Prosthetic Limb Denials: What Happens if Your Insurer Refuses to Act in Good Faith?

Advances in prosthetic limbs have given amputees a chance at resuming a higher quality of life. However, some insurers have denied coverage for prosthetics for bad faith reasons.

Losing a limb can be a devastating experience. However, modern medicine has advanced to the point where amputees can recover much of their former functionality with prosthetic limbs. Decades ago, people with older prosthetic limbs struggled to do many of the activities they loved (such as playing sports or hiking) because those older devices were less natural, less comfortable and did not move in a life-like manner.

Today, however, cutting-edge prosthetic limbs with microprocessors can help wearers walk fluidly and provide much greater stability. This can allow them to live a life that is close to the one they enjoyed before they required an amputation.

Unfortunately, insurers have not always acted in good faith when asked to provide coverage for these advanced prostheses.

Despite the myriad advantages offered by advanced prosthetic limbs, some insurers have immediately denied claims, consigning policy holders to a lower quality of life with an inferior prosthetic.

How the Law Helps People Get Access to High Quality Prosthetics

Our law firm has helped amputees who have been denied coverage for advanced prosthetics. One example: Blue Cross Insurance denied a claim for an advanced “C leg” prosthetic by claiming the technology is “experimental and investigational.” However, these limbs have been recognized as a standard device for more than a decade and are offered to all U.S. soldiers who require an amputation.

Our firm also represented a teacher who requested an advanced, myoeletric artificial arm because it provided much greater dexterity – something she needed to write on blackboards and fulfill other core parts of her job.

A third client of our firm, an actor and father of young children who required an arm amputation, was initially given a prosthetic with a hook for a hand. His insurer denied his claim for an advanced myoeletric arm. With the more primitive prosthetic, this man could not secure acting jobs or play with his children.

In these cases, settlements with the insurer were secured providing access to the advanced limb. Our firm was also able to secure an additional financial payout for damages. In the latter two cases, damages of more than $400,000 were agreed upon.

Fighting Bad Faith Denials

While insurers such as Blue Cross characterize the limbs as experimental and unnecessary, the truth is they are well-established and offer vastly better performance. Because they are more expensive, however, these claims sometimes are denied.

When this happens, it is critically important to work with a law firm that has deep experience in amputee litigation. This experience plays a key role in helping law firms handle the tough, complex cases and negotiations that often arise because of coverage denials.

Investigation Into the Conception Fire Shows Serious Safety Flaws; Boat Owners File Petition to Avoid Liability

A preliminary investigation by the U.S. Coast Guard and the Bureau of Alcohol, Tobacco, Firearms and Explosives reportedly shows that serious safety deficiencies may have caused or contributed to the Conception boat fire.

The fire, which killed 34 people, was the worst maritime disaster in California history. The passengers on the Conception had signed up for a multi-day scuba diving excursion and became trapped under the flames while sleeping below deck.

The investigation concluded that the Conception lacked a key safety measure: A “roaming night watchman.” The night watchman is typically required to walk the ship and alert passengers and crew if a fire or any other threat develops. The investigation also raised questions about whether the crew was properly trained and whether the passengers were given an adequate safety briefing, according to the Los Angeles Times.

While no criminal charges have been issued, officials from the U.S. Attorney’s Office have been on scene and have been coordinating with the investigation. According to The Times, a federal law known as “Seaman’s Manslaughter” was invoked to issue criminal charges against a Missouri duck boat captain involved in a high-profile sinking that cost 17 lives in 2018. The captain of that boat was charged with recklessly failing to assess the weather, steer the vehicle and advise passengers on proper procedures for abandoning ship.

The U.S. Coast Guard also oversaw the investigation that resulted in those charges. Another agency, the National Transportation Safety Board, is also investigating the Conception tragedy,

Jennifer Homendy, who is leading that investigation, told The Times that surviving crew members said the fire was burning too hot to save any passengers.

