Our Answers to Frequently Asked Questions about Personal Injury Claims
| Q: | Will I have to go to court to obtain compensation for my injury? |
| A: | Probably not. We have successfully settled over 95% of our clients’ cases without having to go to court. |
| Q: | When is it a good time to try to settle my personal injury case? |
| A: | You should not attempt to settle your case until you have fully recovered from your injuries or, if your injury is permanent, until you have reached the full amount of medical improvement you can attain. Once you settle your case, you cannot reopen it if you determine at a later time that your condition was worse than you realized. With most injuries, we recommend waiting a minimum of six months after your accident before attempting to settle your case. At that point, we work closely with your doctor to make sure your medical condition has stabilized before we begin settlement discussions with the insurance company. |
| Q: | How much is my case worth? |
| A: | The short answer to this question is that your case is worth whatever a court would award you if we tried the case. Insurance companies have little interest in hiring a lawyer, going to court, and having a court order them to pay what they could have paid to settle the case had they not gone to court. Under Maine law, a court can award to you damages for all reasonable and necessary medical expenses you have incurred as a result of your accident (even if other insurance has paid some of these medical expenses), lost wages (even if your employer has paid you for the time you missed), future lost earnings, future medical expenses, other out-of-pocket expenses, and a sum to fairly compensate you for the pain, suffering, and loss of enjoyment of life you have experienced and will experience as a result of your injuries. If you are married, your spouse is entitled to recover an amount which will fairly compensate him or her for the effect your accident has had on your spouse’s life. |
| Q: | If I am also fault for my accident, can I still recover? |
| A: | It depends. Under Maine law, in order to recover any compensation for injuries you sustain in an accident, you must be less responsible for your accident than the other party or parties. If you are equally or more responsible for your injuries, you are not entitled to recover any compensation. If you are partially responsible but less so than the other party or parties, the compensation to which you are entitled will be reduced to the extent that your actions caused the accident. |
| Q: | Should I hire a lawyer to represent me in my personal injury claim? |
| A: | This depends upon you and the nature of your case. If you are uncomfortable or find it a hassle to deal with an insurance company, an attorney can do that for you. You should certainly obtain the services of an attorney if the responsible insurance company will not settle your case fairly. Most attorneys handle personal injury cases on a contingency basis meaning that if the attorney obtains a recovery for you, the attorney’s fee will be a percentage of that recovery. If the attorney does not obtain a recovery for you, there will be no fee. The financial question in deciding whether to hire an attorney is whether your recovery will be greater after paying an attorney than it would have been had you represented yourself and paid no attorney’s fee. Whether you are financially better off hiring an attorney depends upon many factors including how the accident happened, who is responsible, the severity of your injuries, and the extent of your medical expenses and lost wages. Most law offices, including ours, will be happy to provide a free consultation to anyone with a personal injury case. We recommend that you obtain a free consultation and discuss these factors with an attorney before reaching a decision concerning whether it is in your best interest to hire an attorney to represent you on a personal injury case. |
| Q: | What can I do to assist my attorney in making my case go as smoothly as possible? |
| A: |
There are many things you can do to help maximize your recovery and put this matter behind you. First, make sure you obtain appropriate medical treatment as soon as possible and be compliant with your doctor’s recommendations. You should attend all of your medical appointments. If you have a scheduling conflict with a medical appointment, make sure you cancel the appointment in a timely fashion and reschedule it. You should keep a diary and record every way your injuries are affecting you. If you are married, your spouse should also keep a diary. Ultimately, your attorney’s ability to obtain fair compensation for you depends upon his or her ability to communicate to either an insurance company or to a court how your injuries have effected you. Your attorney’s ability to communicate this information depends upon your ability to communicate the information to your attorney. If you do not record these events as they occur, you will be unlikely to remember them once your medical condition has stabilized and it is time to begin settlement discussions. You should also make every effort to return to as normal a life as possible as soon as possible. We have secured thousands of settlements for our injured clients over the years, ranging from modest amounts into the millions of dollars. Regardless of the size of the settlement, we have discovered that no amount of compensation to our clients has made it worth going through the ordeal which a serious injury and its consequences has upon them. The sooner you can return to good health, work, and a normal life, the happier you will be. We encourage our clients to concentrate on getting better and returning to their pre-injury lives and ask them to let us worry about the legal aspect of their case. |
