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Thursday, October 6, 2016

Businesses are Soliciting Injured Workers - Be Informed


Direct mail is alive and well in the workers' compensation world. We have had instances in the past where attorneys engage in direct mail solicitation of injured workers. Some complaints regarding that generally came from the injured workers or their attorneys. They were perturbed when they received mail from other attorneys, soliciting them to sign up for representation. For a time, I was often asked how and why this occurs. 

The why is easy, advertisement is a reality of commerce. Businesses often contact potential customers for the purpose of soliciting. We all see this every day, with brochures, flyers and letters appearing in our U.S. Mail box. Some of these solicitors even go to great lengths to make their envelopes look official, friendly, and enticing. 

The goal of advertising, I learned many eons ago in business school, is to get one's foot in the door. The pitch is never effective unless someone reads/sees it. In that vein,  I am often amused by the billboards along the Interstate, which advertise for the billboard company. They simply say "made you look," and then provide information on how you might rent that billboard. That is really the point, did they get you to look?

In August, I heard of another approach to direct mail. I cannot make any conclusions about it, as I have not experienced it. But, I have heard the same or similar accusations from multiple sources. And it appears there is significant concern about it. 

The allegation is that a company calling itself the "_______ Network" is using a list of injured workers for direct solicitation. Apparently, a contact that is made with the injured worker is not a a clear sales pitch, but uses wording to suggest that this Network is an official or at least integral part of the workers' compensation system. Nearly anyone that has ever reported a workers' compensation injury will tell you that reporting often results in a fair amount of mail, notices, etc. Information often comes from the state, from the employer, from the carrier, and more. 

In this Network promotion, apparently the Network conveys its involvement in the system and infers that it is prepared to assist the worker. It offers an interaction for the injured worker over the Internet with a doctor. It is a consultation. The connection is through a platform called Google Hangout. According to that service's website, this is a "unified communication service" that supports calls, video chats and more. It sounds a lot like Skype and other video chat platforms.

The injured worker engages with the Network over the Internet. Through this online interaction, the injured worker is allegedly enticed to provide private information about themselves. They then provide a digital "e-signature" consent to the Network. By doing so, the injured worker is apparently committing to be personally liable for payment to the Network for these services, apparently an interactive Internet doctor's appointment. The Network apparently generates a document from the interaction, and sends that to the insurance carrier. That form may be signed by the injured worker. 

The communication from the Network apparently conveys to the carrier that this Internet doctor and the Network are going to provide care for the injured worker. It advises the carrier that if it does not deny or contest this authorization "within three days" then the Network will construe this as the carrier having "consented to pay" for care. There are allegations that various carriers have experienced difficulty in contacting this Network back regarding denial.

Are injured workers in Florida able to select their own physicians.?Well, that becomes complex. Initially, they are not. The statute provides for selection of physicians by the employer, and by implication the insurance carrier. Injured workers are entitled to a "one time change" in physicians, but that election of change can be made one time in each case. 

It is a decision that many advocate should not be made lightly. In many cases, the "one time change" results in the employer/carrier selecting a new doctor to replace the first. In some other situations, the injured worker may be able to select their own doctor in the "one time change" process. There are some who fear that an injured worker's decision to sign up for this video consultation will have elected their "one time change." Others argue that instead, the injured worker might end up financially responsible for this "consultation" or more. 

In one of the notifications about this that I received, there were allegations about the qualifications or background of the doctor involved. Questions are raised about whether the physician is licensed in Florida, and whether information about the doctor is readily available to the injured worker. Some suggest that any patient should want to be aware of their physician's credentials and background. That is likely reasonable advice in any medical care situation. 

The Internet is a great convenience. And the concept of telemedicine is growing. A fair amount of attention has been focused on the benefits it can bring, particularly in rural settings. But, there are those who argue that telemedicine over the Internet is also a little less personal; some advocate for the benefit of an old fashioned, hands-on, physician appointment. 

So, it may be that injured workers are benefited by entering relationships with a doctor that will provide them advice over the Internet. It may be that injured workers would not be. It appears though that this solicitation practice and all that it entails would be something about which injured workers would want to be informed and aware. Informed choices are perhaps better than uninformed.

It may be that insurance adjusters, employers and attorneys will want to provide education and information to injured workers about the workers' compensation system. A better informed injured worker will be better able to make informed decisions about the benefits and risks of their interactions with various vendors who solicit business from them.