“What’s emerging from the interviews is a harrowing story of the last few minutes before the boat was engulfed in flames,” she said. “They felt that they had done what they could do in a very panicked situation.”

Boat Owner Files Petition to Limit Liability

As the investigation into the fire continues, the owners of the Conception are citing a 19th century maritime law to argue that they should not be held financially liable for the incident.

The attorneys for Glen and Dana Fritzler, owners of Truth Aquatics, filed a court petition on Sept. 5 asking a judge to rule out the possibility of having to pay the families of victims compensation for their losses.

The law in question, the Limitation of Liability Act of 1851, has been used repeatedly over the years to limit payouts to victims. The Titanic, the Deepwater Horizon and 2018’s duck boat tragedy are all examples of disaster where the law was invoked.

By filing the petition, the owners of the boat preclude state-level litigation against them, as all claims will not be routed to federal court. According to The Times, this maneuver represents a significant victory for the boat owners and their insurance company — despite timing that may seem quite callous to most observers.

Finding the Right Attorney

If you (or someone you love) has been injured through the negligence of another party, it’s imperative that you seek immediate legal action. By moving quickly, you can help ensure that you aren’t outmaneuvered by negligent parties and their insurance companies.

My employer in Los Angeles will not pay me for all of the hours I have worked. Can I sue my employer?

Most employers in Los Angeles pay their employees all of the wages to which they are entitled. However, unfortunately there are always going to be some dishonest employers who take advantage of employees. They may refuse to pay their employees for all the pay they have earned, which includes not only regular wages, but also vacation time, sick time, overtime, and bonuses. This most often happens when the employees are in a vulnerable position, such as if they do not speak English well or if they are in the U.S. illegally.

If an employee is not paid all of his or her wages, the employee has the right to sue his or her employer. Normally, an employee should consult with an employment attorney, who can help protect the employee’s legal rights.

Some common examples of the law include when workers are not given meal breaks or rest breaks, are not paid enough for overtime, are not paid for all of the hours they work, are not paid for bonuses and commissions earned, and are not paid for all of their unused vacation time when they leave the company. Another very common violation of the law is when an employee is mischaracterized as an independent contractor instead of an employee. This can help employees get out of their legal obligations to their workers.

If you are in Los Angeles and you believe that your legal rights have been violated by your employer, you should speak with an employment attorney. Call me, Conal Doyle, Los Angeles employment attorney, at 310-385-0567. I can help. Call today to learn more or to schedule a free consultation.

My parent choked in a nursing home in Los Angeles. What are my legal options?

I’m so sorry to hear about your parent’s incident at the nursing home. Choking can be scary for anyone, but especially an elderly person in a nursing home. If your parent was harmed as a result of the accident, you may wish to speak with an attorney about your legal options.

Unfortunately, many nursing homes do not correctly supervise or monitor the food intake of patients. Many nursing home residents are on restrictive diets because they have difficulty swallowing. If a nursing home fails to enforce diet restrictions or does not properly monitor a patient while he or she is eating, there is a risk of choking.

Many elderly and disabled patients have swallowing disabilities. There are a number of physical conditions that can interfere with swallowing, such as cancer, Alzheimer’s or dementia, neurological disorders, or simply aging. Normally, a physician will determine the issue and make a recommendation on what the patient can eat and in what form. If a patient with a swallowing disorder is not closely watched or does not have a restricted diet, choking and asphyxiation can occur. Many choking incidents at nursing homes could have been easily prevented if the doctors had followed medical orders.

If your parent has suffered harm as a result of a choking incident in a nursing home, you should speak with an attorney. Call me, Conal Doyle, Los Angeles medical malpractice attorney, at 310-385-0567. I can help. Call today to learn more or to schedule a free consultation.

Lyft Claims Not in the Transportation Business to Avoid ADA

Recently in court, Lyft claimed that it was a technology company, not a transportation company. The move was taken in order to avoid being subject to the Americans with Disabilities Act.

