Defense Base Act Compensation Blog

The Modern Day DBA Casualty

Posts Tagged ‘ALJ’

CNA’s Deadly Paper Games, Just another CNA DBA Suicide in the making

Posted by defensebaseactcomp on June 21, 2012

It is certainly going to have the desired result. 

They are going to kill him and it is going to be soon. 

Before the year is out I believe this man is going to commit suicide.

PTSD Claims to be Expedited

CNA’s Deadly Paper Games do not begin or end with this Injured War  Zone Contractor

Nearly 14 months to the day of a Department of Labor District Director signing an Order approved by an ALJ stating that CNA must provide medical for a  severely Injured War Zone Contractor’s injuries, the details of which were gagged…..

And 3 1/2 months after Injured War Zone Contractor asked the District Director to find them in Default for not doing so……..

CNA produces a stack of  FAXES supposedly sent to Injured War Zone Contractors Doctors stating that they have “re-approved” payment of diagnoses and treatment, most of which were never approved, ever, much less “re- approved”.  In fact for most of the Doctors CNA denied diagnoses and treatment for blast injuries for many years.

Several Doctors stated that yes they received a FAX but that it did not mean they accepted the approval and that it did not guarantee payment.  Payment would have to made in advance.  CNA’s reputation for non payment is no secret.

The rest of the doctors state that they never received “approval” at all.

Unemployed and otherwise uninsured Injured War Zone Contractor pays for some visits via credit card as they are so vital.  Doctor then sends a bill to CNA for payment despite not having received an approval,  which CNA refuses.  Injured War Zone Contractors scheduled visits are then cancelled due to non payment by CNA.

These are deadly games CNA plays in order to continue to deny medical even after a hard won order is produced.

And who do they claim is vague, ambiguous, and whose claims are not supported by Facts, or should we say FAX?

It must be the very well respected and credentialed doctors, or the Attorney, or the Injured War Zone Contractor

This negligent paper game continues despite a recent medical report from February stating:

“I do not understand the entire bureaucracy issue.  He tells me that CNA has written to us and that we are approved for Workers’ Compensation.  We have no record to that effect.  We are just not going to be paid and they are not going to authorize treatment.  Bureaucracies have their problems but this almost seems to be purposeful.

It is certainly going to have the desired result.  They are going to kill him and it is going to be soon.  Before the year is out I believe this man is going to commit suicide.

And he’ll be just another CNA DBA Suicide.

Note:   CNA’s response is to ask for an informal conference.  Several informal conferences, a settlement conference with a Judge, orders signed by a Judge and the District Director, and yet another informal conference after an 18 month default is even a consideration???  Let’s just run this out until the end of year and we won’t have to worry about this guy anyway!!!!

Posted in AIG and CNA, AWOL Medical Records, Civilian Contractors, Contractor Casualties and Missing, Defense Base Act, Defense Base Act Attorneys, Defense Base Act Insurance, Defense Base Act Law and Procedure, Defense Base Act Lawyers, Delay, Deny, Department of Labor, Dropping the DBA Ball, Hope that I die, Injured Contractors, Interviews with Injured War Zone Contractors, LHWCA Longshore Harbor Workers Compesnation Act, Political Watch, PTSD and TBI, Suicide, Uncategorized, Veterans | Tagged: , , , , , , , , , , , , , , , , , , , , | 6 Comments »

Medical bills can wreck credit, even when paid off

Posted by defensebaseactcomp on March 4, 2012

When CNA does not pay Walter Reed and it goes on your credit rating as a “Serious Delinquency to the Treasury Department”

When AIG does not pay Landstuhl and the government attaches your Social Security, your only source of income because they are denying your claim

When CNA, AIG, ACE “approve” your doctors and medical but do not pay the bills

When CNA does not pay laboratory fees that show up on your credit rating years later

When CNA approves your wheelchair but it is repossessed due to non payment

When a US DOL ALJ signs a useless order requiring CNA or AIG to pay your past medical bills and they boldly defy the order

Your credit has been irreparably damaged and it is you that must bear the extreme cost of their abuse, never the insurance company or those that help them get away with this

By Carla K Johnson AP  March 4, 2012

CHICAGO (AP) — Mike and Laura Park thought their credit record was spotless. The Texas couple wanted to take advantage of low interest rates, so they put their house on the market and talked to a lender about a mortgage on a bigger home in the Dallas-Fort Worth suburbs.

