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NPR Reports Insurers Gaining Control in the California Worker’s Compensation System

Posted by SFSM
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on Wednesday, 01 April 2015

According to a recent report by NPR, the worker’s compensation system in California is giving too much control regarding medical decisions to employers and insurers.  The State Compensation Insurance Fund, a quasi-governmental agency, employs anonymous independent medical reviewers.  The reviewers, who are not required to be licensed in the state, have the power to make decisions regarding treatments without ever examining the worker.  Many believe that too much deference is given to the reviewers, who side with the insurance companies 90% of the time. 

In the case of a worker who was injured in a work accident in 1997, reforms made to the California worker’s compensation system have denied her the continuation of effective treatment which included pain medications and a home aide.  This worker might never be able to use her feet again, and suffers from what is known as chronic or complex regional pain syndrome.  After the State Compensation Fund reviewed only the worker’s medical paperwork, and not her actual injuries, the reviewer determined that the medication and the home aide were not helping her recover and thus, denied her request.

Because the reviewers are anonymous, it is impossible to override their decisions or even depose them for trial purposes. 

In another heartbreaking case, a worker who suffered from job related injuries which resulted in paralysis is unable to live at home because his request for modifications to his home for wheelchair access were denied.  Even though his doctor prescribed $170,000 in home modifications, an independent medical reviewer employed by the California Insurance Guarantee Association rejected the prescribed modifications.  However, after NBC4 News in Los Angeles featured the story, the CIGA approved the modifications and publicly announced that the claim was not handled properly.

Click here to read the full NPR story.    

Click here for the audio transcript. 

If you have suffered from a workplace injury, contact an experienced worker’s compensation attorney who will fight for your rights.  Call The Law Offices of Sherman, Federman, Sambur & McInytre, LLP at (866)557-7500.

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Nurses Face Increased Risk of Workplace Violence

Posted by SFSM
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on Monday, 02 March 2015

The Occupational Safety and Health Act (OSHA) has estimated that 2 million Americans a year are subjected to violence in the workplace.  Specifically, there has been new light shed on the violence that many health care providers face on a daily basis.  Nurses are most likely to experience violence, with up to 82% of emergency room nurses reporting that they have been the subject of physical violence, and 100% claiming they had been subjected to verbal violence, according to a survey conducted by the Emergency Nurses Association. 

Last month, the issue of workplace violence for nurses rose to the forefront when a cardiologist was shot at a Boston hospital, allegedly upset over his mother’s death.  Although shootings at hospitals are not common, violent crimes in hospitals have been increasing as reported by the Bureau of Labor Statistics. Emergency room nurses and nurses who work in psychiatric wards are among those employed by the profession that faces the highest risks of injury resulting from violence in their workplace.  Many of those who attack nurses are under the influence of alcohol or narcotics, or suffer from mental illness.  Last year, a 70 year old nurse went into a coma and suffered brain damage as a result of a patient repeatedly kicking her in the head at a New York hospital.  OSHA found that particular hospital had 40 incidents within 3 months, failing to take proper measures to prevent such scenarios from occurring.       

As well as violence causing injury in the workplace, nurses also face a number of other job related injuries and illnesses that are prevalent in the profession.  Back injuries, slip and falls, exposure to chemicals and diseases, and the injuries that may arise from a patient’s violent episode can all contribute toward a Worker’s Compensation claim if you have to miss work due to your condition.

If you are a nurse who has been the victim of workplace violence or suffered injury as a result of performing your job, you are eligible to file a  NYS worker’s compensation claim.  Contact an experienced workers’ compensation attorney who will work aggressively to secure full and appropriate compensation for your injuries. Contact Sherman, Federman, Sambur & McIntyre at (866) 557-7500.


New York Social Security Disability Attorneys

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Potential 2015 Workers’ Compensation Legislation

Posted by SFSM
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on Friday, 23 January 2015

Last year, 2014, the state of New York enacted several Workers’ Compensation bills, including the New York State Commercial Goods Industry Fair Play Act and the NYCERS and WCB Mandatory Exchange of information. To refresh, the New York State Commercial Goods Industry Fair Play Act, in part, established a standard to prevent the misclassification of trucker drivers as independent contractors. This simply means that truck drivers may be eligible for workers’ compensation if they were to suffer an on-the-job injury.

