workmans comp,




#1
so about 3 weeks ago i sprained my ankle at work, went to take a step and it just gave out, didn't slip or trip. work sent me to the ER because they thought it was broken ( i didnt want to go) had X-rays and what not ( no break) the next day my work sends me to there Dr he looks at it, asks me how it happened, after he looks at it he says, well seeings how you didn't trip and it just gave out, you can't get workman's comp. so i have to take my vacation because i can't walk on it very well, and my work says i cant come back till i have a note from my Dr. my Dr looks at it and says 100% this should be covered by workman's comp and i should take them to court, and i would have better off breaking it, it would have healed faster. anyway went back to work a few days ago, still stiff and it still hurts, don't have full range of motion, but I'm the only income for my family and we can't afford for me to be out of work, and short term dis doesn't pay enough for me to make my bills. the real issue I'm having now is that i just received the bill from the ER that was sent to my work then my HR sent it to me saying that it is my responsibility to pay for it, even tho they made me go. so does anyone know if there is anything i can do? the $700 from the ER sucks and i would never had gone if work hadn't mad me. any info would be great. Micah
 
#2
I'm out on comp right now myself. The Sate of Maine has Workers Compensation worker's advocates to assist workers that are out of work and in disagreement with the workers compensation provider that their employee uses. You need to contact the State Workers Compensation board here Maine Workers' Compensation Board: Advocate Division

they should be able to help you with your case. Just explain it to them the same way you did on here and you'll be fine. Good luck
 
#3
Your getting the shaft buddy. Have your employer tell you who they use for insurance. Contact them, if you don't get the response you're looking for contact the state comp, then a lawyer. Most do free consultations too. Just tread lightly, you don't want to be fired for some bogus reason.
 
#4
This is where they got you. went to take a step and it just gave out Then you told the Dr the same thing. I know you was at work but when you told them this that was their out. I do feel they should cover the bills but it a very fine line. They could claim that you done something to it before you got to work. Sorry but WC has got ways to get out of a lot of things. Good luck
 
#5
I investigate WC, I see a lot of stuff, I would suggest that you find a lawyer, consult with them (maybe a free consultation). Most places will make you go to the ER if injured to cover there a$$. The laws in each state are different, but you may be entitled to compensation for at the least the ER bill. I actually went through a lot last year with my own injury, you just gotta put in the leg work; its a game they play. Best of luck, Rub some chain lube into it and get back on the bike ;)
 

05 Busa LE

Donating Member
Registered
#6
Before you talk to anyone else, contact your local bar association for a referral to a reputable workers compensation law firm.
 

skydivr

Jumps from perfectly good Airplanes
Donating Member
#7
Does your employer not have a health insurance plan? Do you not have health insurance also? You can't just rely on workman's comp. If you had vacation time and you used it, how are you out any payroll?

I have been on the receiving end of fraudulent workman's comp claims a couple of times it was criminal how it was used. It's DEFINITELY skewed in the favor of the worker.

Having said that; I had to pay workman's comp for an employee who slipped and fell - but didn't mention he was horsing around trying to show someone a dance move when he did it. He was out for 2 months and got paid his full pay and medical expenses.

We had another employee try to claim that an injury brought back PTSD because he was Serbian, but he left the country long before the civil war started. Oh, and also claimed his PTSD prevented him from having sex with his wife....that was 5 years ago and he is STILL on disability...

OR, the employee who legitimately fell and broke his arm at work (which we paid for) but later filed for full disability - he was caught taking pain meds he was NOT proscribed. Why is the employer liable for that?

OR, the employee who ADMITTED to an officer of the company that he got hurt at home, but wanted to file for WC so that he would also get paid full salary - which is FRAUD. When brought to the insurance company's attention (we HAVE to report it or we could be considered a PARTY TO FRAUD), they STILL PAID IT ANYWAY.

The employer HAS to send you to doctor; if they don't, then the can later be held liable if you HAD broken it or if you claimed worse. P.S. If an employee of ours has an injury at work that we make them go to doctor for, WE pay THAT bill until it's determined if it's WC or not. And if he were out a week we'd pay his salary, even if it were his fault. After that, it becomes a WC issue...
 
#8
get a disability rating from an ortho doctor and ull get a few thousand $$$$. ull have to go to PT numerous times but so what. you dont even need a lawyer. you really dont. the lawyer will take 20% vs. the standard 33% they get in injury cases. comp cases they get 20%. why give them 20%? I dont. just fill out the paperwork and send it in after you get a rating.

there is a formula they use for each body part. its pretty simple. if work wants to stick it up ur azz for mandating you go to the hospital then stick u with the bill then stick it up their azz with a comp settlement. you did nothing wrong but get hurt. thats what workers comp is for. its not just lost time from work.

its done ALL the time and once ur doctor gives you a disability rating the state has to pay you. ur company pays into workers comp. they have to by state law. so get some money out it.
 

jellyrug

Donating Member
Registered
#9
I came off on a Saturday at the track, at around 140mph. Tore all the ligaments in my left foot. Monday back at work on crutches, a week later with a prosthetic boot. Never missed a day. Insurance paid for most of it though. Moral of the story is though that I have never used the system to my personal advantage.
 

Strife

Donating Member
Registered
#10
As far as I know, as long as you are on "Company" time... Workman's comp pays, unless you failed a drug test or such. I'd follow up on it and see if they are liable. With work being hard to keep these days, lots of employers push the limits of what they can get away with.
 
#11
Maine is a different situation. They don't pay 100% of your pay. They pay 80% of your take home pay with a maximum of $637.79. The system here is not skewed to the worker at all. It is skewed to the employer. If you hurt yourself on company time the company IS responsible for the medical expenses unless they can prove the injury occurred elsewhere. Like I said, contact the advocates office here in Maine and they will tell you how to proceed. A lawyer should be your last resort. As far as "using the system to his advantage"? WTF... If the guy got hurt at work..well, he got hurt at work. How is that using the system? Gees
 

dadofthree

Seasoned Beef
Donating Member
Registered
#13
Not a lawyer. The bill was sent to your HR, does it indicate that you are responsible ? If so, you have been well advised to contact State Workers Compensation and then a lawyer who doesn't require money up front to handle this.
 
#14
Make sure you also look into getting your job protected by FMLA (Family and Medical Leave Act)... I have no idea who you work for, but employers of certain size are legally required to adminster FMLA. FMLA is a federal entitlement that legally protects your job and keeps your employer from being able to use your absence as an excuse to terminate you. If your employer is large enough, look into FMLA as they would legally have to hold your job for you and not be able to count that time out of work against you.
 
#15
i work for pepsi co. i do have insurance and my HR said to submit it to them, but that will still leave me with my deductible and then the 10% and i really don't have that money. i was hurt in the proses of my work. had just got off a forklift and was going to pick something up, took a step and my ankle buckled, but as my Dr said, the floor ( concrete ) my not be even or without imperfections, maybe there was a crack ( there are a bunch of small cracks in many places in the where house ) or maybe i was just off balance. i took a week of my vacation ( didn't want to but STD won't cover my bills) and then another 4 or 5 days on std. i really don't care about the loss of pay or the fact i had to use my vacation, i do care about the almost 800$ ER bill that they are saying i have to pay that they made me go to, i asked if i could just go home and go see my DR in the morning. my DR said 100% it was work related and he would gladly go to court and back me up.
 

skydivr

Jumps from perfectly good Airplanes
Donating Member
#16
Before I went out to get a lawyer, I think I'd go up to HR and show them the Dr's statement, and ask them if they want to do this the easy way or the hard way. Sounds like all you want is the ER bill paid.
 

Similar threads




Top