This arose from a class-action lawsuit that was filed in 2017 against Lyft by a woman who claims that the company’s failure to serve people with disabilities is illegal. The lawsuit was filed in federal court, and comes after a settlement with New York City in which Uber, Lyft, and Via agreed to service at least 80 percent of requests for wheelchair-accessible vehicles in under 10 minutes and 90 percent in under 15 minutes by mid-2021.

Lyft is claiming in court that it is in the business of providing an app, not transportation. However, it’s facing other lawsuits as well, one of which is in California, that claim that the company is discriminating against people with disabilities.

Lyft and Uber have been hit with lawsuits on multiple fronts in recent years. Both companies have been sued many times by passengers who claim they have been physically or sexually assaulted. They have also been sued by passengers who have been seriously injured in accidents. The companies have also been under attack by drivers who claim they are employees instead of independent contractors. Finally, many local governments have been taking actions against the companies on a variety of issues.

As ride share companies continue to grow, laws surrounding their operations will continue to expand. If you have been harmed as a result of riding in an Uber or a Lyft vehicle, you should speak with an attorney. If you’re in Los Angeles, call me, Conal Doyle, Los Angeles personal injury attorney, at 310-385-0567. I will provide you with a free consultation on your case. Call today to learn more.

What should I do if I have been injured in an automobile accident in Los Angeles?

I’m sorry to hear that you have suffered injuries in a Los Angeles automobile accident. You most likely feel like your life has gotten turned upside down. If your injuries are serious, you may be unable to work and you may have mounting medical expenses. Your vehicle may not be able to be driven.

Accidents in Los Angeles occur for a few common reasons. The biggest is error by one or more drivers. Many drivers drive while they are distracted by cell phones. Driving while under the influence of alcohol or drugs is another common cause of accidents. Driving aggressively and speeding also cause thousands of accidents every year. Beside driver error, mechanical issues and bad weather also cause automobile accidents.

If you have been involved in an automobile accident in Los Angeles, you have the right to compensation for your injuries. There are some steps you should take in order to get the highest amount of compensation to which you are entitled. First, you should let your insurance company know about the accident right away. You should be honest with your insurer, but do not admit fault. Also, let the police know about the accident, but do not admit fault. Get a copy of the police report after the accident. You should also obtain the other driver’s contact information and insurance information. If there are any eyewitnesses, get their contact information. If you suffered any injuries, no matter how minor, seek medical attention.

You should also seek legal help as soon as possible after the accident. An attorney can help you pursue the case so that you can spend your time on your recovery. Call me, Conal Doyle, Los Angeles personal injury attorney, at 310-385-0567. My team can help.

My mother is in a Los Angeles nursing home and she was given the wrong prescription medication. Can she sue for medical malpractice?

I’m very sorry to hear about your mother’s issues at the nursing home. Unfortunately, medication errors are common, not only in nursing homes, but also across all patient demographics. Often, when a medication error occurs in a nursing home, it occurs because a doctor prescribed the wrong medication or the wrong dosage. In some cases, there may have been an error in the way the drug was administered.

If you want to sue for medical malpractice after your mother was given the wrong drug in a nursing home, your parent must have suffered harm as a result of being given the wrong drug. If your mother was given the wrong drug or wrong dosage but had no side effects or only minor side effects, a medical malpractice case will be very difficult. If your parent suffered death or serious injury as a result of the drug, it is important that the error be traced to its source. That is one reason why it is important to pursue the case as soon as possible after the error occurred.

There are a lot of reasons why medication errors can occur in a nursing home setting. Nursing homes are frequently understaffed. Patients may have issues communicating. Doctors may be rushed and may fail to get a patient’s complete medical history. Nurses may be rushed as well, which can make it difficult to take the time to ensure a patient is getting the correct medication at the correct dose.

If your mother was harmed at a nursing home because of a medication error, you should speak with an attorney. An attorney can help you pursue the compensation your mother deserves. If she is in Los Angeles, call me, Conal Doyle, Los Angeles nursing home malpractice attorney at 310-385-0567. I can help. Call today to learn more or to schedule a free consultation.

