is important because some symptoms do not show up right away after the accident.  By getting a thorough exam from a medical professional you will be able to have your diagnosis in writing for any future legal matters.  If you have a broken bone, cuts or any other type of wound that was caused by the slip and fall document 
  • Inspect the area where you fell – Look around for the potential cause of the fall (weather conditions, uneven flooring or concrete, etc.) Write down what happened as soon as possible because it will help you in your case. 
  • Identify witnesses – Write down names, addresses and phone numbers of anyone in the area where the incident occurs (those who saw you fall and others who were around after the incident).  Even if someone did not see you fall, they might be able to describe your pain and the conditions of the floor, lighting, etc. after you fell. 
  • Follow necessary procedure – If the incident happened in a store or place of business you may need to fill out an accident report or notify a manager.  Make sure the store and manager knows about your accident immediately.  If anyone employed by the store makes a comment saying that your accident did not happen in the store or suggesting that this occurred before, take notes especially the name of person of who made the comment.  
  • Take photos as soon as possible – Try to take pictures of the scene immediately after the accident especially if conditions start to change.  If you do not get photos, you may be at the mercy of the property owner’s version of how they thought the slip and fall accident occurred.  Even if the condition that caused your fall is permanent or semi permanent (ice on the sidewalk, cracks in the concrete) take photos of the area as soon as possible to that you have a record.  
  • Stay at the scene to fill out an accident report and keep talk to a minimum especially about how the fall happened. 

After you submit your slip and fall claim, an attorney or insurance adjusters from the property owner or responsible party may approach you.  Be careful what you say especially since these people work for the opposing party and their insurance companies and they will pay you as little as possible in your case.  Don’t make simple mistakes by saying too much.  

Speak with an attorney as soon as possible.  They will know how to handle the insurance companies and the other party’s lawyers.  The attorneys at Losi & Gangi are experienced in slip and fall injury on property cases.  Call for a free for a free consultation and review of your case at 716-854-1446. 

Article adapted from:  https://injury.findlaw.com/torts-and-personal-injuries/slip-and-fall-accidents-overview.html

https://accident-law.freeadvice.com/accident-law/slips_falls/fall_what_to_do.htm

10 Critical Steps After a Car Accident in New York State

By Personal Injury

Even though the safety features in vehicles has become more advanced over the past few years, there were still over 2 million people injured on the US roadways in 2019.  Over 140,000 people were treated in hospital emergency rooms for injuries stemming from car accidents.  Car accidents often happen in a split second and there are a lot of factors that need to be put  into place after it occurs.  By knowing what to do and who to contact can help you build your case for a personal injury claim.  Here are 10 steps you can follow after you have been in a car accident:

Step 1 – Stop, Check for Injuries and Call 911

New York law requires drivers that are involved in an accident to immediately stop at the scene or as close as possible to see if anyone has been injured.  Call 911 and report the accident to the police.  The 911 dispatcher needs specific information to determine whether police, paramedics or tow trucks will need to arrive on the scene.  The dispatcher will need to know the location of the accident, read nearby street signs, give landmarks and describe what the scene looks like.  If anyone is complaining of pain, discomfort or is noticeably injured or if the accident is blocking traffic an ambulance and police will be sent. 

You are required to give the other driver your name and address, vehicle registration, drivers license information, insurance and license plate number.  If you are the one injured in the car accident do not refuse medical assistance.  Let the EMTs examine you and decide if you should go to the hospital for further tests and observation.  Seeking prompt medical attention after the accident can be crucial to the success of your personal injury claim.  The longer you wait to seek medical attention the greater the chance the insurance company will deny your claim.  If you have been injured and are physically unable to immediately contact the police you can wait until you are able to report the accident.  New York State does not require drivers involved in car accidents to assist those who may be injured.  Anyone who “voluntarily and without expectation of monetary compensation” gives first aid to the injured victim under the Good Samaritan law will not be held liable for the help given. 

If you hit an animal or a car that was unattended you should report the accident to the police.  For the unattended car, even though it is not required by law, you should leave a note with your name and contact information and a brief description of how the accident occurred.  If the animal was a dog or cat see if the animal is ok or needs help and try and locate the owner.  If the car accident resulted in injuries to any person or damage to property is $1,000 or more, you must file a report with the NYS Department of Motor Vehicles within 10 days.  If the police came to the scene of the accident, they are required to file an accident report.  To obtain a copy of a police report, contact the local police precinct who investigated the accident. 

