| Intoxication |
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| When an employee is injured outside the course of his employment, he is ineligible to receive workers' compensation benefits. When an employee becomes voluntarily intoxicated such that he cannot function or perform the tasks of his job, courts will consider him to have departed from the course of employment. Therefore, compensation for an injury incurred while the employee is so inebriated as to be incapable of performing his work will likely be denied. More... |
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| Payment for Representation of a Social Security Claimant |
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| A social security claimant may choose to be represented by a third party in his dealings with the Social Security Administration (SSA). If the third party accepts the role of "representative" on behalf of the claimant, he is prohibited from charging the claimant a fee without prior authorization from the SSA. This holds true even if the claim is denied. To obtain approval from the SSA, the representative must use either of two fee authorization processes.More... |
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| Attorneys' Fees and Costs in Third-Party Actions |
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| When an injured employee initiates a third-party action based on the injury he received in the course of his employment, most states require the employer or its workers' compensation insurance carrier to pay part of the attorneys' fees incurred in bringing the action. They are to pay the fees out of their share of the recovery. Though the majority calls for the employee and employer to share the burden of attorneys' fees, there is still variation among the states as to who is obligated to pay the fees and in what amount.More... |
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| Segregation of Damages in Third-Party Action |
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| In some instances, the recovery resulting from a third-party action will be divided by different items making up the total recovery. For instance, a portion of the recovery could be allocated for the medical expenses paid by the employer, for the employee's pain and suffering, for the loss of consortium, and for punitive damages. When the recovery has been so segregated, the next issue is whether the claim of the employer or its workers' compensation carrier (as the subrogees) can attach to the whole recovery amount or only that portion attributable to the compensation paid. More... |
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| Statutory Defense of Wilful Misconduct |
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| Approximately one-third of the states include the defense of "wilful misconduct" in their respective workers' compensation statutes. Under this defense, employers' will claim that the employee is ineligible to receive, or is only entitled to a reduced amount of, workers' compensation benefits because his deliberate action in, for example, violating a safety rule or committing an aggravated assault, is what caused his injury. More... |
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