[BACK FROM THE DEAD]

Anyone know much about comp stuff?

I've found myself in a strange situation here and not sure what I should do or expect.
The quick rundown is like this:

About 5 years ago I was injured on the job (fell and damaged vertebrae/discs in lower back pretty badly).
I properly documented it with a "incident report" through the company's HR dept, complete with witnesses and was treated @ the hospital.

Fast forward to about 2 years ago:
Been having continued issues with my back since the original injury, saw a specialist and was advised that I needed surgery.
Received the surgery and was "mostly better" for a few months, but slowly returned to being in constant/non-stop pain.
Recent MRI showed ruptured discs are about as bad (again) now as they were before the surgery. Time for another surgery probably.

Things at work have been slow all winter and since I'd been there for almost 5 years I'd worked myself into a good position where light duty work was my assigned duty. This was good for me as I likely couldn't have done the more heavy duty stuff normally associated with our trade with my back being bad like it has.

Well things haven't gotten any better for the company and I was recently told that there was no more light duty stuff available for me, so I agreed to take a lay-off.

Since I'm basically "on the gimp" here I don't know if I can cut it signing on with another contractor where I'd likely have to start off back out in the field doing regular heavy duty work, so I 'm thinking about hitting the comp insurance co again here as I'm basically unable to work due to the continuing decline of my health/abilities from this injury.

They have been pretty good to deal with really so far, and agreed to pay for the surgery and all associated costs before, even though it was over 2 years from the date of the original injury date.

I just kind of wonder what they are going to say now since I've been laid off?
Will they try to say "well we aren't liable for your lack of ability to work because you didn't have a job to go back to even if you were able". ?
I don't know...

Just wonder if there's anything in particular that I want to avoid saying? (Not trying to be deceptive or lie about anything, just wondering how to handle it, as I know their job is to try getting out of paying out on claims).

I've never before asked them for any type pf monetary compensation other than taking care of the medical costs.

They did however at one time a couple years back order me to have a "physical impairment evaluation" done, where they had a Dr evaluate how much of a percentage I was premanently physically disabled due to the injury. They then paid out a lump sum amount check based on the percentage of impairment the Dr said I'd sustained.
I really wish I'd known that was what was going on at teh time, as I took a ton of pain killers prior to doing the (4-hour) physical evaluation tasks.
Had I known all that prior I'd have elected to do the physical evaluation's tasks without taking the pain meds to make it more of an "apples to apples" comparison with my abilities in the work place.
I certainly wouldn't take pain meds like that at work, so their evaluation of my physical abilities from that evaluation were really nothing like what I could bring to the table in a work type environment...

I wonder if I could get them to re do that evaluation w/o the meds? I doubt it.

So anyway, that's about where I'm at here with this, anyone have any similar experiences or advise to offer?


Thanks

 

[shomejim]

Andy, I know how you feel. You have to remember that work comp is insurance. I had basicly the same injury as you, but not as bad. L5 needed surgery to trim where the disc blew out. My surgery was a success in that it relieved the sciata(SP) nerve and eased the pain. However, I reinjured it later in my career and was told by the insurance that they had already paid for 50% of that disc and would not pay as much this time around. Like you, I just wanted to get well and be pain free, not collect big bucks. I'd avise you to consult a lawyer who specializes in work comp claims. They advertise on TV all the time. But a lawyer will get you the best deal (since he gets a cut). I found that they can get more than you can by representing yourself. Usually the insurance pays for the drs. and hospital and medical costs. Then comes the hearing to determine how disabled you are according to the manual. They have cost for everything from fingers to hands to eyes. That's where you need the lawyer. Be truthful and don't try to be a macho man during the evaluations. No pain pills like you did before. Hope this helps, good luck!

 

[Teds SS]

Workers compensation laws vary by state. Check your state for a second injury fund. Some states have one, some don't. They are designed to remove the prejudice and risk of hiring a previously injured person. A new employer may feel you're a higher risk to get hurt again because of your prior injury and won't want to hire you. They'll have to pay for any costs if you're hurt on the job while working for them. The second injury fund will pay part of the medical costs if you are re-injured. Your new employer won't have to pay all the costs. The insurance company isn't liable for you being laid off. Honestly, they want you working. Because if you're sitting around not working you're more than likely going get a lawyer and sue them. Make sure you tell the insurance company your employer told you there's no more light duty work. You don't want them thinking you left on your own. Depending on the terms of your lump settlement they are responsible to pay for the second surgery if you need it. It doesn't matter if you're employed or not. Good luck. These things are complicated and again, every state is different.