Step 2 – Preserve Evidence from the Accident Scene

The actions you take in the minutes following an accident are crucial for developing your vehicle damage and personal injury claim.  This damage can include: car repairs, medical bills including X-rays and MRIs, out of pocket expenses for prescriptions, wheelchairs and costs of travel to treatment, lost wages and pain and suffering.  Take photos if you have a phone or camera available.  This will help determine who was at fault if intoxication was involved and will capture potholes, road obstructions and street signs that were nearby.  Get the registration information, VIN number and make, model, year and license plate number of the other vehicle.  Record the weather conditions and time of day the accident occurred and ask the other driver for their license number, and contact information.  If a witness is present and willing to talk record their statement and make sure they sign off on the information they are giving with their name, address and signature. 

Step 3 – The Role of Police at Accident Scenes

When police arrive at the accident scene they have several different tasks they need to take care of:

  • Arrange care for the insured
  • Secure the accident scene with flares, pylons, tape, etc.
  • Search for physical evidence, including skid marks, obstructions, debris in the road, etc.
  • Question drivers, passengers and witnesses to get information about the accident
  • Conduct field sobriety tests
  • Run warrant checks
  • Issue traffic tickets
  • Give drivers a “case” or “service number” so they can obtain the police report

Wait until the officer is done investigating the accident to speak to them. If the officer is asking you to identify yourself and provide information you must comply but if you are being questioned about the possession of drugs or any other criminal activity, you have the right to remain silent.  If the police officer decides that you violate New York’s traffic laws, you may be issued a traffic ticket.  By signing the ticket it becomes an agreement that you will appear in court at a later date, not necessarily that you are guilty.  At this time you may enter a plea of not guilty to challenge the ticket. 

Step 4 – Call Your Insurance Company and Report the Accident

Call your insurance company as soon as you are able to.  They will open an investigation and a claims adjuster will contact you.  Most insurance policies have a Cooperation and Notice of Occurrence clause that refers to the contractual obligations between the driver, the insured, and the insurance company, the insurer.  This clause requires the insured to notify the insurers of the accident, regardless of fault and to cooperate throughout the investigation.  You should contact your insurance company even if the accident wasn’t your fault.  This is an important step because the other driver might tell their insurance company that you were the one at fault when in fact they caused the accident.  The investigation may show the other driver is fully or partially at fault for the accident due to texting, speeding or engaging in some other form of negligent behavior. 

Even if no one was injured you should still report the accident to your insurance company.  Some injuries such as neck or back pain can take hours or days to appear when you originally thought that you were fine.  The other driver may not have car insurance and that can affect your outcome.  Get as much information from them as possible and let the insurance companies handle your claim.  Sometimes at the scene of the accident, the other driver or passengers may say that they are not injured but at a later date they will file false claims saying they have whiplash to receive compensation from the accident. 

When the car accident is reported to your insurance company, a claim number will be assigned.  Make sure you keep this claim number handy because you will need it throughout the process.  You are not required to give a recorded statement to the claims adjuster but once you do what you say becomes permanent even if you later change your mind about what happened at the accident scene. 

Step 5 – New York’s No-Fault Insurance Law

New York State relies on a no-fault car insurance system also known as Personal Injury Protection (PPI) coverage.  No-fault is designed to cover medical bills, out of pocket expenses and lost wages if you get into an accident.  PIP does not give compensation for pain and suffering.  PIP covers bodily injury expenses regardless of who caused the accident.  This means you don’t have to sue the other party’s insurance company, just contact your own carrier and file a clim. 

You can pursue your injury claim against the at-fault driver and their insurance company if you are seriously injured.  A serious injury happens when your medical expenses exceed $50,000 and can include death, loss of a fetus, bone fracture, permanent loss of the use of a body organ and a medically determined injury or impairment that is not permanent but keeps you from performing your normal routine for at least 90 days.  If you have been seriously injured in the car accident, file a personal injury claim with your own insurance company (first party claim), file a personal injury claim with the at fault driver’s insurance company (third party claim) and file a lawsuit against the at fault driver. 

