Ask Me Help Desk - Employee Severely Shocked at Work

So you are saying that if they had to miss a month of work and had $15,000. Worth of hospital bills that the employer or somebody would not be responsible because they had NO permanent damage?

Quote:

Originally Posted by N0help4u

sideoutshu disagrees: That is not true. What would the damages be?

Her hospital bill. Why isn't she entitled to her hospital bill being paid????

Hospital bill is an automatic pay through Workers Comp, sort of like no fault - no question that her medical expenses will be paid.

Question is - I think and I've lost track :) - what about suing the company for not calling her mother.

And, again, I don't see damages rising to a level which is serious. Perhaps the company should have been a little more understanding and used poor judgment, if not from just a PR standpoint, but that's not a crime.

When I said "damages" I think at the time I meant pain and suffering and permanent injuries but everybody cares about this but the OP who has moved on -

(And the post does say she was electrocuted and I thought, "Oh, boy," and then I read the post.)

Quote:

Originally Posted by sideoutshu

Her hospital bill, assuming she doesn't have medical insurance, would likely be reimbursed through worker's compensation.

I thought in a work related accident workers comp is primary and anything else is secondary - thought it's the same as no fault. You can't run it through your health insurance because no fault is primary - ? Am I wrong?

And, yes, unfortunately for OP and his friend you cannot collect because someone is a jerk - if only that were true!

Okay all I was saying is that somebody should be responsible whether it is workmens comp.
Arbys, the manufacture of the equipment, whatever.

Quote:

Originally Posted by JudyKayTee

I thought in a work related accident workers comp is primary and anything else is secondary - thought it's the same as no fault. You can't run it through your health insurance because no fault is primary - ? Am I wrong?

And, yes, unfortunately for OP and his friend you cannot collect because someone is a jerk - if only that were true!

No you are right. My thought was that for what seems to be a trivial injury, it might be better to save the hassle of opening a comp claim and just pay with your own health insurance. Personal health insurance is never going to question a single ER visit.

I will address the idea that hospital bills are automatic, no bill is automatic first the insurance company goes by the report from the place of work, and I have seen dozens of cases where they deny the workers comp bills at first. And I have seen a few take over 5 years to get the insurance compan to pay one penny. And in many cases, yes you have to sue, if they insurance company denies the claim.

For example if on this shock, the place of work claims it was done by the employee plugging something in incorrectly or by using a machine in an improper manner, they may deny the claim

Also if a injury is done due to workers comp, a persons health insurance is not liable to pay for it, as soon as they find out it was work related, the health insurance company denies the payment also.

It is not uncommom at all, on a injury to have both workers comp and their health insurance to both deny the claim, each say the other should pay.

But I will disagree, one of the first basic questions is " is this a work related injury" if they check yes, that claim is denies or if paid, and is audited they will request their money back.

Will medical coverage most likely pay one bill, OK most likely, but legally they are not obligated to pay, and if they do, they can require you to repay it, if it is latter discovered to be a workers injury

Quote:

Originally Posted by sideoutshu

No you are right. My thought was that for what seems to be a trivial injury, it might be better to save the hassle of opening a comp claim and just pay with your own health insurance. Personal health insurance is never going to question a single ER visit.

I don't recommend lying when you fill out the form about how the accident occurred, where the accident occurred, who is responsible - maybe it'll take WC forever to pay, maybe not but, again, I don't recommend lying when asked.

I see PLENTY of instances where someone covered by no fault (occasionally WC) decides it's too much trouble to try to collect, files under their heath insurance, finds out there ARE injuries and that lie comes back to bite them.

Quite frankly, I'm surprised that an Attorney would recommend that the claim be filed against the health insurance instead of the WC carrier which is legally responsible - no matter what the circumstances, no matter how long it takes to get paid.

Quote:

Originally Posted by Fr_Chuck

IBut I will disagree, one of the first basic questions is " is this a work related injury" if they check yes, that claim is denies or if paid, and is audited they will request thier money back.

Will medical coverage most likely pay one bill, ok most likely, but legally they are not obligated to pay, and if they do, they can require you to repay it, if it is latter discovered to be a workers injury

I find this to be surprisingly bad advice from an Attorney.

SHe has witnesses, and pictures of the fry station area. The Employer has not made the claim and it has been 5 days, since the insident.

The employee if the work place will not do the report, they can contact the state workers comp directly and file a report, They have to do this, since there is a time frame to file.

Also who actually owns the place, do they have a corporate HR department, it appears they are not talking to the proper people, it is hard to believe they will not take a report seriously.

Quote:

Originally Posted by Fr_Chuck

The employee if the work place will not do the report, they can contact the state workers comp directly and file a report, They have to do this, since there is a time frame to file.

Also who actually owns the place, do they have a corporate HR department, it appears they are not talking to the proper people, it is hard to beleive they will not take a report seriously.

Frchuck just said it all -

I'm wondering if this is actually Arby's owned or a franchise -

Quote:

Originally Posted by go-ask-mom

Her supervisor is "supposed" to take down the info. and turn it in within 24 hours of the injury to whoever their W/C Ins. point person is. Being that it's Arby's I guarantee they have a WC Rep.

She can NOT sue her employer "Arby's"- as that is why WC Ins. exists...it is an insurance paid by employers with 50(?) or more employees. Company's must carry it unless they are smaller and then they still must put up a bond. The Ins. is provided "in lieu" of suing the company....this way the employee can get immediate/long term care and a portion of wages until they can return back to suitable work.

The only other suit that can be brought would be a "tort" claim against a third party...which may be possible in her case being that the machine malfunctioned and shocked her. The "tort" would be against the manufacturer of the machine/fryer. Not her employer. (She would still have an original WC claim for the inury too- and a "tort" case.)

She needs to contact an attorney that specializes in Workers Compensation and not just go off of what one atty has told her. She should consult with many, as the initial consultations with them are free. She needs to basically interview these atty's. as they can & will be completely different in ideas and methods! So see who she gets a "feel" for. Plus, in some states the amount atty's. can charge is limited such as in CA (I think its 12.5% BUT in other states it can run a typical 33.3% !! Tort atty's are even higher!)

Then there are a million different rules, again depending on the state, such as the first initial doctor...some you may have to see their doctor but in others you can choose your first dr. Most of the time you will always be seeing a "company doctor" but you are free to be treated by anyone you choose ....the thing is, workcomp will not have to cover those expenses for visits, again, depending on the state and WC Ins. provider, so this means out of your pocket! Your typical employee health ins. benefits will NOT cover any work related injuries, so this is all your personal expense.

WC is a mess and you are almost forced to hire an atty. to know what your rights are, what you can and can not do, what THEY can/not do, and just to navigate through the whole process! It's not something you want to deal with alone anyway, when you are hurt and trying to get "legitimate" treatment. It is an uphill fight but with a knowledgeable atty. she should do fine. First things first...get the initial report of workplace injury filed!! (Another thing is they will deny almost 99% of all workcomp claims.....but you can and must APPEAL their decision!)

She needs to get the injury reported ASAP so a claim can be started! If nothing else have her contact HR where she works... if it is still ignored then contact the main 'corporate' Arbys HR line... she'll hear something from them on how to proceed!