Worker's Comp- update

BrittanyCupcakes · June 2013

BF is still in a lot of pain. He's been to the doctor three times now. I'm not really sure what they're doing, other than evaluating his limitations, writing prescriptions, and scheduling follow-ups.

They were saying it's a muscle tear. Today he went in for another follow up. He's been losing feeling in his right foot now, and the doctor noticed that his hips are now crooked, so they're sending him to physical therapy. I don't like that they haven't even looked for a diagnosis.

We got a big packet in the mail today with all the details of worker's comp, including choosing his own doctor, getting a second opinion, etc. So we'll be trying to figure that all out this weekend- finding another doctor and hopefully getting some answers.

The last time he talked to someone from work (I don't know if it was an HR person or if it was the nurse), they said he had to deal with their claims department from that point on, mentioned that the claims department would have to look into the case and make a decision on whether he could keep his job. That sent up red flags. He did contact a lawyer after that discussion, although we'd still prefer to avoid that route if we can. I'm an optimistic person, and I'd like to believe that the company will do the right thing, within the law, and we won't need to take legal action. But I'm not naive and I know that's still a big possibility.

I keep hoping he'll feel better soon and will be able to return to work and everything will be fine. He's so grumpy these days from being bored and in pain. He's missed nearly a full week of work now. Since they haven't really told him what's wrong with him, we have no idea what we can expect. He'll have two weeks of physical therapy before his next follow up appointment and then they'll determine if he can return to work.

HFrizzle · June 2013

Have they done any diagnostic tests, like an MRI? I would definitely be looking into getting a second opinion if they haven't.

BrittanyCupcakes · June 2013

As far as I know, nothing except an Xray. We're going to work on getting a second opinion this weekend. I don't know how they expect physical therapy to help when they don't even know what the problem is.

norbert5 · June 2013

Sounds like a really frustrating place to be in.

I agree with Hfrizzle. A second opinion with some diagnostics tests would be good. I would hope the company would not dismiss him so quickly after an injury.

CousinVicki · June 2013

i am , yet again, confused. wasn't he only there for a few days, and part-time?? most companies you have to be there for 90 days to get ANY kind of benefits, let alone be 'guaranteed' your job? it's not like he was there for years?

who is paying for your lawyer? your pet photography job?

Jalee85 · June 2013

As far as I know if would fall on his previous employer if he was there for over 6 months...but the rules maybe changed I'm not sure!

CousinVicki · June 2013

Jalee85:
As far as I know if would fall on his previous employer if he was there for over 6 months...but the rules maybe changed I'm not sure!

i don't think he had a previous job? ha

are you LOOKING to sue? maybe get some fast money? this would solve a lot of your problems, and BF can go back to well, doing nothing. sounds fishier and fishier!

Jalee85 · June 2013

Actually, I may be thinking of if you lose your job not workman's comp...sorry I got my terms mixed up! Its been a long day!

BrittanyCupcakes · June 2013

CV if you actually read the words I wrote, you'd see that we want to avoid taking legal action. We're not looking for a lawsuit. We just expect the company to cover his medical expenses related to this injury, and that he'll have a job once he's able to return to work. We have not retained a lawyer, and do not plan to unless we have to. Asking questions to understand his rights and options is completely different than hiring a lawyer to sue someone.

It only sounds fishy if you twist my words. We can't have the lifestyle we hope to have someday unless he is able to work. I grew up with a disabled father, and that is the last thing I want for my daughter. I want her father to be able to be there for her big moments. I want him to be able to sit in a chair long enough to attend her high school graduation. I want her to learn by example that we can get where we want in life through hard work. Nobody is looking for a payout here.

And I apologize if it comes across as attentionseeking by posting about this here. I posted the first thread because I had a few questions and was looking for input. I posted this thread because I wanted to update anyone who might be interested in finding out what was going on. That's all.

jnsmith85 · June 2013

BrittanyCupcakes:
CV if you actually read the words I wrote, you'd see that we want to avoid taking legal action. We're not looking for a lawsuit. We just expect the company to cover his medical expenses related to this injury, and that he'll have a job once he's able to return to work. We have not retained a lawyer, and do not plan to unless we have to. Asking questions to understand his rights and options is completely different than hiring a lawyer to sue someone.