Step 6 – New York Auto Insurance Requirements

The minimum auto insurance liability coverage required by New York law is

  • $25,000 for bodily injury and $50,000 for death of one person in one accident
  • $50,000 for body injury and $100,000 for death of two or more people in one accident
  • $10,000 for property damage in one accident

New York required no fault of at least $50,000 to pay medical expenses, lost earnings and other necessary expenses within a reasonable doubt related to injuries suffered in an auto accident.  Auto insurance policies issued in New York State must also provide uninsured motorist coverage for bodily injuries in an amount equal to the policy’s liability limits for bodily injury coverage. 

Step 7 – New York’s Pre Comparative Negligence Law

Pure comparative negligence law occurs when an accident that occurred in New York State results in injury damages that exceed the no fault requirements.  The victim in an accident can still seek compensation from the negligent driver even if the victim shared some responsibility for the accident.  The amount of compensation the victim receives will be lessened by the percentage of their own contributing negligence to the accident. 

Step 8 – Retain an Attorney or Represent Yourself

Some personal injury claims can be handled without legal representation while others require an attorney.  Two types of injuries that occur from car accidents are soft tissue and hard injuries.  Soft tissue injuries include strains and sprains to tendons or muscles, minor bruises, first degree burns and whiplash.  Soft tissue injuries usually don’t result in substantial medical bills and since they don’t involve complex issues of law, a victim can usually negotiate their own injury claim with the insurance company.  Hard injuries are more series and include head trauma, fractures, gashes that require stitches and other injuries that require extensive medical care.  Hard injury claims often require filing a lawsuit. Compensation for a serious injury claim can be substantial and by representing yourself, you won’t be as effective as an experienced personal injury attorney. 

Step 9 – When to Consider Filing a Small Claims Court Lawsuit

If you are unable to settle your injury claim, you may want to file a lawsuit in Small Claims Court.  Small claims can be filed in city courts that may not exceed $5,000 and under $3,000 in town or village court.  Here is why you should file in small claims court:

  • The at fault driver was uninsured or under insured
  • Your car or other personal property was damaged and the cost to repair it is under the small claims limit
  • The insurance company refuses to offer fair compensation in the settlement
  • The insurance company denies your claim
  • You can’t find an attorney who will accept your case 

Step 10 – Know the Statute of Limitations

Whether you handle your own personal injury claim or have an attorney represent you, New York’s Statute of Limitations will apply.  A Statute of Limitations is the time period in which you have to either settle your claim or file a lawsuit.  If the statute of limitations expires (3 years) you forever lose your legal right to pursue compensation from the at fault driver or their insurance company.  If the statute of limitations is about to expire and you haven’t settled your claim, you must file a lawsuit to stop the statute from running out.  This makes your case exempt from the statute of limitations expiration date. 

The injuries that occur from a car accident could mean life long pain and suffering.  If you were recently involved in a car accident and need legal representation call Losi & Gangi at 716-854-1446.  We will represent you throughout every step of your case and make sure you get the compensation that you deserve. 

Article adapted from: https://www.injuryclaimcoach.com/new-york-car-accident-guide.html

Five Steps to Developing an Effective Workplace Safety Program

By Workplace Safety

Five Steps to Developing an Effective Workplace Safety Program

If you are an employer of any size, it is important to prioritize and put workplace safety first to protect both your employees and your financial assets.  You should have a workplace safety plan put into place but if you don’t, here are five steps you should be following to ensure your employees are safe while at work

Step 1: Demonstrate Company’s Commitment to Workplace Safety

Make workplace safety a company-wide value.  Add a sentence in your company’s mission statement so it becomes top of mind.  Management should reflect these values not only in their words but their actions.  They should conduct a thorough investigation and give detailed reporting of every workplace accident while encouraging employees to follow proper safety procedures. 

Step 2: Assess Workplace Risks and Hazards

You will need to get a professional assessment of the everyday hazards specific to your workplace.  Management should release a company wide survey to give employees the opportunity to express their concerns confidentially.  Since the employees work in these conditions every day, it is important to get their opinions and they can often give insight about risks that aren’t obvious to someone who isn’t privy to them on a daily basis.  During both the professional and employee assessments, make sure to create a distinction between workplace hazards (building layout and design), activity hazards (anything related to machinery) and environmental hazards (air quality, chemicals, fumes, etc.)