 The NYCERS and WCB Mandatory Exchange of information, among other things, mandated the exchange of information between the New York City Employees’ Retirement System (NYCERS) and the Workers’ Compensation Board (WCB) in an effort to implement pension plan offsets for the workers’ compensation benefits a retiree receives for the same injury.

This year, 2015, several previously proposed pro-labor workers’ compensation bills are likely to be reintroduced at the state legislature. Among them includes a bill which would require a presumption of permanent total disability if an individual is approved for social security disability benefits; a bill which would allow claimants to choose their own pharmacy; a bill that would allow death benefits to continue if a spouse remarries; a bill which would require medical treatment guidelines for all body parts and medical conditions; and a bill prohibiting the retroactive application of the medical treatment guidelines. While it remains unclear whether these proposals will be adopted, it is important that New York workers remain informed of potential rights and protections.

If you have suffered a work related injury, you may be eligible to receive compensation for your injuries, medical bills, and other damages. An injury on the job can occur in a number of ways and can jeopardize your ability to provide for you and your family. To learn more about the compensability of your claim, contact our experienced attorneys at Sherman, Federman, Sambur, & McIntyre, LLP. Call (866)-557-7500 or click here to speak with our office.  

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Can a Company Require an Employee to Provide Notification Before Seeking Medical Treatment?

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on Friday, 14 November 2014

In short, no.  Employers cannot required employees to give notification before seeking medical treatment. The issue arose in court after a FedEx employee alleged that he was fired for such a lack of notification.  In the September 24, 2014 decision, a federal judge ruled the policy was effectively illegal.

According to reports, the employee had notified supervisor that he was suffering from back discomfort. As a result, the employee was scheduled for “light duty” for the duration of week. The employee subsequently scheduled an appointment with a physician's assistant, who provided him with a note requesting his employer, FedEx, keep him on light duty until he could receive a complete evaluation. However upon receiving the note, FedEx fired the individual.

Although FedEx claimed that the then-employee violated company policy by not notifying his supervisor ahead of time that he was seeking medical treatment, the United States District Court for the Northern District of Illinois Eastern Division determined that the company’s policy violated the employee’s right to seek medical treatment without interference.

As the Court opined, “[By] definition, imposing any prerequisite an employee must satisfy before seeking medical treatment 'interferes' with the employee's right to seek and obtain medical treatment and therefore runs afoul of the [state] Workers' Compensation Act."

In New York State, workers' compensation laws cover nearly all New York employees. If you are injured on the job, it is important that you seek immediate medical attention as soon as possible. While you are not required to notify your employer that you are seeking medical attention, New York workers’ compensation law does require the injured employee to notify their employer about the injury and the way in which it occurred within 30 days of the accident causing the injury.

If you or a loved one have any questions regarding your workers benefits, social security, or disability benefits contact our experienced attorneys at Sherman, Federman, Sambur, & McIntyre, LLP.  

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The Retirement System’s New Stance On Cervical and Lumbar Fusion Surgery

Posted by Sherman Federman Sambur McIntyre
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on Monday, 14 April 2014
in Disability Pensions



By: Sean Patrick Riordan, Esq.  

The New York State Retirement System has recently, and radically, changed its disability program and this change comes at the expense of its members. Based on an internal Medical Board decision, the Retirement System can now require a member to undergo a single-level cervical or lumbar fusion surgery prior to being approved for a disability pension. This position can and will have a major impact on disability applicants moving forward.

For many years, the Retirement System, confirmed by the state’s highest courts, has required members applying for disability retirement to undergo “reasonably safe” medical procedures which can restore them to full duty. Traditionally, this standard applied to areas of the body such as knees, shoulders, hands, etc. Frankly, this standard was never previously considered unreasonable by members or their attorneys. If a relatively routine and safe surgery, which could remedy a member’s condition, existed, the member was expected to have the surgery and proceed back to work if post-operative care went well.

Until last year, the Retirement System did not consider cervical or lumbar fusions to be “reasonably safe” procedures and, therefore, members applying for disability benefits did not have to fear being denied by the Retirement System because they did not want to undergo these highly invasive procedures. Unfortunately, this has been officially changed.

Following the Retirement System’s decision to consider spinal fusion surgery to be “reasonably safe” procedures, I, along with three other respected disability attorneys, petitioned the Retirement System to re-visit and reconsider its decision. While the System did re-visit the issue, it has remained steadfast in its determination.

