A Message to Insurance Companies, Self-Insureds and Others: Some of Your Lawyers Aren’t Always On Your Side

Imagine that one of the law firms that you hire to defend you and your insureds wants you to pay more, a lot more. It’s true.

One law firm proudly states that it defends employers, self-insureds, and [insurance] carriers in matters involving workers’ compensation, auto claims, slips and falls, and many other types of personal injury lawsuits.

But whose side are they really on? After all, this law firm wants to void and eliminate all medical fees schedules based on Medicare and other non-Pennsylvania guidelines, thus increasing the amount that its clients would have to pay for medical care, and even for future medical care in some cases.

You don’t have to imagine it. It’s true.

This Pennsylvania-based insurance defense firm is arguing in a case in the Commonwealth appeals Court that every fee schedule based on an outside formula is unconstitutional. This means that according to a law firm that exclusively represents insurance companies, employers and self-insureds, the fee schedules that they use to determine how much to:

  • Pay for medical bills
  • Pay for hospital bills
  • Pay for medical tests
  • Pay for diagnostic tests
  • Pay for medical equipment
  • Pay for pharmaceuticals, and
  • Pay for every other type of medical care

would be void (in other words – all of these fee schedules would be eliminated) if they were based on a Medicare fee schedule, the Red Book for medications/pharmaceuticals, and any other guidelines that the Pennsylvania legislature did not create.

That’s right, every doctor, every hospital, and every type of medical provider could charge and would be entitled to be paid whatever amount it asked for based on this logic. I am certain that insurance companies would be thrilled to know that their lawyers are taking a position that would cost them millions, all because they don’t like how a small group of pharmacies is compensated under the Pennsylvania Workers’ Compensation Act for dispensing medication to help injured workers deal with pain without exposing them to cheap, addictive opioids.

Here is what the firm wrote in their Commonwealth Court brief:

It was unconstitutional for the legislature to delegate the law on pricing of pharmaceuticals to a private company without providing that company with any policy direction, limits, or guidance, and with the ability of that private company to change the rules at rates at its whim, in secrecy, and without legislative review.

Analogously, this also means that it is unconstitutional for the legislature to delegate the law on pricing of medications and other care to Medicare without providing any policy direction, limits, or guidance, and with the ability of Medicare to change rates at its whim, in secrecy, and without legislative review.

Our office does not and never will represent insurance companies, we represent injured workers, victims of auto accidents, slips and falls and other negligence. We also recognize that fee schedules are necessary, and that they are best when derived from reputable sources like Medicare and the Red Book. Otherwise, the cost of medical care would have no boundaries.

Imagine that.

Attorney Daniel Siegel Named 2019 Influencer of the Law by Philadelphia Inquirer

2019 Influencers of Law Awards – Attorney Dan Siegel One of Two Honorees in Personal Injury Category

Havertown Personal Injury, Appellate and Ethics Attorney Daniel J. Siegel has been named a 2019 Influencer of the Law by the Philadelphia Inquirer, one of only two honorees in the category. Dan will receive his award Tuesday, March 26th, at the Crystal Tea Room in Philadelphia, PA.

As a winner, Dan Siegel was selected by Inquirer readers and evaluated by an expert panel of judges who felt he shaped, changed, and transformed the legal industry. Dan was one of 54 winners who will be honored at the awards ceremony; he was profiled in a special section of the Sunday Inquirer today, which will reach nearly 1 million readers.

The Inquirer described Dan Siegel’s accomplishments and summarized some of his community service:

“Attorney Dan Siegel’s cases have changed the law, and either preserved or extended the rights of countless persons injured at work, on the job, and in other ways. Dan is a recognized leader in the local, regional, and national legal communities. For example, he is a pioneer in the emerging area of the intersection of technology and legal ethics, and his firm is the first in the nation to offer Technoethics guidance to lawyers. In addition, he is the author of 13 books, including treatises on workers’ compensation, legal ethics, law practice management and efficiency and time management.

“Dan serves the community in many ways. He has served as a Commissioner in Haverford Township since 1988, and is recognized for his success in bringing transparency to the community; his efforts have also led to the Township’s adoption of emerging technologies, and its focused replacement of its aging infrastructure. Among his community efforts, he has been pro bono counsel to the Foundation for Ichthyosis and Related Skin Types for over 20 years.”