Step 3: Create a Written Protocol for Employees

Once you have determined all workplace hazards, you can sort to create the blueprint for your safety program.  Employee job descriptions must be clear in writing and must state specifically the issues and requirements regarding safety and health responsibilities.  By having these requirements in writing, it saves room for error when employees are unclear and may need further explanations of their job requirements. 

Step 4: Emphasize Employee Education

After the safety guidelines have been created, you need to relay the information to your employees.  Training should be done when employees are first hired but once new procedures or equipment have been introduced, you should be training your employees on the new protocol.  If you notice new hazards or an employee has transferred, training should be done to refresh the current team.  By constantly reviewing and training your employees, they will be up to date on proper safety guidelines and less mistakes will be made.

Step 5:  Implement and Evaluate 

You should be investigating all workplace accidents no matter how small you may think they are.  Most incidents are usually preventable and once you determine the cause you can figure out a solution so that this does not happen again in the future.  Accidents open the door to making working conditions safer for the employees in the future.  All employee feedback whether anonymous or not should be kept at the forefront.  Workplace duties and employees are always evolving and new safety risks can rise every day.  This is sometimes faster than most employers realize and you don’t want it to be too late where an accident could be fatal. 

Once you put these steps into place, your workplace safety program should be executed immediately to your employers.  Hold dialogue between employees and employers and encourage questions to be asked.  If you have been injured at work due to an unsafe workplace call Losi & Gangi today at 716-854-1446 and speak with one of our attorneys.  

Article adapted from: https://www.ehsinsight.com/blog/5-steps-to-developing-an-effective-workplace-safety-program

Are Wear & Tear Injuries Compensable?

By Workers Compensation

Many jobs require you to perform the same motions over and over everyday.  The repetitiveness of these motions could result in you developing a number of small injuries over a period of time.  Most people think of carpal tunnel syndrome when it comes to repetitive motion pain, often coming from typing and overusing computers but it can be repeated stress on your back if you are a baggage handler or a hospital worker who lifts patients in and out of gurneys all day. 

As small traumas build up over time, these injured employees may need medical treatment and take time off of work to deal with the pain.  Repetitive Stress Injuries (RSIs) include more than 100 types of injuries and ailments caused by the body’s wear and tear over time.  If your job requires you to repeat similar motions day after day you might be at risk of developing this condition.  These injuries are considered compensable and should be claimed under the Workers’ Compensation law.  An RSI, otherwise known as a continuous motion injury, is caused by repetitive stress and strain to muscles and other body parts such as ligaments, tendons, spinal discs and nerves.  If you have this type of injury you might notice constant and reoccurring aches and pains in your hands, back, legs, neck and shoulders. 

Workers in any industry can develop RSIs.  If your job involves repeating any of the following job duties overtime they may become problematic:

  • Moving heavy objects
  • Computer typing and using a mouse
  • Stocking inventory
  • Digging and landscaping
  • Using machinery and power tools
  • Lifting hospital patients
  • Lifting a heavy weight (boxes, pallets, loads)
  • Standing in the same position

If your injury is not listed, it does not mean it is not an RSI.  This is where you should contact a Workers’ Compensation attorney to answer your questions. 

The RSI category is very broad and the intensity of pain and discomfort varies case by case.  Common problems include:

  • Carpal tunnel syndrome – specific nerve damage in the wrist, which can lead to aches, numbness and tingling in the hand or fingers.  This is common in jobs that require computer, shifting or joystick use.
  • Irritation and inflammation of a bursa, which is a fluid filled sac that helps cushion a joint and is often associated with overusing joints, carting heavy items and reaching overhead.
  • Tearing and irritation of the tendons, which connect bones to muscles and can be linked to overusing or over-stretching specific muscles
  • Stress fractures – small bone cracks due to repetitive actions or overloading that could come from running, walking, jumping and other rhythmic actions
  • Patellofemoral syndrome – the weakening of kneecap cartilage due to repeated kneeling, squatting and climbing
  • Epicondylitis – otherwise known as Tennis Elbow, which causes swelling and pain in the elbow often due to joint strain and overuse
  • Plantar Fasciitis – inflammation of the fibrous tissue along the bottom of your foot that connects your heel bone to your toes

It is important not to ignore warning signs of RSIs.  Your injuries might build up slowly but they can lead to pain that can be just as intense as a dramatic accident, like a fall. 