Their credit report contained a shocker: A $200 medical bill had been sent to a collection agency. Although since paid, it still lowered their credit scores by about 100 points, and it means they’ll have to pay a discount point to get the best interest rate. Cost to them: $2,500.

A growing number of Americans could encounter similar landmines when they refinance or take out a loan. The Commonwealth Fund, a private foundation that sponsors health care research, estimates that 22 million Americans were contacted by collection agencies for unpaid medical bills in 2005. That increased to 30 million Americans in 2010.

Surprisingly, even after the bills have been paid off, the record of the collection action can stay on a credit report for up to seven years, dragging down credit scores and driving up the cost of financing a home. An estimated 3.4 million Americans have paid-off medical debt lingering on their credit reports, according to the Access Project, a research group funded by health care foundations and advocates of tougher laws on medical debt collectors.

Among them are Nathen and Melissa Cobb of Riverton, Ill., who tried to refinance their home last year. They didn’t qualify for the loan because of $740 in medical bills that had been sent to a collection agency. The Cobbs were surprised because the bills — nearly a dozen small copayments ranging from $6 to $280 — had been paid before they tried to refinance. The collection action took their credit score from good to mediocre and is likely to mar their credit report for years.

“I’m not one of those people trying to ditch out on my bills,” 34-year-old Melissa Cobb said. “I’m really frustrated.”

Medical bills make up the majority of collection actions on credit reports, and most are for less than $250, according to Federal Reserve Board research.

Please see the original and read more here

Posted in ACE, AIG and CNA, Chartis, Civilian Contractors, Defense Base Act, Defense Base Act Attorneys, Defense Base Act Insurance, Defense Base Act Lawyers, Department of Labor, Dropping the DBA Ball, Injured Contractors, LHWCA Longshore Harbor Workers Compesnation Act, War Hazards Act | Tagged: , , , , , , , , , , , , , | 1 Comment »

Social Media as Evidence: Good Times Yield Bad Results

Posted by defensebaseactcomp on February 6, 2012

Cross Posted from Workers Comp Insider

Photo Courtesy of Arkansas Appeals Court

by Jon Coppleman February 6, 2012

ABC news has picked up a story out of Arkansas: Zack Clement suffered a hernia while moving a refrigerator for his employer, Johnson’s Warehouse Showroom. He underwent multiple surgeries, but the pain lingered, so he filed for a continuation of benefits. Among the pieces of evidence at his trial were party photos posted on his Facebook page, which show Clement drinking (and little else). When his claim for reinstatement was denied, Clement appealed, citing the unfairness of the Facebook evidence.

ABC wrote as follows:

In an opinion, written by Judge David M. Glover, the Arkansas Court of Appeals states: “We find no abuse of discretion in the allowance of photographs. Clement contended that he was in excruciating pain, but these pictures show him drinking and partying.”

“Certainly these pictures could have a bearing on a Clement’s credibility, albeit a negative effect that Clement might not wish to be demonstrated to the ALJ or the Commission, ” Glover continues. “We hold that there was not an abuse of discretion in allowing the photographs.”

Justice in the Details
At first glance, the judge’s comments might be cause for alarm. An injured worker suffering from chronic pain might well be capable of having a few drinks with friends. (One can only hope that the alcohol does not interfere with any prescribed -or unprescribed – pain medications.) If the photos were the primary evidence of Clement’s condition and the basis for denying the claim, Clement would have good reason to object. However, this is not the case.

In the course of his carefully reasoned findings, Judge Glover reviews in detail the medical history of Clement’s claim. Even after multiple surgeries and several changes in treating doctors, Clement complained of ongoing pain. Extensive medical testing revealed no abnormalities and no evidence for the pain itself. He has been released to full duty. It is this detailed history and the lack of medical evidence that lead Glover to conclude that any further treatment would fall outside of the workers comp system. The Facebook photos are by no means the foundation of his findings. Nonetheless, he decides that the photos are a legitimate piece of the case file and admissable as evidence.