We must now litigate this matter on a case-by-case basis before the courts over the next several months and determine whether the judges agree with the Retirement System. However, if you suffer from a cervical and/or lumbar spine impairment, your doctor has recommended or discussed spinal fusion surgery with you and you do not wish to undergo such surgery, you should consider the following:

  • Have your doctor clearly document the risks associated with the surgery and that your physician has discussed these risks with you.

  • Clearly document the risk factors you have considered in making your decision not to undergo the surgical procedure.

  • If you are not a surgical candidate, this should be clearly documented in your treating physician’s notes. (This can include any medical condition which precludes surgery).

  • If you have an adverse personal experience with surgery, this should also be documented at the time of your application for disability retirement benefits. (Did you have a negative physical reaction during a prior surgery? Did your close friend or family member have a fusion surgery with an adverse outcome?)

  • If there is an extraneous reason you do not wish to undergo fusion surgery, this should also be documented (single parent, sole caregiver to children and do not wish to face the risks of surgery)

While we may not like the Retirement System’s stance on the spinal fusion issue, we must start to deal with it and protect our members. In that vein, just because the Retirement System “generally” considers single-level spinal fusion surgery to be reasonably safe, that does not mean that it is specifically safe for you. Nor does it mean that you are necessarily “unreasonable” in refusing such a surgery. Documenting why you would refuse the surgery is now paramount.

As always, if you have any questions, issues or concerns, please do not hesitate to contact me directly at (631) 240-0811, This e-mail address is being protected from spambots. You need JavaScript enabled to view it. or toll free at the number listed below. 

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[Police Officers] The New 3/4's Slip & Falls = "Reasonable Anticipation"

Posted by Sherman Federman Sambur McIntyre
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on Wednesday, 07 December 2011
in Workers' Compensation

By:  Sean Patrick Riordan, Esq.

Sherman, Federman, Sambur & McIntyre, LLP.

Over the last several years you have read articles, written by me and others, which outlined the slow decline of "slip and fall" occurrences as they relate to "3/4's accidents." Since 2008 virtually everyone that came into my office with these type accidents was told that "a 50% Performance of Duty Disability Retirement is more realistic." However, I am pleased to write that this article outlines the re-emergence of these type occurrences as possible "accidents" which can enable officers to get their 3/4's benefit. By no means are all slip and falls going to be awarded 3/4's, but the Appellate Division, in several recent decisions, has outlined the type of slip and falls that can be granted benefits. In short, there is new hope for those that are permanently disabled from police work as a result of a slip and fall occurrence.

The courts have paid special attention to what they believe the officer could have "reasonably anticipated" at the time of their fall. Another way to phrase this is what the Police Officer "knew or should have known" about the condition on which they slipped, prior to falling. Much of the Court's thought process surrounds officers' normal duties and the risks associated therewith.  For example, in a 2011 3rd Department decision where an officer tripped while chasing a subject through a "dimly-lit street", the officer was held to be performing his ordinary duties and should have reasonably anticipated that streets can contain various impediments to an officers safety, especially when dimly lit.  (Murray v. New York State Comptroller, May, 2011).

In Stone v. New York State Comptroller an officer was carrying a trundle to assist a heart attack victim with the aide of an EMT. The EMT suddenly pushed the trundle forward causing the officer to fall backward against an open screen door. The Court found that this occurrence was NOT an accident because the officer was performing her ordinary duties in carrying the trundle and that the risk of her peers uncoordinated movements is inherent in such duties. However, the Court goes on to give keys to what they will consider an "accident." The Court notes that the officer in Stone failed to produce any evidence that:

            (1) a hazardous condition existed

            (2) a defective condition existed

(3) that the cause of the injury was entirely unrelated to the ordinary risks of the job.

The Court thereby sets out three ways for an officer to prove he has sustained an "accident" when injured as the result of a slip and fall.  

In two subsequent decisions, the Court followed the train of though laid out in Stone. In Tierney v. New York State Comptroller, a Police Lieutenant "slipped on discarded food while stepping out of an office building where he routinely worked and fell down stairs. In his testimony the Lieutenant stated he did not previously observe food on the steps (which caused his fall) when he entered the building earlier that day and he did not see the food immediately prior to slipping on it either. In overturning the Comptroller's denial of benefits the Court noted that the State failed to show that the hazardous condition (i.e. the garbage on the steps) could have been "reasonably anticipated."