If you notice any of these problems you may have an RSI:

  • Joint or muscle weakness
  • Hypersensitivity
  • Tingling or numbness
  • Lack of endurance
  • Clumsiness
  • Hands and joints feel like “dead weight”
  • Coldness in your hands that won’t go away
  • Using your non-dominant hand to avoid pain in your dominant hand
  • Adopting “awkward” posture to make common actions more comfortable

You may be susceptible to these injuries if you work in a high stress job, use a computer for several hours a day, are not active and lead a sedentary life, have loose joints and are sleep deprived.

If you are having similar problems and think you have developed an RSI from repeating the same motions at work, you could be entitled to Workers’ Compensation.  You should report your injury immediately to your employer and seek medical care.  The attorneys at Losi & Gangi can help you file a claim and advise you on your benefits.  Call us at 716-854-1446 and we can start working on your case today. 

Article adapted from: https://blogs.lawyers.com/attorney/workers-compensation/are-wear-and-tear-injuries-compensable-59768/

What is Personal Injury Protection Insurance? Do I Need It?

By Personal Injury

Personal Injury Protection (PIP) provides medical related benefits for injuries that drivers and passengers receive as a result of a car accident, regardless of who is at fault.  New York is a no-fault insurance state, so all motorists are legally required to carry Personal Injury Protection.   

What does personal injury protection cover? 

Personal Injury covers three main things

  • Medical costs
  • Financial losses
  • Death

Personal Injury Protection will cover all most injuries that are sustained in a car accident including:

  • Emergency Room visits
  • Doctors visits
  • Surgeries
  • Medical supplies (wheelchairs, walkers, crutches, canes, etc.)
  • Diagnostic testing (CT Scans, MRI, Xrays)
  • Ambulance transfers
  • Physical therapy
  • Dental treatments

If a driver or passenger of the vehicle is unable to work as a result of the injuries that occurred in the collision, PIP will cover economic losses.  It will cover 80% off the monthly earnings that are lost or up to $2,000 per month which ever amount calculates out to less.  The total amount will be paid for a period of three years or less after the accident happened. 

You will also receive $25 a day if you are unable to attend to daily chores as a result of the injuries that were sustained in an accident (unable to do laundry, clean the house, grocery shopping) and have to pay someone else to do these for you, you will receive compensation under PIP.  If a driver or passenger ends up passing away during the accident, PIP will issue up to $2,000 to assist with the cost of a funeral and burial.  If you wish to have financial protection, you can purchase additional Personal Injury Protection.  This will increase your limits but also increase your premiums.

The cost of Personal Injury Protection varies in the state of New York similar to your type of insurance coverage.  The cost of PIP is determined by your age, driving record, type of vehicle and where you reside. 

New York State provides some of the highest minimum limits on PIP in the country.  But should you purchase additional coverage? The cost of medical expenses that are associated with a motor vehicle accident may be greater than the limits under Personal Injury Protection.  If you have good health insurance coverage, additional PIP may not be necessary to purchase but if your health insurance is not great, additional PIP may be worth the investment.  There is also the option of purchasing Optional Basic Economic Loss coverage (OBEL).  This provides you will an extra $25,000 in benefits that can be put towards lost wages and medical expenses.  Depending on the extent of your injuries and how long you will be out of work as a result of these injuries, OBEL might be something you should consider.  Since your wages lost benefits are only covered up to $50,000, if you will be disabled longer or experience a sizable reduction in your monthly wages with basic PIP coverage it would be beneficial to purchase OBEL coverage. 

In New York State, you will have 45 days after the date of the start of your medical treatment to file for repayment.  You will need to show proof of your treatment from the medical doctors who are treating you and be submitted by your insurance company.  It should be documented that the injuries were caused by an accident, the extent of the injuries and the type of treatment you are receiving.  You will have 90 days to file a claim in New York State for lost wages and submit written proof of your lost wages.  Once you file a claim, your insurance company will have 30 days to reimburse you from the date your forms were received. 