In my limited experience, Facebook seems to be a platform for superficial news and, for the most part, images of the good times. It is difficult to imagine that Clement would have used this public forum to post pictures of himself suffering excrutiating pain. If he had chosen to do so, this might have provided evidence in his favor. However, his friends would likely have chided him for being such a downer and even then, the court might have dismissed the images as theatrical exaggeration.

Facebook may now be the preferred means of presenting our personal narratives, but it is unlikely to help us make our case in a court of law.

Please see the original and read more here

Posted in ACE, Defense Base Act, Defense Base Act Insurance, Defense Base Act Law and Procedure | Tagged: , , | 1 Comment »

CNA and AIG failure to provide medical despite ALJ/DoL orders

Posted by defensebaseactcomp on April 4, 2011

Reckless endangerment of lives by CNA and AIG refusing to provide court ordered necessary medical and psychological care.

Contact us if you fall into this category dbacasualty@yahoo.com for an upcoming news story

Posted in AIG and CNA, Defense Base Act, Defense Base Act Law and Procedure, Department of Labor, Dropping the DBA Ball, OALJ, PTSD and TBI, Racketeering | Tagged: , , , , | 1 Comment »

ALJ Stephen L Purcell appointed Chief Administrative Law Judge

Posted by defensebaseactcomp on January 27, 2011

On January 16, 2011, Stephen L. Purcell was appointed Chief Administrative Law Judge.

Judge Purcell served as the Department’s Acting Chief Judge beginning March 4, 2010, and was the Associate Chief Judge for DOL’s Longshore and Traditional programs from 2007 to 2010.

Congratulations ALJ Purcell  and  Thank you for taking the job on permanently

Posted in Defense Base Act Law and Procedure, Department of Labor, OALJ | Tagged: , , , , | Leave a Comment »

Stranded DBA Claimants

Posted by defensebaseactcomp on October 8, 2010

Due to the suspension of a DBA Attorney by the OALJ’s office some claimants have been receiving notices from their assigned ALJ’s that they must retain another attorney or represent themselves at their hearing.

If you retained this attorney it is he who should have notified you of his suspension.  The ALJ’s are only able to notify the claimants they had been assigned.

Here we have ALJ Romero, true to form, treating the client as if she is somehow at fault for this and sends her a notice on the 17th of August requiring a response by September 1st.  Looks like she did not make the cut.  If anyone knows this claimant please let her know the status of her claim.

Other claimants have received these notices with barely concealed contempt inferred in the wordage.

IN THE MATTER OF
JULIE PERKINS
Claimant
v.
SERVICE EMPLOYEES INTERNATIONAL, INC.
Employer
and
INSURANCE COMPANY OF THE STATE
OF PENNSYLVANIA
c/o Chartis Property Casualty
ORDER REMANDING CASE
On August 17, 2010, an Order issued to Claimant advising that Attorney Dennis Nalick had been suspended from appearing in a representative capacity before this office until such time as his suspension from practicing law in the State of Illinois is lifted and he is re-admitted to practice.
Claimant was ordered to notify the undersigned whether she wishes to proceed to hearing with alternate counsel or without representation. In the event Claimant did not notify the undersigned by September 1, 2010, she was informed that her claim would be remanded to the District Director for further
appropriate handling. Claimant has not responded to the Order.
– 2 –
IT IS HEREBY ORDERED that this case be remanded to the
District Director for further handling.
ORDERED this 20th day of September, 2010, at Covington,
Louisiana.
A
LEE J. ROMERO, JR.
Administrative Law Judge

Posted in Defense Base Act Law and Procedure, Department of Labor, Dropping the DBA Ball | Tagged: , , , , , | 11 Comments »

CNA DBA Casualty Merlin Clark “Alleged” Seventh Anniversary of his “Alleged” Injuries in Iraq

Posted by defensebaseactcomp on July 6, 2010

July 7, 2003

Doing Battle Area Clearance in a RED ZONE with no security, no weapons, under orders to work anyway, appearances are everything don’t you know

“Allegedly” being blown up in front of  numerous witnesses,  six of whom “allegedly” caught the rest of the frag, he was medivac’d to Acinetobacter Alley, Dogwood Field Hospital in Baghdad.

