Check out some similar questions!

passmeby · Oct 29, 2009, 09:22 AM

Scenario: Person gets a work-related injury at about 10 AM... they get off work at 2PM, so they missed several hours of work (both due to the ER visit and they were told to NOT return to work due to the injury (they had no choice, as of course the employer would face problems like liasbility and such). He was put in a special boot device and crutches as well, which are items not allowed inside the facility where he works, to top it off. They had to go to the ER immediately following the injury. The injury was investigated fully, as is the normal practice for insurance purposes, and was deemed absolutely work-related 100%. Anyway, if the injury happened around 10 AM, and the person missed work because of going to the ER... is it correct that the person should be paid .for the time they had to spend in the ER and for the remainder of the day because they were not allowed to return to work?

Also, there was a follow-up appt a couple weeks later and the person was made to clock out and not get paid for the time spent at the Dr apppt (it was about 2-3 hours). I also thought this was wrong, I had thought that anything related to a documented, approved work related injury was compensated for as far as getting paid for missed work in the regard of Dr appts. I know it's covered as far as being paid a percentage of wages due to ot being able to work, BUT what I am unsure about is if the missed work due to ER and DR visits related to the injury is covered as well. I'm pretty sure it should be covered, but I want to bee 100% sure.

This is my assumptions, please correct anything that is incorrect:

Day of injury, you get paid for time spent going to Dr or ER plus get paid for remainder of day that injury happened, as he was not able to go back to work due to Dr's orders

Get paid for time and travel spent attending follow up appts during work hours.

Get paid for mileage to and from appts related to injury.

Medications are covered.
________

All appts and being sent to ER were decisions and appts made by the employer, not made by him. He was only doing what they told him to do as far as appts, he made no appts on his own.

We were charged for all meds, which I kept all reciepts for and intend to include this info in my response to the disability company (they're trying to not cover this stuff). We were never given a case # or special insurance/prescription card to use to pay for the meds. The Dr's were paid for, so that's no issue, it's just the prescriptions.

This injury, while it has healed for the most part (well, it feels better, I don't know if it's completely healed or if it won't re-injure easily, as he had no surgery on it, just rested it and waited it out). It was torn ligaments in the foot. If he continues to have problems with this issue, what recourse does he have? He never signed anything relieving them of responsibility nor did he sue them or anythig like that, so can he do anything if he continues to have medical problems?

Thank you for any help, I need it ASAP! Thanks again!

I know I asked many questions, and would like as much info as possible, BUT the bolded items are vital and what I need to know ASAP, so anyone with help, please help with that stuff most importantly. The other stuff is not so urgent. Thanks again.:o

JudyKayTee · Oct 29, 2009, 09:26 AM

Worker's Comp is complicated - you need the services of an Attorney. The Laws/rules also vary by State.

This site explains it all, by State: http://www.workerscompensation.com/

(Everybody needs/wants help on an "urgent" basis.)

passmeby · Oct 29, 2009, 10:16 AM

Thanks for the link, very good link! There is no lawsuit, that's not an issue, we have no plans to sue, that is not even a consideration. It is urgent because I have to get this info together in a timely manner so as to not miss any deadlines. I'm pretty sure the link you provided would help me well enough to complete the packet of info I am putting together, it is really just a relatively minor dispute between what should be covered and what is not covered. The Insurance Co is trying to cover as little as possible and I think they think they can get away with it, but I want to be well informed so as to not get taken advantage of. I know for sure they have to pay for meds, Dr's and mileage at the very least, but they are trying not to (besides the Dr's, that they are paying for without problem), so that makes me think that who knows what else they are tryimng to get away with.

I had an experience with WC years ago and I know for a fact I was paid for the remainder of the day I had to miss out on when the injury happened, but it was in NY state so I don't know if it's different here or not. There is a phone # on your link, I am going to call as soon as I finish this reply and I will come back and let you know the outcome just for your knowledge. Thanks again.

The only reason I may urge him to get a lawyer is just in case this is not resolved amicably and/or if there is a re-injury due to rushed medical care and a rush to get him back to work (they have a shortage of employees, so they tend to do things like this! ).

But anyway, thanks, Great link.

JudyKayTee · Oct 29, 2009, 10:25 AM

I do a lot of third party Workers Comp cases (action against, for example, the manufacturer of a defective machine and the employer turns into a third-party Defendant) and it's very complicated. Make sure you cover all the bases, don't volunteer more than you need to, cover the possibility the damage is more substantial than the Physician thinks at this time.

That's why I recommend an Attorney but you certainly can handle this yourself.

passmeby · Oct 29, 2009, 11:50 AM

Well, depending on the outcome of what I can do myself (I'm getting all paperwork, including mileage, medication bills/reciepts, and other relevant things... ) So if it is not resolved, I will most assuredly get an attorney for him, just in case there is a problem that may resurface, so that he has recourse. I'd hate to see another injury due to the same initial incident and have him unable to do anything about it, even if it's just getting the medical aspect taken care of.

But I'm at least going to give it a heck of a try to get it staightened out myself! What the problem is, is that they're trying to shirk responsibility as far as paying mileage, medicines and things like that. So I think I can take care of that myself with a bit of diligence, but we'll see. I just may end up wanting to go with a lawyer if they continue trying to weasel out of their responsibilities under the law.

Thanks again. I'll report back as soon as I get this call made, just so that you have it as reference for any future question.

Later!

passmeby · Oct 29, 2009, 12:15 PM

OK, I made the call... they couldn't tell me too much, bt one piece of nfo that was particularly valuable was that as long as he worked for at least half of the work day, they do indeed have to pay for the remainder of the day. And as far as paying for time off for follow-up appts, it is the employers discretion.

Thanks again. Still have more questions, but my husband has to ask them as it's his private info.