It only sounds fishy if you twist my words. We can't have the lifestyle we hope to have someday unless he is able to work. I grew up with a disabled father, and that is the last thing I want for my daughter. I want her father to be able to be there for her big moments. I want him to be able to sit in a chair long enough to attend her high school graduation. I want her to learn by example that we can get where we want in life through hard work. Nobody is looking for a payout here.

And I apologize if it comes across as attentionseeking by posting about this here. I posted the first thread because I had a few questions and was looking for input. I posted this thread because I wanted to update anyone who might be interested in finding out what was going on. That's all.

You didn't come across as attention seeking or whatever else it was that cousinvicki said you were doing. Don't worry about her!! I hope it all works out for y'all. I can just imagine the huge amount of stress it is putting on you during your pregnancy!!!

shelliescove3 · June 2013

Keep us posted with diagnosis and things! Good luck this weekend!!!

bkeane619 · June 2013

CV is bein a nudge. Hope you get some answers soon. I hope he can keep his job. As for lost pay I think he isn't eligible for short term disability till he works for 90 days so that sucks. Good luck this weekend.

BrittanyCupcakes · June 2013

mmgkms:
bkeane619:
CV is bein a nudge. Hope you get some answers soon. I hope he can keep his job. As for lost pay I think he isn't eligible for short term disability till he works for 90 days so that sucks. Good luck this weekend.
Agreed. CV seemed to be on a roll last night lol Brittany, ignore the shoddy detective work, and I hope everything gets better for you and your BF.

Thanks. He was told he'd be receiving short term disability, 2/3 of his weekly pay. Of course, now they're saying that they only agreed to give him 15 hours per week when he was hired, versus the 20 hours he was told (and scheduled for), and so they're going off of 2/3 of 15 hours. His contract doesn't say anything about minimum hours, so we're SOL there. We're going to have to make it work in the meantime, but I'm going to have to completely re-do our budget, since that makes a huge difference when things are as tight as they are. I know we'll find a way to manage.

scamberlous3000 · June 2013

CousinVicki:
Jalee85:
As far as I know if would fall on his previous employer if he was there for over 6 months...but the rules maybe changed I'm not sure!
 i don't think he had a previous job? ha
 are you LOOKING to sue?  maybe get some fast money? this would solve a lot of your problems, and BF can go back to well, doing nothing.  sounds fishier and fishier! 

I don't think this is very fair. I've been in a very similar situation, and sometimes it's necessary to lawyer up in order to get the medical care you need. With my situation, I had no choice. The WC insurance company denied me necessary medical attention and tried to settle for 5,000 with no future medical coverage, and if I hadn't lawyered up I would be about 200,000 in the hole. I didn't see a penny of that. It went straight towards paying my hospital and surgery bills.

The fact that he hasn't been given or scheduled for an MRI yet with a back injury is a HUGE red flag that something is already amiss. Plus, from a legal standpoint, a WC case is NOT a way to make fast money. It is a very long and drawn out process that takes years and, in my state, your payout is solely based on how much you were earning in the first place. So, if he was making an hourly rate, his WC would be based off that and it would be virtually impossible to get a huge settlement unless he was deemed permanently disabled, which isn't likely.

Mostly, with WC cases, patients are seeking for their medical bills to be covered not for a huge settlement which probably wouldn't happen with this case. Plus, when you're dealing with your SPINE why wouldn't they want to do everything in they're power to protect their health?