The attorneys at Losi & Gangi want to ensure that all drivers are protected by insurance and stay safe while they are on the road.  If you are interested in learning more about Personal Injury Protection or have recently been involved in an auto accident call us today at 716-854-1446 and one of our attorneys can explain what your insurance will cover.

Article adapted from: https://www.newyorkmotorinsurance.com/blog/personal-injury-protection-in-new-york-state/

What is Workers’ Compensation Fraud?

By Workers Compensation

Workers’ compensation fraud occurs when someone willfully makes a false statement or conceals information in order to receive workers’ compensation benefits or prevents someone from receiving benefits to which they might be entitled.  The people who may be committing this fraud can be employers, employees, providers or anyone else involved in the system. Unfortunately, the people that commit workers’ compensation fraud are making your premiums higher, higher prices on goods and services and lost pay due to draining business profits. 

When employers commit workers’ compensation fraud, they are usually doing this to avoid paying workers’ compensation premiums.  Employers can use a variety of tricks to accomplish this goal such as using shell companies.  Shell companies are inactive companies without significant assets that can be used to disguise business ownership from law enforcement or the public. 

Here are a few examples of Workers’ Compensation Fraud

Claimant Fraud

  • Malingering or exaggeration of symptoms
  • Working while allegedly disabled and not reporting income
  • Claiming a job-related injury that never occurred
  • Claiming a non-work related injury as a work-related injury
  • Falsifying mileage reports

Employer Fraud

  • Underreporting payroll or misclassifying employees for lower insurance premiums
  • Deducting premium dollars from employee’s wages
  • Employer knowingly fails to have necessary workers’ compensation coverage

Medical or Health Care Provider Fraud

  • Providing unnecessary testing or treatment of injured workers to reap financial benefit
  • Billing for services or treatment never performed
  • Billing the workers’ compensation insurer and the workers’ health insurer for the same services

Workers compensation is a benefit to all employees.  The Office of Workers’ Compensation is there to protect injured workers and if you need help understanding your workers’ compensation rights call the attorneys at Losi & Gangi at 716-854-1446 to help give you all of the information you may need. 

Article adapted from: https://www.thebalancesmb.com/workers-compensation-fraud-examples-4101604

What Does No-Fault Insurance Mean?

By Personal Injury

No-Fault Auto Insurance laws require every driver to file a claim with their own insurance company after an accident regardless of who was at fault.  In states with no-fault laws, like New York, all drivers are required to purchase Personal Injury Protection (PIP) as part of their auto insurance policies. 

No-Fault applies only to state laws that both provide for the payment of no-fault first party benefits and restrict the right to sue (limited tort).  Under no fault- laws, motorists may sue for severe injuries and pain and suffering only if the case meets certain thresholds.  These thresholds relate to the severity of injury and may be expressed in verbal terms or monetary threshold, which are dollar amounts of medical bills. 

Some laws also include minimum requirements for the delays of disability incurred as a result of the accident.  Because high threshold no-fault systems restrict litigation, they tend to reduce costs and delays in paying claims.  Verbal thresholds eliminate the incentive to inflate claims that may exist when there is a dollar “target” for medical expenses.  In some states, verbal threshold has faded over time due to the broad judicial interpretation of the verbal threshold language and PIP coverage has become the target of abuse and fraud by dishonest doctors and clinics that bill for unnecessary and expensive medical procedures. 

New York State is one of 12 states that have no fault auto insurance laws and has verbal threshold.  State auto liability insurance laws fall into four categories: no-fault, choice no-fault, tort liability and add-on.  The major differences between the four are whether there are restrictions on the right to sue and whether the policyholders own insurer pays first-party benefits, up to the state maximum amount, regardless of who is at fault in the accident. 

In the 1970s many states for the first time allowed accident victims to recover financial losses from medical and hospital expenses and lost income from their own insurance companies.  Twenty-four states now have laws that allow policyholders to obtain compensation for auto accidents from their own insurers.  Out of the 24 states, 12 have placed restrictions on the right to sue through a monetary threshold, which allows a suit to be filed for pain and suffering when medical expenses reach a certain stipulated amount or through a descriptive or verbal threshold, which allows suits only when the injury incurred meets the criteria for a serious injury as defined by state statute.