Our Answers to Frequently Asked Social Security Disability Questions
| Q: | What does it mean to be disabled? |
| A: | Under the Social Security Act, disability means the inability to engage in any meaningful work paying $870.00 per month or more because of a physical or mental impairment which is expected to result in death or will last for a continuous period of at least 12 months. |
| Q: | How do I apply for social security disability benefits? |
| A: | The best way to file a social security disability claim is to go in person to the nearest social security office and speak with a representative of the Social Security Administration (SSA) and arrange to file a claim in person. Alternatively, a person may contact the SSA by telephone and arrange for a telephone interview in order to file a claim. |
| Q: | If I have assets, such as money in the bank, will this affect my eligibility for social security disability benefits. |
| A: | If you are applying for social security disability insurance benefits (SSDIB), the amount of money you have is irrelevant. The amount of your assets is relevant only to a claim for Supplemental Security Income (SSI) benefits which is a need-based program. |
| Q: | How long after I become disabled do I have to apply for benefits? |
| A: | In most cases, once you have worked enough in order to be insured for social security disability purposes, you must work for five out of the last ten years in order to still be eligible for benefits. Therefore, if you become disabled, you still have five years in which to prove your eligibility. You can only receive benefits retroactively for 12 months prior to the date you file your application. There is a five-month waiting period from the date on which it is determined that your disability began before you can receive benefits. |
| Q: | If I am disabled as a result of a work-related injury, can I receive workers’ compensation benefits as well as social security disability benefits at the same time? |
| A: | It is possible to be eligible for benefits under both the Workers’ Compensation Act and the Social Security Disability Act, although there is a limit on the benefits one can receive from both programs at the same time. If you are awarded social security disability benefits, the Social Security Administration will take an offset for the amount of workers’ compensation benefits you are receiving. You may still be eligible to receive some social security disability benefits depending upon how high your earnings were during the last several years you worked prior to the beginning of your disability. |
| Q: | Do I have to be permanently disabled to obtain social security benefits? |
| A: | No. You qualify for benefits if you (1) have been disabled for at least a year, (2)are expected to be disabled for at least a year, or (3) have a condition which is expected to result in death within a year. |
| Q: | How does the Social Security Administration decide if I am disabled? |
| A: | The Social Security Administration will gather your medical records and consider all of your health problems, as well as your age, education, and work experience. If the Administration decides you are unable to perform your past work, they will then decide whether you are able to perform any other work which is generally available in the regional or national economy. In making this determination, the SSA will consider your health problems, as well as your age, education, and work experience. |
| Q: | Am I eligible for benefits if my medical problems keep me from being hired for any jobs? |
| A: | The Administration is not interested in whether an employer will hire you; only whether you are able (despite your medical problems) to perform jobs which exist in significant numbers in the national or regional economy. |
| Q: | If I am denied benefits on my first application, what should I do? |
| A: | You can appeal that decision by requesting that the Administration reconsider their decision. You can do this by calling your local social security office and telling them you want to request reconsideration of the denial you received. After several months, you will receive a Notice of Reconsideration from the Administration. If you are denied at this stage, you can request a hearing before an Administrative Law Judge. |
| Q: | Is there anything I can do to improve my chances of winning my social security disability claim? |
| A: | The best way to increase your chance of being awarded benefits is to provide the Administration with all of the information they request in an as accurate and honest a manner as possible. You should not exaggerate your problems, nor should you minimize them. You should tell the Administration about all of your problems, both physical and emotional. If you are denied on both the initial application and on reconsideration, your chances of winning your claim at the hearing before an Administrative Law Judge will be improved if you hire an attorney to represent you. Statistics from the Social Security Administration show that those people who hire an attorney to represent them are much more likely to win their claims than those who do not. |