I'm sorry, but if you've never experienced a back injury with all of the joys that come along with it including excruciating pain, numbness, sciatica, unrelenting discomfort, and the inability to participate in normal, everyday activities such as lifting groceries into the car or even YOUR CHILD then you, CV, dont have a leg to stand on here. Back injuries are no joke and should not be taken lightly regardless of if he was hurt while working a fulltime or part time position.

huntjul · June 2013

My understanding of worker's compensation is that it pays your medical expenses if the injury was on "clock time" but NOT that you 100% get to keep your job. If you can't do your job (and aren't expected to be able to return to it in a timely fashion), they don't have to continue your employment. That is where long term disability kicks in to pay you - not worker's comp.

But I could be wrong here.

scamberlous3000 · June 2013

huntjul:
My understanding of worker's compensation is that it pays your medical expenses if the injury was on "clock time" but NOT that you 100 get to keep your job.nbsp; If you can't do your job and aren't expected to be able to return to it in a timely fashion, they don't have to continue your employment.nbsp; That is where long term disability kicks in to pay you not worker's comp.But I could be wrong here.

I think you're right and it it all varies by state, but I'm pretty sure that, after a certain amount of time has passed, your position with the company is not guaranteed.

jorkz821 · June 2013

huntjul:
My understanding of worker's compensation is that it pays your medical expenses if the injury was on "clock time" but NOT that you 100 get to keep your job.nbsp; If you can't do your job and aren't expected to be able to return to it in a timely fashion, they don't have to continue your employment.nbsp; That is where long term disability kicks in to pay you not worker's comp.But I could be wrong here.

Thats what I thought too.

sooner1981 · June 2013

BrittanyCupcakes:

BF is still in a lot of pain. He's been to the doctor three times now. I'm not really sure what they're doing, other than evaluating his limitations, writing prescriptions, and scheduling follow-ups.

Just because you are not sure what they are doing at the doctors appointments doesn't mean that they are not doing anything. The important things that are happening are what you are listing--they are evaluating his recovery, they are making sure his pain is adequately controlled, and ensuring that he receives follow-up care. Back pain is a tricky area, because most back injuries do not require "active treatment" to heal. They just require rest and anti-inflammatory medication to help calm the muscle down and allow it to repair.

Please keep in mind that with back injuries, more treatment is almost always NOT better. I work in employment law and see SO many instances of people who had some back pain from a work-related injury, they get into the workers' comp. system and then they get over treated. Over x-rayed and over scanned (which can increase your later cancer risks, depending on what kinds of scans are used), over treated with pain pills that they become addicted to when prescription-grade ibuprofen would have been sufficient, and over treated and encouraged to get all sorts of exploratory back surgeries, even fusions and other extremely risky procedures that cause permanent disability or restrictions, due to over eagerness on everybody's part (the patient and the doctor) to "get the problem solved." The neuro/spine experts that I have talked to over the years on these cases routinely say that overtreatment causes more disability than the actual injuries themselves. So be so careful if you start hearing talks of escalating treatment.

They were saying it's a muscle tear. Today he went in for another follow up. He's been losing feeling in his right foot now, and the doctor noticed that his hips are now crooked, so they're sending him to physical therapy. I don't like that they haven't even looked for a diagnosis.

The "diagnosis" that they have given him is a torn muscle. This can cause radiating pain. The hips being crooked and weirdness in his foot can be caused by how he is holding himself to compensate for the pain on one side of his body. All our systems are connected, so if he is really hurting in his back, that affects how he holds himself and which muscles he is now relying on--which causes all sorts of alignment issues. Physical therapy seems like a great next step--and again, it is non-invasive, doesn't expose him to radiation, is conservative, and fully paid by workers' comp. benefits, so it is provided at no cost to him. Why would he not want to take advantage of that?

We got a big packet in the mail today with all the details of worker's comp, including choosing his own doctor, getting a second opinion, etc. So we'll be trying to figure that all out this weekend- finding another doctor and hopefully getting some answers.