In the early 1990s, pure no-fault which prohibits most lawsuits for bodily injury, began to gain support.  Pure no-fault addresses the waste of resources and the inequities in the liability system and the need to affordable coverage for medical care and rehab costs.  The first attempt at a pure no-fault system was a plan to pay for no-fault auto insurance through a fee collected on gasoline sales.  This failed in all states due to opposition to the gasoline usage based fee but the pure no-fault idea was incorporated into a variety of legislative proposals in various states. 

No-fault

The No-fault system is intended to lower the cost of auto insurance by taking small claims out of the courts.  Each insurance company compensates its own policyholders for the cost of minor injuries, regardless of who was at fault in the accident.  No-fault can often be used to denote any auto insurance system in which each driver’s own insurance company pays for certain fosses regardless of fault.  No-fault applies only in states where insurance companies pay first-party benefits and where there are restrictions on the right to sue. 

The first-party benefits known as Personal Injury Protection (PIP) are a mandatory coverage in true no-fault states.  Since New York is a no-fault state,  drivers may sue for severe injuries if the case meets certain conditions known as the tort liability threshold. 

Choice no-fault

In choice no-fault states, drivers may select one of two options: a no-fault auto insurance policy or a traditional tort liability policy.

Tort Liability

In traditional tort liability states, there are no restrictions on lawsuits.  A policyholder at fault in a car crash can be sued by the other driver and by the other driver’s passengers for the pain and suffering the accident caused as well as for out-of-pocket expenses such as medical costs.

Add-on

In add-on states, drivers receive compensation from their own insurance company, similar to no-fault states but there are no restrictions on lawsuits.  The word add-on is used because in these states, first party benefits have been added on to the traditional tort liability system.  In add-on states, first party coverage may not be mandatory and the benefits may be lower than in no-fault states.

Effectiveness of No-Fault Auto Insurance

Insurers general favor laws that provide for verbal thresholds on suits instead of dollar thresholds.  One of the disadvantages of having a dollar target for medical expenses is that it may lead fraudulent claims.  Unless the law includes a provision that enables the threshold to be adjusted to keep pace with inflation, its effectiveness in curbing litigation wears down.  In states with higher than average PIP benefits is that dishonest providers of professional service have found ways to cheat the system increasing the cost of auto insurance.

In many no-fault states, PIP coverage is being exploited by fraud rings that include corrupt doctors and chiropractors, lawyers and pain clinics.  These groups have created “medical mills” or phony clinics that file fraudulent auto insurance medical claims.  New York State modified regulation 68, a reform adopted in 2002 that substantially shortened the time period for reporting auto accident injuries and submitting medical bills.  This reduced notification time allows insurers to look at the treatment plan sooner to there are fewer opportunities for unnecessary medical tests and treatments. 

If you have recently been in an auto accident contact Lost & Gangi today at 716-854-1446 to help guide you towards the next steps.  Let us help you get the compensation you deserve. 

Article adapted from https://www.iii.org/article/background-on-no-fault-auto-insurance

What If My Employer Doesn’t Have Workers Comp Insurance?

By Workers Compensation

Most employers offer their employees numerous benefits including health and dental insurance, 401K and more. When employees are injured at work, they usually have to go though New York State’s workers’ compensation system to get reimbursed for medical treatment and to receive other benefits.

New York State Employers must carry workers’ compensation insurance through a third party insurance carrier or through a self-insured program set up by the employer. In most cases, employers must get workers’ comp insurance when just one person is hired. Large employers may insure themselves but need to apply with the state and meet very stringent self-insurance requirements. Even if they aren’t required to buy workers’ comp insurance, many employers choose to have it for their employees.

But what happens if your employer doesn’t have workers’ comp insurance? You may sue the employer in a civil court by filing a personal injury claim. In this case you can seek the full amount of your losses without being subject to an arbitrary cap set by law. Most states only pay around two-thirds of the worker’s wage loss for temporary disability benefits only up to a certain amount for a limited period of time. You can also collect money damages for emotional distress caused by your injuries otherwise known as “pain and suffering” and may be able to collect punitive damages which are intended to punish the employer if its bad misconduct caused your injuries. Neither of these can be rewarded through workers’ comp.

If you sue in court it can be a much slower process. It can be months or even years before you see any money through a lawsuit rather than a few weeks with workers’ comp. Since workers’ comp is a no-fault system you will need to prove that your employer was at fault for the personal injury accident. Talk to a lawyer immediately so that you can start the process and make sure your suit is filed in a timely matter.