Lastly, in Murphy v. New York State Comptroller, a Police Officer "slipped on black ice" as he exited his vehicle onto an airport taxiway in the month of January. Murphy had testified that on the day of his fall the weather conditions were cold and clear with no precipitation. The Officer also stated in testimony that he had not seen any ice prior to exiting the vehicle and had never before experienced ice in the area in which he fell unless it had recently snowed. In overturning the Comptroller's denial the Court wrote:


"the Comptroller's decision relies on the premise that encountering slip or icy surfaces was inherent in petitioner's performance of his job during winter. While this Court has held that a fall occasioned by a slippery surface is not an accident when that condition could have been reasonably anticipated, a denial upon such ground must be supported by the record and not rest merely upon speculation...we have never countenanced a doctrine...that would hold that any slip and fall during the course of work performed outside during winter renders that event foreseeable."

While the above statements of the Court seem obvious to us, their power and importance cannot be understated. What does it all mean to officers? First, as we have said for some time, it is important to be detailed in your initial Injured Employee Report. If you believe that you are injured due to an "unforeseeable" event, describe in such report why the condition that caused your injury was unknowable and the facts and circumstances that made it unknowable. The Court is making clear in their recent decisions that not everything an Officer encounters during their work is "foreseeable", so be clear from the outset why it wasn't in each particular occurrence. We don't want to have to wait for you to testify in order for the State to understand why this occurrence is unexpected.

Second, where there is a hazardous or defective condition that causes your injury, take pictures immediately after the event. The cliché that "pictures speak a thousand words" cannot be truer than in disability proceedings. It is important that we show the State the condition that caused the injury. The pictures will enhance the credibility of the claim. Many of these cases will now come down to our documentation, so we should and must produce all evidence possible.

As always, if you are injured in the course of your duties and need assistance filing the necessary paperwork, please do not hesitate to call or email and discuss the matter with our firm.

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Additional Information Relative to Filing a Worker's Compensation Claim - English

Sherman, Federman, Sambur, & McInture, LLP is a Long Island, NY based workers’ compensation firm. We provide services to the greater New York area including but not limited to Brentwood, Garden City, Hempstead, Islip, Manhattan, Riverhead, essentially all of Long Island (Nassau and Suffolk county), Sysosset, Bay Shore, Hampton Bays, East Hampton, West Hampton, the North Fork, New Jersey, Connecticut, Pennsylvania, Massacheusetts the South Fork, Down Island, the North Shore, the South Shore, Mattituck, Jamesport, Cutchogue, Commack, Wyndanch, Longbeach, Queens, the Bronx, Brooklyn, etc. We cover all urban, suburban and rural areas alike (i.e., the entire Tristate area).

Services include workers accident, workers compensation, social security disability, and veterans disability. We have worked with and represent heart attack patients, herniated discs, those injured on the job, pertaining to occupational disease illness for bread winners, the elderly/old, exclusive remedy requires, death benefits, fraud, office related injury, posttraumatic stress syndrome, abogado, lesions, compensation, laborales, en mass, section 32, HEP C, hepatitis, permanent disability, pre-existing conditions, 3rd party injuries, neck injury, sue worthy, employer induced, 32 settlements, WCB permanent-partial, carpal tunnel, car crash, arthritis, CRPS, temporary partial, TPD, complex regional pain syndrome, etc.

We are the best law attorneys/work injury lawyers/SSI and SSD attorneys, located in New York City. We can provide a free consultation for your case. Simply fill out our NY state intake form. There is also a printable version available via that same new client intake form link.

Where can I file a workers comp, SSD (social security disability), veterans claim in New York? Please contact us to set up an appointment!

Please view our testimonials above via the top-most navigation menu. You may also view our frequently asked questions (FAQ) pertaining to your SSI/SSD/Worker's Comp claim.

Moreover, please contact us with any questions related to: withdrawal, workers comp forms relative to NY/NJ/CT, NY workers compensation laws, Suffolk County and Nassau County WC Laws, questions regarding doctors in Long Island who may be able to assist with your comp case, "When should I get an attorney for NYS WC case?", filing for benefits, repetitive motion, all WC related forms and, potential fees and awards for your case, questions related to the WC board, questions relative to changing your reward, average weekly wage, reopening a workman’s comp case, SSI Attorneys and assistance, questions regarding making/filing another application whilst you have a pending appeal, reopening post-decision cases, voluntary withdrawal from the workforce, "Who pays for workers comp?", judge(s), spine stimulators, how to begin your WC case with SFSM via, wages and wage estimates, claiming your rewards for a filed case and the respective guidelines to winning.