The Influencers of the Law program will feature opening remarks by Terry Egger, Publisher and Chief Executive Officer at the Philadelphia Inquirer. The program will also feature a fireside chat with Pennsylvania Attorney General Josh Shapiro.

Another Appellate Victory – Case Was Dismissed, Now the Plaintiff Gets His Date in Court

Our client had been represented by another attorney in this New Jersey premises liability/slip and fall case. Not surprisingly, the defendant filed a Motion to Dismiss alleging that our client had not presented sufficient evidence to let a jury decide his case. The trial court judge agreed and dismissed the case.

Fortunately, the client then hired us (at the referral of his personal attorney) to file and handle the appeal. And today the New Jersey Superior Court, Appellate Division, agreed that the trial court had erred by dismissing the case, and reversed its decision. Our client now has his day in court, where we will also represent him. After all, while we handle lots of appeals, we also are ready and able to handle cases from start to finish.

Last year, we won 94% of the appeals and motions we handled, and while we haven’t compiled the statistics for 2018, we are confident that our rate of success will continue to be far better than average. Why? Our team works to assure that we address all of the key issues in a persuasive manner. We summed up this case as follows:

By granting Defendant’s Motion, the Court removed the jury’s right to make credibility determinations (1) whether Defendant Voorhees had actual or constructive knowledge of the dangerous condition home, (2) whether Plaintiff adequately identified the nature of his fall on the garage stairs, and (3) about the weight, if any, to be given to the building codes identified in Plaintiffs’ expert report. Thus, the trial court abused its discretion by impermissibly engaging in fact-finding and making credibility determinations.

Thanks to our team, Attorneys Nicole Kratzer (who helped me prepare the brief) and Christa Frank High (who argued the appeal), for this great victory. Now our client will have his day in court.

Click here to read the New Jersey Appellate Division Opinion.

 

Hamlet & Lawyer Advertising

Ah Hamlet, the famous line, “The lady doth protest too much, methinks,” came to mind last in the context of lawyers, lawyer advertising, and the Rules of Ethics. As many people know, the majority of our firm’s clients are lawyers and law firms, who trust us to provide ethical guidance, as well as representation before the Disciplinary Board of the Pennsylvania Supreme Court. I also write and lecture about ethics for various publications legal. One of my most recent ethics columns, in The Philadelphia Lawyer, the Philadelphia Bar Association’s award-winning magazine, discussed changes to the American Bar Association Model Rules of Professional Conduct relating to attorney advertising. My opinion was that because no attorney has ever been disciplined for violating the advertising rules, changing them (and making them far weaker in my opinion) would be a meaningless gesture.

Click here to read my column. You can come to your own conclusion.

One lawyer read the column and accused me of  “using a professional periodical to serve [my] own agenda. It also seems like an attempt to at best criticize our Firm/your competitors, and at worst defame them for being unethical and violating the rules of professional responsibility.”

My agenda, as I responded, is “that we should have Rules that are enforced, enforceable, and complied with.” Lots of Rules apply to lawyers; in fact everything we do involves Rules. Yet it remains my belief that the advertising Rules aren’t enforced. As my column noted, “Examination of the published disciplinary decisions on the Pennsylvania Supreme Court website confirms the absence of any public discipline for advertising rules violations.” In other words, no lawyers have ever been publicly disciplined for violating the Pennsylvania advertising Rules.

I then asked a few people if they thought my article was directed at any firm, any practice area, or any identifiable group other than lawyers whose advertisements appear to be contrary to the Rules. They thought my column was law firm neutral, and merely highlighted the opinion I have espoused for years. 

Thus, as one person noted, the lawyer doth protest too much.  

Oh, and ironically, one law firm I represent, for which I provide guidance about advertising content, including TV and radio, called for advice shortly after I heard from the other lawyer. They weren’t offended by my column.

I guess, again referring to Hamlet, it depends on whose petard is being hoisted.

Philadelphia Business Journal Honors Attorney Dan Siegel as “Best of the Bar” In Personal Injury Litigation

The Philadelphia Business Journal has named Attorney Daniel J. Siegel a “Best of the Bar” Honoree in the area of Plaintiff Personal Injury.

In addition to having great success with individual workers’ compensation and personal injury matters, Dan is being honored because of his numerous appellate victories over the past year, cases that have dramatically expanded the rights of injured workers and others.

Dan will receive his Award at a ceremony on Thursday, October 25th. He is one of only three personal injury attorneys being honored, and the only appellate lawyer being honored in this category.

Click here for more information.

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