Over the years our legislature has endeavored to legislate away the ability of injured or disabled people to collect monies from more than one source. Moreover, health and disability insurers, under the euphemism “coordination of benefits,” have clauses in their policy which essentially state:
“If someone else should pay, we won’t. If we do pay, we expect you to repay what we spent on your medical bills.”
Occasionally, we see a few employers, who have paid sick pay during the injured employee’s absence, expecting to be repaid (the sick pay) from the proceeds of legal recovery.
At Plymale and Dingus, we believe the medical insurer or employer should pay the cost of recovering these monies – not you. As part of our service, we often negotiate with the medical insurer or employer to either pay their fair share of attorney fees or reduce the amount they expect to be repaid. Different payers have different policies and different degrees of willingness to negotiate, but we take pride in our ability to obtain maximum concessions from them – our work often results in more money in your pocket.
Sources of Recovery
Most clients are unaware of the sources of recovery available to them. Some of these should be vigorously pursued by you and your lawyer while others should be left alone.
The following are several examples of sources of compensation which should be investigated and pursued:
- The at-fault party’s liability insurance, whether it be auto, homeowners, umbrella, or commercial.
- Your own insurance policies: Many drivers are uninsured or have inadequate insurance. We often find additional monies available for you in your own auto policy or that of a family member with whom you live. If you were a passenger, you can recover benefits from the driver’s policy, and if you were in a car owned by another, then we can explore that person’s policy. Whether monies come from medical payments coverage or uninsured/underinsured motorist coverage, there is often compensation available to you – this will become clear after our attorneys investigate all sources of monies with a careful reading of the applicable policies.
- Workers’ compensation: If you were driving or riding on the job and are injured in a covered car you may collect both workers’ compensation benefits and money from the at-fault person’s insurance company.
- If your injuries disable you so that you cannot work, you may collect not only the insurance money but also social security disability from the Social Security Administration or pension benefits provided through your employer.
In conclusion, you need the guidance of a lawyer or lawyers, knowledgeable and experienced in injury claims, to guide you through legal action and maximize your recovery. Our attorneys are well-versed in cases of car accidents, trucking collisions, motorcycle accidents, back injuries, brain injuries, and more. Our team is passionate about helping you through your case and fighting for your rights.
When families put their loved ones into a nursing home, they expect that they will receive adequate care for their physical, medical, mental, and social needs. Nursing homes have a responsibility and a duty to provide reasonable and adequate care, and when they fail in any area of that care, it may be considered neglect. Regrettably the nursing home industry is dominated by corporations who own and run the nursing home facilities whose main focus in profit. Those few nursing homes that refused to take Medicaid patients because of the rate for Medicaid reimbursement seem to provide an acceptable quality of care. Could it be that this is because their per patient fees are higher? Most elderly people cannot afford to spend $5000 or $6000 a month for nursing home care and are dependent on Medicaid to pay the bill.
Nursing home neglect may include any number of failures, from not providing adequate nutrition to actively ignoring patients who ask for assistance. Families of loved ones who were neglected can file lawsuits against the individuals and the facilities responsible for failing to provide expected care. Neglect in the nursing home is often considered a kind of abuse most seen in the form of inaction, or a failure to act. This failure to act may be unintentional and may result from either understaffing or staffing by unqualified individuals. This is sort of neglect often results from the efforts of the nursing home attempting to increase profits by cutting costs.
In the nursing home context, neglect may happen in several ways. Some of the more common are:
- Failure to provide adequate medical mental health or dental care
- Failure to monitor a patient’s health condition
- Inadequate hygiene such as bathing, toilet use, and clothing changes
- Failure to change or clean the patient after incontinence
- Inadequate food, nutrition, or hydration
- Not aiding the residents with their mobility
- Failure to provide adequate equipment or assistance for the safety of the patient resulting in falls or other accidents which were preventable
- An inadequate number of, or inadequately trained staff
- Ignoring calls for assistance
- Deactivating call lights
In summary, nursing home operators often treat the elderly and infirm as “commodities” rather than people. The difference between what the state pays the operator and the amount he spends to care for the patient is his profit and the amount of profit determines whether he drives a Chevrolet or a Rolls-Royce.
Sometimes injury is caused, not by the staff at the nursing home or by shortcomings in its’ physical facility, but by the physician retained by the nursing home to provide medical care to their patients. The way medical services are delivered today makes it impossible to find a family practitioner willing to come to see only one patient in a nursing home no matter the strength of their past relationship. Accordingly, the nursing home hires a physician to come in and make the rounds of patients whom the nursing staff indicate needs his service or the patient requests to see him. On average, the patient sees the doctor a few times each week and when a doctor fails to recognize or inappropriately treats injuries caused by a lack of mobility assistance or infections that result from poor hygiene, there may be a medical malpractice suit against the doctor.
So, what do you do upon learning that your loved one is being neglected?
- Call the Ohio Department of Health complaint hotline at 800-342-0553
- Email a complaint to the Ohio Department of Health that includes the following:
- Your name and address
- The name and address of the facility
- The names of the individuals involved
- Names and contact information for witnesses
- The name of the patient and room number
- The date, time, and frequency of the incident
- Your opinion is to whether the incident is an isolated event or systemic problem along with your reasons for that conclusion
- And, a description of any other action you’ve already taken.
- Fill out an Ohio Department of Health complaint form which can be downloaded from the department’s website.