He was then medivac’d , along with some “Alleged” Acinetobacter to Landstuhl where he was left without a  Medivac for five days.  This in complete disregard of the doctors orders to get him out of there ASAP  so  he would not lose his leg, but still his employer/carrier

DID  NOT ARRANGE ONE.

The military got him to Walter Reed for an extended visit in the “Alleged” OR , ICU, and Ward 57, before CNA so proudly medivac’d him to a civilian hospital.  You would have thought they parted the Red Sea

Merlin, we sure hope that your “Alleged” Injuries turn out to be nothing more than that, Alleged.

Think of how different your life will be when both of your legs and both of your arms and hands work again, you can hear again, you can think clearly again, your back, neck, head do not cause you constant pain, you can sleep at night, your leishmaniasis “heals on it’s own” as they said it would seven years ago.

You’ll be able to work at your profession again, providing a humanitarian service, valued as a person, not treated like a criminal who has already been convicted,  relieved of his rights by an Administrative Law System and those they serve.  You’ll have that money back in your bank account that was drained to cover expenses and will have added considerably more to it.

Your daughter can get the last seven years of her childhood back.

Oh, Please ALJ, make it go away,  make it all be “Alleged”………..

Posted in Acinetobacter, AIG and CNA, Civilian Contractors, Contractor Casualties and Missing, Defense Base Act Law and Procedure, Department of Labor, Exclusive Remedy, Follow the Money, Leishmaniasis, Misjudgements, OALJ, Political Watch, PTSD and TBI, Racketeering, State Department | Tagged: , , , , , | 6 Comments »

!! Junket Time in New Orleans !!

Posted by defensebaseactcomp on March 15, 2010

AIG, CNA, their defense lawyers and claims adjusters, their third party medical providers,  DoL ALJ’s, DoL District Directors  and some of the plaintiff’s lawyers gather for another Dol sponsored conference.  A few days to get to know each other better, discuss how to better “work together”……

Loyola Annual Longshore Conference 2010- Overwhelmingly for the Defense again

March 18 – 19, 2010
Sheraton New Orleans Hotel
New Orleans, Louisiana

Though overburdened with DBA claims the DoL is still sending four Administrative Law Judges to New Orleans with taxpayer money.  Even the new sitting Chief ALJ Purcell has time for this  defense speaker  bloated gathering.

Judge Gee continues her Conference Circuit this week while DBA claims on the West Coast wait as long as a year for a decision after a hearing.

All will  get to play Jeopardy with Rosenow, a privilege normally reserved for the injured unfortunate enough to live within the Cabal’s jurisdiction, or whose lawyers take it upon themselves to put them there because THEY live there.

A few possible answers……

Who is Dr. John Dorland Griffith?     Why is it not PTSD?   Why we call it an IME even though it isn’t?

Posted in AIG and CNA, Department of Labor, Racketeering | Tagged: , , , , , , , , , , , , , | 1 Comment »

It’s the Friday Fest Question of the week from our readership Who is the Worst ALJ?

Posted by defensebaseactcomp on February 12, 2010

So, Who, in your humble opinions,  is the worst ALJ?

Posted in Department of Labor, Misjudgements | Tagged: , , , , , , , , | 3 Comments »

Alarming Pattern in Defense Base Act TBI and PTSD Claims

Posted by defensebaseactcomp on January 13, 2010

As we research and document we have noticed the following pattern in DBA cases when it comes to PTSD/ TBI claims:

First, the insurance company lawyers viciously defame the claimant and his/ her family, oftentimes with the coerced help of former coworkers.   Although the DSM IV clearly states the emotional impact of PTSD , namely irritability and outbursts of anger (D2), the ALJs routinely turn around and use the symptoms of PTSD to blame the victim or label them with personality disorder although there is no history of this behavior in their past.

Oftentimes their families are unfairly blamed for being the cause of  ‘personal stressors’ to shift the blame and malign them in hopes that they will drop the claim and to deter others from filing a claim.