| Q: | How long does the average social security claim take from start to finish in Maine? |
| A: | Generally, although each case is different, each stage of the process takes approximately three months. Therefore, it takes about three months to receive a decision on your initial application, three months to receive a decision following a request for reconsideration, three months to receive a hearing after you have requested one, and three months to receive a decision after a hearing. |
| Q: | What happens at a social security hearing? |
| A: | Social security hearings are relatively informal. Oftentimes, the judge will ask a doctor and/or a vocational person to be present at the hearing to assist the judge in determining whether you are disabled. The judge, or your lawyer if you have one, will ask you questions about your educational and vocational backgrounds, as well as your medical problems. The judge and/or your lawyer may also ask questions of a medical advisor or a vocational expert if they are present at the hearing. Following the hearing, the judge will issue a written decision indicating whether you have won or lost your claim. |
| Q: | If I hire a lawyer, how will that lawyer be paid? |
| A: | In almost all cases, an attorney receives 1/4 of the retroactive benefits if the claimant wins, and no fee if the claimant loses. |
| Q: | If I receive social security disability benefits, will I also get Medicare? |
| A: | Yes. If you are approved for any kind of social security disability benefit other than Supplement Security Income, you will also receive Medicare after you have been entitled to social security disability benefits for two years. |
Our Answers to Frequently Asked Worker's Compensation Questions
| Q: | After I have been injured at work, how soon must I tell my employer about my injury? |
| A: | In order to receive benefits, you must tell your employer that you have been injured within 90 days of your injury or the date you learn that you have been injured at work.(Example: A doctor tells you that an injury is related to work you do.)If you wait more than 90 days after your injury to inform your employer, you may forever lose your right to claim benefits. |
| Q: | Am I entitled to see a doctor for my injury? |
| A: | Yes. For the first ten days of your medical treatment, your employer has the right to choose a health care provider to treat your injury. After that time, you have the right to select a health care provider. |
| Q: | After I have begun treating with my own health care provider, can my employer ask me to see another doctor? |
| A: | Yes. Your employer or their insurance carrier is permitted to ask you to see another doctor of their choice for an “independent medical examination.” After they choose one doctor to examine you, they are not allowed to choose more than one more doctor without approval from the Workers’ Compensation Board. |
| Q: | What medical benefits am I entitled to? |
| A: | Under the Workers’ Compensation Act, you are entitled to payment for all medical treatment you receive which is reasonable, necessary, and causally related to your injury. You are also entitled to be reimbursed for prescription medications and for mileage to and from health care providers. |
| Q: | Am I entitled to compensation if I am unable to work as a result of my injury? |
| A: | Yes. If you miss more than seven days of work due to your injury, you are entitled to receive weekly compensation benefits from your employer or their workers’ compensation insurance company beginning on the eighth day of work that you have missed. If you miss more than 14 days of work, you will also receive payment retroactive to the date of injury. |
| Q: | How much will I be paid if I miss time from work? |
| A: | For injuries occurring after January 1, 1993, you will be paid 80% of your earnings after taxes. In most cases, your average weekly wage is calculated by averaging your earnings from your job during the 52-week period prior to your injury. |
| Q: | I received a “Memorandum of Payment” indicating that my claim is “voluntary payment pending investigation.” What does this mean? |
| A: | This means your employer is paying your claim without accepting it completely. By doing so, your employer retains the right to reduce or suspend your benefits unilaterally after providing you with the 21-day notice of their intention to do so. |
| Q: | If I receive a 21-day notice from my employer indicating that they plan to reduce or terminate my benefits, is there anything I can do to retain my benefits? |
| A: | Yes. You can file a request for a Provisional Order with the Workers’ Compensation Board asking a hearing officer to reinstate your benefits pending a final determination by the Board after your claim has been fully litigated. Within a brief period of time, the hearing officer may enter an order reinstating your benefits completely or partially, or may refuse to enter an order at all. |
| Q: | I return to work following my injury but am earning less money than I was at the time of my injury, am I still entitled to receive workers’ compensation benefits? |
