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1. Medical: Begin by telling your spouse what you desire medically in case of a serious injury. Note: You can also make end-of-life instructions (such as when to discontinue life support) on the Utah Advance Healthcare Directive form. And organ donation is often addressed when you renew your drivers license at the DMV, but you can address it here too.
2. Family / Friends: Next, I address any family issues such as who to notify first in case you are in a serious accident. You may also want to provide the contact information for any close friends or ecclesiastical leaders (i.e., your pastor or bishop) you want notified.
3. Employment: Next is employment. Provide the contact information for your boss and perhaps your HR Manager so your employer can be notified. Since I am self-employed, I provided my spouse with information on how to contact the Utah Bar, my landlord, my business insurance company, and my tax advisor. Also, I reminded my spouse to please coordinate with the Post Office to hold my mail until arrangements can be made for another attorney to take over my cases until I can return.
4. Disability: I also provided instructions on who to contact for help applying for Social Security Disability.
5. Insurance: Next, in case of my death, I provide the contact info and policy number for my life insurance policy. Likewise, if you have long term care insurance, you can include that information here too.
6. Miscellaneous: Next, I provide some suggestions to help my wife manage our vehicles since I primarily handle car maintenance for our family. Moms–not to be sexist here–in your letter to your husband, perhaps you will provide guidance on child care, assuming you primarily handle day care issues for your family. The purpose of the letter is to make it easier for your spouse to press forward in case of your disability or death. The goal is to decrease spousal stress during a difficult time.
7. Probate: Next, I suggest which attorney or law firm I trust to handle probate / trust issues, if necessary.

Lastly, you can close the letter of instructions with a few words of comfort and assurance. This letter, however, is meant to address the “business” side of your life; it is different than a “last letter to my family” where you might share personal experiences, beliefs and hopes for your children and grandchildren. After I wrote my letter of instructions, I shared it with my wife and saved a copy in our estate planning binder. I felt really good. I had taken a concrete step toward helping my family be prepared to deal with the stress that attends a serious accident.

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Since 1986, the Labor Commission and courts have decided many cases involving pre-existing conditions to decide if the worker got hurt during an “unusual and extraordinary exertion.” Here are some scenarios that passed the test and were found to be “unusual and extraordinary exertions”:
–Climbing a ladder while carrying a 20-30 lb roll of tar paper, then having one foot slip and both feet landing on the rung below, resulting in back pain. Oyler, 11-0033.
–Repetitive exposure to significant levels of ammonia fumes. Raftery, 03-0865.
–Attempting to jostle into place a roll of paper that weighed approximately 2,400 lbs.
–Repetitive exertions such as moving many boxes or objects weighing less than 50 lbs.

It seems, however, that there are more cases where the Labor Commission finds that the exertion was not unusual or extraordinary:
–Stumbling but not falling while walking on pavers. Rizzo, LC 09-0452.
–Catching oneself while twisting with some weight on an unsteady platform, such as a boat, airplane, bus, or train. Murray 2013 UT 38.
–Slipping, falling, hitting knee on a hard object like a metal track. Monroy, 09-0861.
–Twisting knee while stepping down and later tripping on floor mat. Fact that mat was greasy is irrelevant to worker’s exertion. “Tripping over such surfaces frequently occur in nonemployment life.” Stennett, 99-1024.
–A one-time lunge and twist, even though “forceful.” Bigler, 95-0838.
–Unexpected impact from behind, sufficient to cause startled response & lurch forward. Schreiber, 97-0608.
–Missing a step at the bottom of a flight of stairs, or falling with a jolt when the slab of coal on which you are standing breaks and drops 12 inches. Wardle, 03-1191.
–Squatting off and on for about an hour before twisting-knee injury. Jimison, 13-0037.
–Slipping on wet floor while carrying 38-lb box, resulting in a back injury. This “exertion is similar to slipping while carrying luggage, a full garbage bag or a small child.” Withers, 12-0071.
–Leaning forward briefly to inspect the concrete and gutter line with one’s torso twisted and his right foot 18 inches above and perpendicular to his left foot when the injury occurred. Sneddon, 13-0886.
–Climbing a ladder and striking one’s head [on unseen box overhead]—to be similar to the common exertion of stepping onto a stool and striking one’s head on an overhead object. Quintana, 14-0582.
–Standing up suddenly and striking one’s head on an overhead electrical box. Woll, 14-0647.
— Crouching down and lifting 35-lb bag from shelf 4” off floor and twisting while lifting. Jensen, 07-0005.
— Lifting and twisting with a 47-lb box. Dahl, 08-1282.
— Stepping backward off a cement riser about 8-12 inches high after retrieving a 20-lb box, miscalculating the distance and coming down hard on one leg, resulting in back pain. Stone, 04-0602.
— Kicking a freezer door while holding a tray of food, resulting in knee pain. Germer, 05-0318.

The analysis of whether an exertion is unusual and extraordinary is very fact-specific. Please do not simply assume that your pre-existing condition rules out a workers compensation claim because repetitive exertions of small weights can often pass the “Allen” test and result in compensable claims. Also, occasionally the evidence does not support the insurance company’s argument that the injured worker even had a contributing pre-existing condition. The law is that the pre-existing condition must actually contribute to the industrial injury. In short, it is often wise to consult with an experienced workers comp attorney to determine if you have a viable claim.