Secondly, the insurance shrinks produce false (misquote DSM IV etc.) and fraudulent medical testimony (fake bad scale; falsify psychological test results)

Based in large part on that defamation;

The ALJs denied all the initial PTSD claims, starting with Talbot, Eysselinck, Meredith and many others  (Thompson indirectly by insisting that the last body recovery mission triggered his PTSD)  because they were misled by the insurance quacks that the onset of PTSD symptoms is immediate and did not read the DSMIV evidence in the record. (see Course: Symptoms usually begin within the first 3 months after the trauma, although there may be a delay of months, or even years, before symptoms appear)

Third, the company falsely claims that the traumatic event never occurred/ or that no records/ witness exist;   leading to totally insane findings like civilians contractors were not exposed to life-threatening events in the Iraq war.
It’s not that they don’t know better.  Even the US Army’s official threat assessment fails to persuade them in their plush chambers half a world removed:


Daily Threat Update January 14, 2004:

“Analysis of recent attacks and information indicate that anti-coalition groups and affiliated foreign fighters as well s local resistance groups in Iraq are becoming more sophisticated and may be coordinating their anti-coalition efforts…..

There has been an increase of attacks involving  civilian / contractor personnel throughout Iraq …..

Recent weeks have seen a significant increase in the threat against civilian ‘soft targets’.   This includes attacks against western contractors and those associated with the CPA,  Iraqis cooperating with the coalition …..

The threat of kidnapping remains high …

This threat is highest in Baghdad …

Finally
, they assert that the claimant is either exaggerating or faking his impairment and then paint them as dishonest because of some minor or irrelevant discrepancy between what their numerous doctors wrote down in their treatment notes (or failed to mention) and the various depositions/ testimony of mentally impaired people who suffer from memory and attention problems.

This deceitful scheme has worked time and again.  The real question is why do many administrative law judges credit these slanderous fabrications and lies regarding war exposure.   Even when they find that a witness has lied, no action is taken against such person or employer/carrier who clearly put them up to it, thus encouraging AIG/CNA to use the same depraved tactics time and again with total impunity.

You may read the references to the DSM IV here

Posted in AIG and CNA, PTSD and TBI | Tagged: , , , , , , , , , , , , , | 9 Comments »

Resolution of Doubt

Posted by defensebaseactcomp on September 5, 2009


Stephen C Embry
Resolution of Doubt
This is a good post you’ll want to read in it’s entirety at

“the purpose of passing the Longshore Act was a humanitarian one, to provide a remedy for injured workers, and that the duty of the U.S. Department of Labor is to provide vigilance in protecting those workers.

The administrative law judge must resolve doubts in favor of the worker.”

Posted in Uncategorized | Tagged: , , , , , , , | 1 Comment »

The DBA’s Exclusive Remedy: Why Danny Fitzsimons’ PTSD was a Non Issue?

Posted by defensebaseactcomp on August 16, 2009

The Defense Base Act includes a clause called the “Exclusive Remedy” making the DBA the employers exclusive liability and the employees’s exclusive remedy.

When the contract company  purchases the cost reimbursable DBA insurance for it’s employees it has just been released of all liability for any reason.   It is relieved from  litigation by the employee or his/her family members.  Many employees have never heard of the DBA or know that it is their exclusive remedy.  There is no “policy” delivered to them for their perusal or signature.

There is no financial gain to the employer by screening for PTSD and no financial loss to them when an employee snaps.  Even worse, when an employee files a claim for PTSD they most often are denied diagnoses and treatment by the DBA insurance companies AIG and CNA.

When the employee is forced into years of litigation in the Department of Labors’ Administrative Law System they will be pitted against their employer.   AIG and CNA will subpeona the employers representatives and fellow employees to testify against them at their hearing.  They may lie and blame this mental illness on the wife, or stepchildren,  anything but the stress of working and living in a war zone.

Many of the deaths and injuries to civilian contractors in the war zones were due to negligence on the part of the employer.     Employers often failed to provide necessary safety equipment, security,  and/or to implement, or allow to be implemented,  the most basic Safety and Standard Operating Procedures that would normally be followed.   So far there has been no consequence to bear on the companies or individuals who were negligent.