I was injured by police in Los Angeles. Can I sue the police department?

I am very sorry to hear that you were injured by the LAPD. The police have tough jobs, and with those jobs come a lot of power to benefit society. Most officers use that power wisely. However, some police officers take advantage of their positions.

Police officers are under a lot of stress, which sometimes involve violence. In many cases, police are justified in using a lot of force in arresting a suspect. Sometimes the public may believe that the force is excessive but may be what is required under the circumstances.

However, sometimes police officers do step over the line and abuse their power. The agency responsible for training the officer can be held responsible if the conduct was a result of a policy or custom. The agency can also be held responsible if it failed to properly train their officers to handle the situation. Also, in some cases people get hired as officers who should not have been hired. If that occurs, the agency responsible for hiring the officer could be held liable for damages.

If you have been mistreated by the police in Los Angeles, it is important that you find an attorney experienced in police misconduct to handle your case. Call me, Conal Doyle, Los Angeles personal injury attorney, at 310-385-0567. My team can help. Call today to learn more or to schedule your free consultation.

My religion prevents me from working a lot of holidays and my employer fired me in Los Angeles. Is that legal?

I am sorry to hear that you were fired because of your religion. Treating someone differently in the workplace because of his or her religion is illegal under both federal and state law. Under federal law, Title VII of the Civil Rights Act of 1964 makes religious discrimination illegal in the workplace. Under California law, the Fair Employment and Housing Act makes workplace religious discrimination illegal.

The laws also require employers to reasonably accommodate an employee’s religious beliefs. This could include changing schedules for religious events. However, an employer does not have to completely alter the business in order to accommodate an employee. The law only requires that the employer reasonably accommodate an employee’s religious practices. An employer isn’t required to accommodate any requests that would cause more than a minimal burden on the employer’s business. If an employee is vital to a business and the breaks that he or she needs off for religious holidays cannot be worked around, the employer is not required to allow the time off. However, if a simple schedule change can be accommodated, the employer is required to do so. Employees who are discriminated against at work because of their religion practices have a short period of time in which to make a complaint with state and federal officials. Also, there is a limited time in which to file a lawsuit over religious discrimination. If you believe you were discriminated against on the basis of religion, you should call an employment attorney as soon as possible. If you’re in Los Angeles, call me, Conal Doyle, Los Angeles employment discrimination attorney at 310-385-0567. I can help. Call today to learn more or to schedule a free consultation.

I was visiting Los Angeles as a tourist and I suffered serious injuries. What are my legal options?

There are millions of visitors to Los Angeles each year. Some visit for the beautiful scenery, the Hollywood scene, nightlife, sporting events, or tourist attractions. Others may be visiting family members or friends or may be in town on business. Visitors to Los Angeles face many of the same dangers that people who live in L.A. face.

Some common accidents that tourists may experience include automobile accidents, rideshare accidents, taxi accidents, accidents involving public transportation, slips and falls on someone else’s property, and injuries as pedestrians or bicyclists. Unfortunately, when tourists are injured, insurance companies may try to take advantage of the accident victim. The insurance company may believe that tourists who are injured are unwilling or unable to come back to the city to pursue a claim, so they may make intentionally low offers to settle the case.

An experienced personal injury attorney can help an accident victim understand what his or her case is worth, and to what damages the accident victim is entitled under law. An attorney can help resolve the situation with the insurance company. If the parties are able to settle, the accident victim would most likely not have to come back to Los Angeles. However, if a lawsuit is required, the accident victim may need to come back to Los Angeles at various points during the case.

Before you settle an accident case for an artificially low amount just because you don’t live in Los Angeles, you should speak with an attorney. Call me, Conal Doyle, Los Angeles personal injury attorney, at 310-385-0567. I can help. Call today to learn more or to schedule a free consultation on your case.