Many states have special funds reserved for people who are injured while working for an uninsured employer otherwise known as “Uninsured Employers’ Funds”. Under these funds you may be able to get your medical bills covered or receive payments for a portion of your wage loss from it. Check with New York State’s workers’ compensation office for more information on how to file a claim or call the Workers Compensation Attorneys at Losi & Gangi today at 716-854-1446 and we can get you the proper representation you will need in your case.

Traumatic Brain Injuries in Construction Workers

By Personal Injury

A traumatic brain injury (TBI) is a type of injury that damages the brain itself and causes it to malfunction. It usually results from a blow to the head or a jolt to the head and body. An object penetrating the skull can also cause a TBI.

Construction workers sustain more traumatic brain injuries than employees at any other type of workplace in the United States.  That is because construction sites are much more dangerous than other places of employment. There is typically heavy machinery, constant motion, and high work surfaces involved in construction and the risks become greater when using this equipment.

Safety interventions must be emphasized in the construction industry.  More than 2,200 workers died of a traumatic brain injury from 2003 to 2010. Traumatic brain injuries represented one-quarter of all construction fatalities during the eight-year period.  More than half of fatal work-related traumatic injuries were a result of falls from roofs, ladders, cranes, and scaffolds.

How a TBI affects a person depends on its severity, and on where it occurs. There are various stages of severity. For example, a concussion is classified as a mild TBI. Some consequences of a TBI may include amnesia, coma, and even death. 

A TBI is very difficult to treat because of the wide range of symptoms and complications it presents. Each injury affects a person differently, both physically and emotionally.  Sometimes symptoms may not show up for days or even weeks after the injury has occurred. Confusion, persistent headaches, slow thinking or speaking, sleep changes, increased sensitivity to light and sound, tinnitus, and moodiness are all possible symptoms after a TBI.  The more quickly a diagnosis can be made, the sooner treatment can begin.

In order to prevent a TBI, a construction worker must wear a hardhat and adhere to the safety precautions on their job site.  Sometimes accidents do happen and Losi & Gangi will be there to represent you in your case. If you are currently experiencing a TBI from a construction accident and have any questions, please call us today at 716-854-1446 to speak to one of our attorneys. 

For more information on traumatic brain injuries in construction workers, please see the below links:

https://www.safetyandhealthmagazine.com/articles/13868-niosh-construction-workers-at-high-risk-for-traumatic-brain-injuries

https://www.ishn.com/articles/106029-construction-workers-at-highest-risk-of-traumatic-brain-injuries

How to Prevent Injury When Working in a Factory

By Workplace Safety

As an employee you have the right to a safe working environment, no matter the nature of your job. Most of our clients at Losi & Gangi have been personally injured as a result of construction accidents, slip and fall accidents, motor vehicle accidents or other job-related injuries. Here are some tips on how to prevent injury when working in a factory:

– Keep Workspaces Clean
A cluttered, unclean work area makes it difficult to maneuver around and workers are more prone to hazards when it is messy in the workspace.  Keep shared areas clean and tidy to prevent any accidents.

– Proper Signage
There should be proper signs around work areas in noticeable places and in spaces where specific procedures should be practiced.

– Report Dangers and Accidents
It is important that employees report dangers and accidents that they come in contact with so that others do not come across the same issues.

– Provide Proper Training
Make sure all staff are properly trained for their jobs including how to use equipment and follow safety procedures.

– Provide Proper Equipment
Employees must have on proper safety equipment for the job at all times.

– Avoid Shortcuts
A lot of people take shortcuts when they’re familiar with their job or are in a hurry. Even though some safety precautions may be time consuming, they can be the difference of a life or death situation.

– Get the rest you need
Drowsiness and overworked employees contribute to a lot of the accidents that happen in factories. Be sure to get as much rest as possible to perform the job tasks to your full capability.

We don’t want to see you get hurt, but if it happens on the job, our workers’ compensation attorneys at Losi & Gangi are here to represent you fairly and accurately. Get in touch with us today at 716-854-1446

More information is available at the following website:
https://www.business.com/articles/workplace-accidents-how-to-avoid-them-and-what-to-do-when-they-happen/