Why is he unhappy with the doctor he is seeing? He got injured one week ago today, and has already been to 3-4 follow up visits and received a referral for physical therapy. What do you want to hear from another doctor? Is he searching for stronger pain control--if so, have him talk to this doctor who he is in almost daily contact with. Is he wondering why his recovery is taking so long? Again, he was injured seven days ago--recovery from muscle tears, especially in big muscles like the back, usually take longer than 7 days. What is he hoping to get out of a second opinion?

The last time he talked to someone from work (I don't know if it was an HR person or if it was the nurse), they said he had to deal with their claims department from that point on, mentioned that the claims department would have to look into the case and make a decision on whether he could keep his job. That sent up red flags. He did contact a lawyer after that discussion, although we'd still prefer to avoid that route if we can. I'm an optimistic person, and I'd like to believe that the company will do the right thing, within the law, and we won't need to take legal action. But I'm not naive and I know that's still a big possibility.

By law, your boyfriend has to talk to the workers' compensation claims department to coordinate his treatment. His employer cannot do that, or they would risk being sued by your boyfriend for not informing him of all his available benefits. They are not trying to hide the ball--they are just following the rules.

In most states, if an employee is injured and suffers permanent disability/restrictions (can no longer lift more than x number of pounds and the job requires heavy lifting or activity), the employer can absolutely terminate the person's employment because they no longer satisfy the base requirements for the job. At that point, they would need to rely on long-term disability, if they have signed up for those policies. Employers are not required to keep their payrolls full of people who are not able to do the work that they were hired for. That being said, in most states, they cannot fire him just because he is injured while he is in treatment and recovering. Again, once he is in the workers' compensation system, it is out of the employer's control.

At some point, your boyfriend will reach MMI (maximum medical improvement). At that point, he will either go back to work with no restrictions or have some degree of permanent disability. If he has no restrictions, the employer will take him back and he will continue to have a job.

If he has restrictions and those restrictions don't allow him to do his former job, he will likely be terminated at that point. He can then seek "benefits" through the workers' compensation system for his restricted earning capacity. But this is a very last ditch deal--and it is not the gold mine that so many people think it is. For example, in my state, if you lose three fingers from a hand in an accident, it will probably prevent you from doing most manual jobs--however, those three fingers, combined, will get you about 55 weeks of comp. benefits. So, if you were working 15 hours a week at 10 bucks an hour ($150/week expected income), that would be $100/week of comp. benefits (2/3 of regular weekly income). 55 weeks of payments for your missing three fingers would give you a lump sum total of $5,500 for those three fingers (along with getting all your medical bills paid for--which is really the point of the workers' compensation system). Of that $5,500, if you had lawyered up, you would have to pay your lawyer a certain percentage of your settlement.

Now, this is just my state--every state is different. But there is virtually no way of "coming out on top" by milking a workers' compensation claim--again, the faster you can get in and out, the better for everyone involved.

I keep hoping he'll feel better soon and will be able to return to work and everything will be fine. He's so grumpy these days from being bored and in pain. He's missed nearly a full week of work now. Since they haven't really told him what's wrong with him, we have no idea what we can expect. He'll have two weeks of physical therapy before his next follow up appointment and then they'll determine if he can return to work.

I would bet that the two weeks of physical therapy and additional rest during these next two weeks will bring him relief and he will start seeing some improvement. If he does not have any improvement, then I am sure your doctor will, at that point, start looking into further treatment options--but just remember, conservative treatment is almost ALWAYS better with back pain. Don't get sucked into a situation that he can't get out of and winds up permanently restricted at age 25 due to overly-agressive treatment. Because regardless of the treatment he receives, he is not going to get any greater cash compensation--all that w/c money only goes to the doctors and surgeons.

Hope that helps! And I hope he starts to feel better soon--my brother and dad are both plagued with bad backs and they are sometimes completely down and out with spasms and unable to get out of bed. They always recover after a few days of rest and aleve/ibuprofen and go on to live their lives pain free on most days.

sooner1981 · June 2013

Bump burp.

CousinVicki · June 2013

he wants to keep a 15 hour per week job??? time to start looking for full time!

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