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1. Private health insurance (i.e., Cigna, SelectHealth, Altius, EMI Health, SelectMed, Aetna, etc.), if your job or your spouse’s job offers it.
2. COBRA health insurance from a previous employer. Contact your previous employer (Human Resources), if needed, to get information.
3. Medicaid. It can take a while to get approved, so submit an application ASAP via the Dept of Workforce Services (DWS).
4. The Doctors Volunteer Clinic of St George. This is an outstanding medical resource offered through the donations and efforts of many generous volunteers, donors and physicians. To qualify for their medical services, you must meet their income guidelines, i.e., be below 200% of the poverty level. For example, a family of four must have a monthly income less than $3,973 (which equates to $47,676 per year).
5. Family Health Care clinics in St George and Cedar City. If you do not have any health insurance they offer a Sliding Fee Discount Program based on family size and income, so a typical medical visit will cost between $25 – $80. Website: www.familyhc.org.
6. IHC Financial Assistance. Apply as soon as possible. IHC generally wants patients in need to seek financial aid from all available sources. If you meet their guidelines, they will use a sliding scale based on your income and ability to pay. IHC Financial Aid is particularly helpful if you need an urgent surgery or other procedure that a family clinic does not provide.
7. Do not remain silent – “ask [for help] and ye shall receive.”

Note: If at all possible, try to get proof that the workers compensation adjustor has actually denied your doctor’s request for pre-authorization. The legal principle here is to give the workers compensation adjustor an opportunity; if he says “no” then you’re free to go elsewhere, get the treatment, and still file a workers compensation claim for reimbursement. If you do not give the adjustor an opportunity to pre-authorize the treatment, then the Labor Commission will likely deny your claim for reimbursement. (Reference: U.A.C. R612-300-2)

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1. Fully Litigated Case / No Settlement: Full litigation means we go to the hearing with a Labor Commission judge; the injured worker testifies and is cross-examined; the judge decides the facts of the case and obtains an opinion from a Labor Commission Medical Panel; and the judge renders a decision. The injured worker or the insurance company may then appeal to the Labor Commissioner (or to the Appeals Board), then to the Utah Court of Appeals and then to the Utah Supreme Court. This process typically takes many months.
2. Direct Referral to a Medical Panel: In this situation, the insurance company’s lawyer and the injured worker’s lawyer type up the facts of the case–we all agree what happened. We just disagree on what medical treatment is needed. So, the judge then skips the hearing and moves on to the medical panel phase. This speeds up the litigation by about three months and saves the injured worker from having to testify at a hearing.
3. Settlement of Indemnity Only with Medicals Left Open: “Indemnity” means “compensation for loss”; it is the money that goes to the injured worker, not to the doctor. Workers Comp cases typically involve claims for indemnity (money to injured worker) and for medical benefits (money to doctor). Indemnity is usually classified as Temporary Total Disability benefits or Permanent Partial Disability benefits. Sometimes the injured worker and workers compensation insurance company decide to settle the indemnity portion of the case and let the medical issues go to the Medical Panel and the Labor Commission judge for resolution. This type of settlement is the best way to go in certain situations.
4. Settling the Current Claim Only: Occasionally we will settle only the current claim and leave open the possibility of future claims in case the injured worker has some future medical problems due to the industrial accident. Settling only the current claim is fairly rare.
5. Full & Final Settlement: Here, the injured worker agrees that she cannot bring any future claims stemming from a particular accident even if her medical condition worsens in the future. Insurance companies like full & final settlements because it allows them to close the case file forever. These settlements typically happen before the hearing, so the shortest amount of time to get to a settlement is about four months from the time we file the claim with the Labor Commission.

Some of the factors we discuss when contemplating settlement are: the severity of the client’s injuries and loss of function; the client’s age, education and future work prospects; the strength of the evidence in the case; whether the injured worker has access to healthcare through private insurance or Medicaid / Medicare, and the client’s financial situation. If you have any questions about settling your workers comp case, feel free to call Tim Daniels Law Services for help.

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In 2016, however, the Utah legislature passed a law allowing employers to include volunteers in their workers compensation coverage. Employers who obtain workers compensation coverage for their volunteer workers must post notice of this fact in the workplace and on its website where it recruits volunteers.

If you decide to volunteer for an organization or company, it would be wise to find out if workers compensation coverage is provided. If so, then you would likely go to WorkMed or WorkCare if you get hurt on the job and file a workers compensation claim. If not, then you would go to your own doctor and not file a workers comp claim.

Lastly, if the organization or company pays you for your work but still insists that you are a volunteer, you may need a lawyer’s help if you get hurt at the job. Sometimes companies try to avoid paying for workers compensation insurance by telling their workers they are volunteers. This tactic is called misclassifying employees. It is usually illegal and runs afoul of the Utah Workers Compensation Act and US Dept of Labor rules.

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321 N. Mall Dr. R-251
St George UT 84790

The goal is to give more clients in St George, Washington, and Hurricane convenient access to legal advice for their workers compensation, probate or adoption questions. The Cedar City office will continue to serve clients from Iron, Beaver, Garfield and Sevier Counties. To ask a question or schedule an appointment, call or text me at (435) 592-1235.

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Nevertheless, this insurance medical exam is a crucial point in your workers compensation claim; it is how the insurance company often obtains “evidence” to justify denying any further benefits. Usually, the adjustor will not send you a copy of the doctor’s report. Rather, the adjustor will send you a denial letter summarizing what the insurance doctor said. Then the adjustor will terminate benefits. (Hence the wise advice to save some money for a “rainy day”.)

So, if the workers compensation adjustor has notified you that you have an appointment with the insurance company’s doctor, feel free to call me with any questions you may have. I offer a free 20-minute phone consultation.

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Have a question? Call me at (435) 592-1235 or visit www.timothydanielslaw.com.

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