Archive for the ‘wage loss coverage’ Category

Physician Assistance on Proof of Wage Loss

Previously I posted a blog on this subject. Since that time, I don’t believe that much has changed with physician’s offices concerning this subject, so I am revisiting this issue to give health care providers another opportunity to make changes to their policies and procedures to assist personal injury clients with proof of their wage loss.

I make the preliminary comment that there is a big difference between the records of physicians who are familiar with the ins-and-outs of personal injury insurance claims and those that do not have this experience.

I have a current auto claim involving a teacher. The client’s medical records say nothing about him missing work, nor do they make any comment about the difficulties that he experienced while at work as a result of his injuries. He had to take off a half day of work to visit the chiropractor. He took several full days off work immediately after the accident. He also missed full days of work periodically because of a flare up on his injuries. There is nothing posted in his medical records about any of this.

The school district does not require a doctor’s excuse for an employee to utilize their sick days or personal leave days. The use of sick days has a damage value equal to the client’s daily rate of pay, even though the injured party did not lose any income because he used them.

I have been informed that some physicians don’t have off-work slips to give to their patients. If your office doesn’t have them, you should generate a simple off-work excuse form. Give one to the client so that they can forward it to their human relations/payroll departments (even if it is not required), so that the reason for the absence can be documented.

Obviously, if the physician doesn’t query the patient about their work absences and the difficulties that they are experiencing at work, then those wage loss details cannot be documented. I don’t believe that many physician’s offices routinely ask their patients if they had to take off work to be able to treat with the provider.

So, in this example, the teacher had about $8,000.00 in wage loss, but the adverse insurance company did not assess any damages for lost income because there was nothing in the medical records, human relations and wage loss documents from the school district to verify that the absences were related to accident-related injuries.

I would like health care providers who treat accident victims to be aware of this insufficient documentation of wage loss damages.

So what can physicians do to assist personal injury patients with verification of past wage loss?

1. The doctor must be cognizant of the fact that wage loss needs to be documented, so that he can query the client about it.

2. Since a doctor’s excuse can be an element of proof for past wage loss, the treating physician should always give the patient a doctors excuse to verify any absence from work, whether the employer requires it or not. The doctor should advise the patient that he should forward the doctor’s excuse to their personnel department, payroll department, or human relations department, so that it becomes part of their payroll/personnel records.

3. The physician should document any absence from work in his patient’s records by referencing how the patient’s condition prevented him from working and/or how the patient’s condition would be exacerbated by the physical tasks associated with the patient’s work.

4. Previously, I have written about how references to “duties under duress” can increase the value of a claim because they objectify pain and suffering. Likewise, the physician should inquire on each visit about how the patient’s condition is affected by work. Are you experiencing any pain while working? Have you missed any days/hours of work because of your injuries and associated pain since your last visit? If so, this information should be documented in the patients medical records. If interim full days of work have been missed, the physician should comment on his opinion concerning whether this missed time from work was reasonable and consistent with the patients injuries. Obviously, this documentation may take a few minutes to do, but it is extremely valuable to verify and take the mystery out of proof of past wage loss.

5. The patient should communicate the difficulties he’s experiencing at work to the physician, even if the physician doesn’t ask about it. When the physician asks the question (how have you been doing since your last visit?), the patient should communicate information concerning his work difficulties to the physician. Documentation of wage loss and difficulties experienced at work is a two-way street. The patient should communicate wage loss and work distress information to the physician, and the physician should inquire of the patient about how his work is affecting his injury, and document this information in his records.

6. Insurance companies don’t like to pay for past wage loss and have been successful in defending wage loss claims because of lack of documentation in medical records. Obviously, if wage loss and work distress information is entered in a patient’s medical records, the insurance companies will be more inclined to award them adequate compensation on their wage loss claim.

Lack of wage loss information in medical records makes these claims easy to defend. Work distress documentation is also important for proper documentation of pain and suffering in general. If the physical requirements of a patient’s work affects their accident-related pain and suffering, then documentation of this work distress must be noted in the patient’s records.
This is a common sense plan of the verification and documentation of past wage loss. To my knowledge, nobody has taken the time to articulate to physicians how important proof of past wage loss is to a personal injury claim. Hopefully, this article will result in the beginning of an improved plan for the documentation of past wage loss and the distress that injuries place on a patient’s ability to perform their work-related duties.

Rental Car, Towing, and Wage Loss Coverage

Rental car coverage is a fairly inexpensive coverage which you can add to your auto insurance policy. Generally, this coverage will provide you with a finite sum of rental car coverage in the event your vehicle is involved in an accident and it needs repair or if it is a total loss. The upper limit on this coverage is generally less than $1,000.00. There is also a limit on the daily cost of the rental car. Generally speaking, most policies will pay up to $30.00 per day and will provide a maximum of $500.00 – $800.00 of coverage.

Another inexpensive coverage is towing coverage. In the event your vehicle breaks down, or if it is involved in an accident and needs towing, this coverage will pay your towing bill.

In the event you are involved in an accident, it is comforting to know you can have your vehicle towed to a repair shop, and that you can obtain a rental car without the detriment and delay involved with relying on the adverse driver’s insurance to pay for your towing and rental car expenses. Oftentimes, your carrier will arrange a direct billing with the rental car company. When they do allow for direct billing, the rental car company bills your insurance carrier directly instead of you. Most first-party and third-party carriers have this arrangement with Enterprise Rental Car.

In the event your auto insurance company pays under your collision coverage, rental car coverage, and towing coverage, they have the ability to subrogate against the at-fault party’s insurance company. They can be paid by the adverse carrier up to the limits of the adverse driver’s property damage liability limits. Many of the insurance companies have agreements under which they resolve these disputes outside of the court system.

Wage loss coverage is available on most auto policies. It will provide you with a finite sum of wage loss coverage. Each insurance company is different regarding the amount of wage loss coverage that they offer. In most cases, it can be as little as $1,000.00 or as high as $10,000.00. The premium for this coverage is reasonable. In most cases, there usually is a ten (10) day or two (2) week period that must elapse before this coverage becomes effective. Wage loss coverage pays only a portion of your wage loss, such as 2/3’s of the actual wages, and will only pay up to the limit of your coverage.

Once again, you should check your policy or consult your agent to determine the costs of these coverages and the terms and conditions associated with them.


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