Paul McGuigan and Darren Hoare are dead.   Young children have lost their fathers and their own financial futures as the DBA will little if anything, reimburse them for this loss.  It’s possible these families will never see a dime from the DBA insurance company.  Hopefully there were supplemental policies in place.

Danny Fitzsimons was lost to this world years ago when his mental instability was not properly addressed.

He now stands in the eyes of the Iraqi’s as representative of all those who have abused them over these years.  He is being fast tracked through their legal system to a possible hanging.

As the facts of this tragedy come to light we see clearly how many times the opportunity to prevent it were overlooked.

The only ones who will pay the price are the dead, injured, incarcerated, their families and the US taxpayer who paid for the insurance policies and may reimburse the insurance companies for the claims, to include their attorneys,  under the War Hazards Act.

The DBA and it’s Exclusive Remedy clause are a free pass to unmitigated negligence.

Posted in Uncategorized | Tagged: , , , , , , , , , , , , , , | 10 Comments »

Required Reading for ALJ’s and Claimants Lawyers, Vicariously experienced traumas

Posted by defensebaseactcomp on June 30, 2009

Assessing Combat Exposure and Post-Traumatic Stress Disorder
in Troops and Estimating the Costs to Society

Implications from the RAND Invisible Wounds of War Study

http://www.rand.org/pubs/testimonies/2009/RAND_CT321.pdf

‘Major depression is often not considered a combat-related injury;

however, our analyses suggest that it is highly associated with

combat exposure and should be considered in the spectrum of

post-deployment mental health consequences.’

‘Assuming that the prevalence found in this study is representative of

the 1.64 million servicemembers who had been deployed for OEF/OIF

as of October 2007, we estimate that as of April 2008 approximately

303,000 OEF/OIF veterans were suffering from PTSD or major depression.

We also found that some specific groups, previously underrepresented in

studies — including the Reserve Components and those who have

left military service—may be at higher risk of suffering from

these conditions.

Vicariously experienced traumas (e.g., having a friend who was

seriously wounded or killed) were the most frequently reported.

About 10-15% of OEF/OIF veterans reported NO trauma exposures,

and about 15-20 percent reported exposure to just ONE event

(largely death or injury of a friend), so most (close to 75 percent)

reported multiple exposures

.Compare these findings to those of the ALJ’s who are giving these

cases to AIG and CNA    The DBA X Files

Posted in Uncategorized | Tagged: , , , , , , , , | 2 Comments »

Is your DBA Attorney working in your best interest?

Posted by defensebaseactcomp on February 19, 2009

According to the Defense Base Act your attorney does not get paid unless they get you something more than the insurance company was providing, just because they said they would.
Considering that in 70% of all DBA claims the insurance company files an LS 207 immediately denying benefits of any kind despite the amount of blood on the ground, getting something more is hardly a  risk.
In one recent claim an attorney who was fired for not even reading the claimants file was paid.

So where is the incentive for them to work in your best interest if they are going to get paid whether you do or not?

It might be easy for a lawyer who doesn’t care to walk your case right through to a stipulation agreement or settlement that is not in your best interest.  Would you know the difference?

If you do not  research the complicated DBA/WHA, and LHWCA
laws in detail you will have no idea what to expect.
Even then these Acts are interpreted by lawyers, judges who are  appointed from within, the Department of Labor claims examiners,  benefits review boards, which means there is a considerable amount of OPINION attached to your claim, your future.

On the other hand the defense lawyers are well seasoned DBA attorneys who know all the tricks to keep the insurance companies from having to pay the medical and lost wages the DBA was put in place to provide you.  You will be pitted against your employer even if you still work for them.  Your fellow workers may be asked to testify against you. 
Some of the defense lawyers for the insurance companies have been working with the Department of Labor appointees and employees, the Administrative Law Judges, the Benefits Review Boards  members, the third party medical providers and attending seminars with them for years now.

Look for a lawyers track record before you jump on board.
If the company you were working for when you were injured suggests one you probably don’t want to go there.

AIG, CNA, and ACE are going to be repeat customers.

You are going to be a closed file.

Posted in Uncategorized | Tagged: , , , , , | 8 Comments »

 
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