Persons with disabilities contributed to in a material way by drug addiction and/or alcoholism (DA&A) lost Title 11 and SSI payments and Medicare and Medicaid eligibility under the Contract with America Advancement Act of 1996. The standard for determining whether DA&A “materially contributes” to a disability has been around since 1994. Under the standard, DA&A … Read more
As the treating physician, your opinion is vital to the outcome of your patient’s Social Security disability claim. In fact, it may control the outcome of the claim. Under a recent policy ruling, if a treating physician’s medical opinion is well-supported and not inconsistent with other substantial evidence in the record, it is given “controlling … Read more
Doctors with patients who have been inured or have Social Security disability claims are usually asked to provide evidence. But what do the Social Security people mean by “disability”? And what kind of evidence do they need from doctors? There is no universal definition of “disability.” It depends on who is defining it – Veterans … Read more
Your patient suffered an injury on the job. The injury is an accepted Workers’ Compensation claim. The workers’ comp insurance carrier (“the insurer”) has been paying your bills. Now, you think your patient needs surgery. The surgery is not needed as an emergency measure to preserve life, function or health, but you believe surgery will … Read more
This is the third in our series reviewing basic medical-legal aspects of our legal specialties. The focus of this edition is Oregon Workers’ Compensation law. Issues frequently arising in Workers’ Compensation disputes include “preexisting conditions” and “major cause.” The bulk of Volume 27 of our Medical-Legal Journal is devoted to sorting out the various applications … Read more
If your patient has a work-related injury or an occupational disease, it is important for you to understand the current definition of “pre-existing condition.” This requires an understanding of a number of key terms used in workers’ compensation cases. The revised definition of “pre-existing condition” became effective January 1, 2002. Even though it has been … Read more
This firm represents hundreds of injured workers a year. After 10 or 15 years, certain patterns emerge. One particularly conspicuous pattern is that of the worker with a low back injury. We hope this overview of how such a work injury claim unfolds will be helpful to our readers, especially those who may become involved … Read more
Workers’ Compensation claims involving injuries on or after January 1, 2002, have been subject to changes in the law, including a new definition of “pre-existing condition.” Generally, a “preexisting condition” is a medical condition which a worker had prior to a claimed work injury or occupational disease, and which contributed to it. The definition … Read more
Injured workers who found themselves without a remedy when their work injury claims were denied were given another option when the Oregon Supreme Court issued its opinion in Smothers v. Gresham Transfer, Inc. in May 2001. Terry Smothers filed an “occupational disease” claim for a lung disorder developed after exposure to fumes and mist containing sulfuric … Read more
Your patient suffered an injury on the job. The injury is an accepted Workers’ Compensation claim. The comp insurance carrier (“the insurer”) has been paying your bills. Now, you think your patient needs surgery. Although not needed as an emergency measure to preserve life, function or health, you believe surgery is required to help your … Read more