Regardless of the outcome, Sherman, Federman, Sambur, & McIntyre, LLP is here to help. And our success is driven by our combined passion to help you!

El pariente adicional de Información para Archivar una Pretensión de Indemnización Laboral - Espanol

Sherman, Federman, Sambur, y McInture, LLP es una Larga Isla, Nueva York basó a la firma de compensación por accidentes de trabajo. Le proveemos los servicios al mayor área de Nueva York incluyendo pero no limitado a Brentwood, la Ciudad Jardín, Hempstead, Islip, Manhattan, Fuente de Un Río, esencialmente todo Sysosset Bastante Isleño,, Costa Baya, Hampton Bays, Hampton del este, West Hampton, el North Fork, Nueva Jersey, Connecticut, Pensilvania, Massacheusetts lo Al Sur Tenedor, la Isla Caída, el North Shore, lo Al Sur Costa, Mattituck, Jamesport, Cutchogue, Commack, Wyndanch, Longbeach, las Reinas, el Bronx, Brooklyn, etcétera (Nassau y condado Suffolk). Cubrimos todas áreas urbanas, suburbanas y rurales por igual (i.e., el área entero Tristate).

Los servicios incluyen accidente de trabajadores, compensación de trabajadores, incapacidad de seguro social, e incapacidad de veteranos. Hemos trabajado con y representamos a los pacientes de ataque al corazón, los discos herniados, esos heridos en el trabajo, relacionado con la enfermedad de enfermedad profesional para ganadores de pan, las personas de edad/viejas, el recurso exclusivo requiere, beneficios por muerte, fraude, la oficina relató lesión, síndrome postraumático de estrés, abogado, lesiones, compensación, laborales, masa en, sección 32, HEP C, la hepatitis, la incapacidad perpetua, condiciones preexistentes, lesiones 3 de fiesta, la lesión del cuello, entable demanda digno, el empleador inducido, 32 acuerdos, WCB parcial en la permanente, el túnel del carpo, el accidente automovilístico, la artritis, CRPS, el empleado eventual parcial, TPD, complique síndrome regional de dolor, etcétera.

Somos los abogados de ley de mejor abogado /trabajo de la lesión del abogado /Ingreso Suplementario de Seguridad y SSD, localizado en la ciudad de Nueva York. Podemos proveer una consulta libre para su caso. Simplemente llene nuestra forma de la toma del estado de Nueva York. Hay también una versión imprimible disponible por ese mismo nuevo enlace de la forma de la toma del cliente.

¿Dónde puedo reportar a unos trabajadores comp, SSD (la incapacidad de seguro social), pretensión de veteranos en Nueva York? Aquí mismo en Sherman, Federman.

Por favor mire nuestros testimonios arriba por el menú que se sobrepasa más de navegación. Usted también puede mirar nuestras preguntas preguntadas (el archivo de preguntas frecuentes) frecuentemente relacionado con su la pretensión Comp DE SSI/SSD/Worker.

Además, por favor contáctenos con cualquier preguntas con las que se relacionó: El retiro, ¿ las formas del comp de trabajadores referente a NY?, Solicitando beneficios, moción repetitiva, todo WC formas relacionadas y, premios y retribuciones potenciales para su caso, las preguntas se relacionaron con el pizarrón WC, preguntas referente a cambiar su recompensa, salario medio semanal, reabriendo un trabajador Abogados comp de caso, de Ingreso Suplementario de Seguridad y la asistencia, tiene objeciones acerca de referente a la confección /limadura otra aplicación aun mientras usted tiene una súplica pendiente, reabriendo casos de postdecisión, retiro voluntario de la población en edad laboral, ¿ "quien paga para trabajadores comp"?, El juez (s), los estimuladores de la columna vertebral, cómo empezar su caso WC con SFSM por medio de, sueldo y salario estima, pidiendo sus recompensas como demanda por un caso archivado y el respectivo conjunto de directrices a ganar.

Sin tener en cuenta el resultado, Sherman, Federman, Sambur, y McIntyre, LLP es aquí para ayudar. ¡Y nuestro éxito es conducido por nuestra pasión combinada para ayudarle!