| A: | Yes. If you return to work and your injury prevents you from earning your prior average weekly wage, you are entitled to receive partial incapacity benefits equal to the difference between 80% of your after-tax pre-injury average weekly wage and 80% of your earnings after you return to work. |
| Q: | How long can I receive benefits for lost time from work? |
| A: | You are entitled to receive benefits for the entire time you are unable to work. If your incapacity to work is partial, the length of time you can receive benefits depends upon your date of injury. If you were injured on or after January 1, 1993, and your incapacity is partial, you are generally entitled to receive benefits for a maximum of 364 weeks with some exceptions. You can ask the Workers’ Compensation Board to order the employer to continue paying you benefits after 364 weeks if you will suffer an extreme financial hardship without these benefits. If you were injured on or after January 1, 1993, and your injury has caused permanent impairment greater than the permanent impairment of 75% of injured works, you are entitled to receive incapacity benefits as long as your work injury prevents you from earning what you were earning at the time of your injury. |
| Q: | What is the statute of limitations? |
| A: | The statute of limitations is the amount of time you have to file a claim for benefits. The statute of limitations varies depending on the date of injury. At a minimum, you have two years after the occurrence of your injury, or the last time your employer made a payment on your behalf, to file a claim. If you do not file a claim within the specified time, you will never be able to assert a claim. |
| Q: | I received a notice from the Workers’ Compensation Board regarding a mediation in my claim. What is this? |
| A: | When there is a dispute regarding some aspect of your claim, the Board will schedule a conference in an attempt to resolve the dispute. A mediator will be present to discuss your case with both you and your employer and/or their insurance company to try and reach a resolution of the dispute without further litigation. If your claim cannot be resolved by the mediator, you will need to file a formal petition and proceed with litigation before the Workers’ Compensation Board in order to receive any benefits which have been denied. |
| Q: | If there is a disagreement about a medical opinion, is there a procedure by which I can ask the Board to appoint a doctor to examine me and resolve the dispute? |
| A: | Yes. Under Section 312 of the Workers’ Compensation Act, a party has the right to ask the Board to select a doctor to examine the employee. If the Board selects the physician, the doctor’s opinion is entitled to substantial weight, which means there must be clear and convincing evidence that the doctor was wrong in order for his or her opinion to be rejected. The parties can also agree on a physician to examine you. If both sides to agree to a physician, his or her opinion is binding on both parties. |
| Q: | Does my employer have to give my job back to me? |
| A: | If you can return to work and your job is still available, your employer must offer your job back to you. If your job has been filled, or you are unable to return to that job because of your injury, your employer must give you a job you can perform with your injury if such a job is available. Your employer must also make reasonable accommodations for your injury. Unfortunately, if your employer does not have work available for you, you do not have the right to force them to create a job for you. Your right to be reinstated is limited to one year after your injury unless your employer has more than 200 employees, in which case your right to be reinstated is limited to three years after your injury. |
| Q: | Do I have an obligation to look for work once I have a work capacity following my injury? |
| A: | Yes. As soon as your doctor releases you to return to work, you should check with your employer to see if they have any work for you. If they do not, you must begin looking for other work which fits any physical restrictions you may have. If you do not look for work, your employer or their workers’ compensation insurance carrier may reduce or terminate your weekly benefits. |
| Q: | Do I need a lawyer to represent me in my claim? |
| A: |
Whether an injured employee needs a lawyer in a workers’ compensation claim depends upon several factors, including the severity of the injury; the length of time the employee will be out of work; the nature of the dispute, if any, between the parties; and the amount of benefits at stake. Most lawyers will consult with an injured employee free of charge and help determine whether representation is necessary. If you are unable to obtain a lawyer, you will, in most cases, be able to obtain assistance from an Advocate at the Workers’ Compensation Board free of charge. |
| Q: | Can my employer discriminate against me because I file a workers’ compensation claim? |
| A: | The law specifically states that your employer is forbidden from discriminating against you for filing a workers’ compensation claim. If you think your employer has discriminated against you because you filed a workers’ compensation claim, you can file a Petition to Remedy Discrimination. If you prevail on that petition, your employer will be responsible for paying attorney’s fees. |