 

[Kim57]

You need advice from an attorney that handles workman's comp.
As Tedds SS stated the laws will vary.
It's possible your Doctor can declare you 100% disabled from the type of work you were doing then you would be eligible for disability payments through SSI.
My back injury rendered me totally disabled from the trade I had been in for 25 years.
There isn't a company I know of that will take the chance on hiring some one with a bad back.
Kim

 

[RichG]

Usually WC will pay for retraining if you can't perform the job you used to do, such as some form of computer training etc. Talk to WC first, if they are of no help, get a lawyer.

 

[Hiline51]

I've been through 4 knee scopes, a total knee replacement, 2 cervical spine fusions, lower back laminectomy, rotator cuff and a torn bicep (40 years climbing poles). All between '05 and '11. All work comp. The guys are right. The laws vary from state to state, get a reputable work comp attorney (one that does ONLY work comp). Most will represent you for no fee just a percentage of any permanent disability settlement due you. Mine even helped file a SS disability claim. :thumbsup:

 

[cv67]

Eliminating your light duty position sounds real fishy to me

You need an atty who does nothing but this.
The right one could medically retire you so youre taken care of.

Going through hell with a case now fighting it yourself is fruitless it seems.

 

[seventychevy]

Like everyone said, get an attorney. I hurt my back picking up a tire at work 2 1/2 years ago and have been fighting WC ever since. I resored to an attorney after I caught my WC case worker in several lies. It didn't help that my manager told them I was faking and holding out for money to buy a Chevelle ( everyone who knows me knows my passion for them ). When I first got hurt they did x-rays and said I pulled a muscle. Two months later they finally did an MRI and saw L4/L5 herniated and L5/S1 "protruding" but then they tried to say "degenerating disc disease". My pain level seems to be trending up and have tingling and numbness in borh legs and other progressive issues. They did another MRI last week and when I went in for the review the pain mgmt guy (not a dr.) admitted he did not view the MRI and only read the report. I'm no dr. but when I looked at it L5/S1 seems to be "protruding" further than it was two years ago when they did the first one. Oh yeah, I had 2 epidurals that did not help but now they want to do injenctions in my hips for the pain in my leg...??? Their two surgeons who reviewed my first MRI both said no surgery because my herniation is in the center of the disc instead of off to one side... what difference does that make? South Carolina WC seems to want to throw meds at the situation instead of help the patient heal.

I lost my job because I was told they no longer had a light dutry position as well. Of course, when it suited them they didn't have any problem keeping me on my feet in the store by myself for 10 -13 hours at a time. But because I can no longer pick up tires they let me go to. It took me 5 months to find a job, but this past Friday I was hired by an agency to work at the BMW plant in Greer, SC driving cars off the line. At lot of walking, but I do get to sit as well; and my back has held up so far.

I feel your pain; and no pun intended. It is no fun at all. Bottom line get an attorney... I'm going back to mine.

 

[BACK FROM THE DEAD]

Thanks guys, guess I know what I'll be doing with the rest of my week...

 

[rel3rd]

Being in a very similar situation right now myself, the best advice given is to consult an attorney immediately. NOBODY from any liable insurance company will ever have YOUR best interest as their priority. Their job/priority is minimizing any and all monetary payouts...PERIOD.

Without a knowledgeable WC attorney, you will be at a serious disadvantage. Been there, done that. I tried to be a "nice guy" and let my company do the right thing, but as everyone told me would be the case...it didn't happen. If you don't protect yourself, they'll screw you any way that they can...

 

[MalibuLou]

Andy, welcome to the circus. I managed WC programs in California for 35 years. Every state is different so I'll offer only one comment. Before retaining an attorney (who won't always have your best interest at heart) I would contact the Alaska Division of Workers Compensation. They, like many states, have an Information & Assistance Unit. Their contact information is:
Anchorage Office
3301 Eagle St, Ste 304, Anchorage AK 99503
Tel: (907) 269-4980
Fax: (907) 269-4975

 

[BACK FROM THE DEAD]

Andy, welcome to the circus. I managed WC programs in California for 35 years. Every state is different so I'll offer only one comment. Before retaining an attorney (who won't always have your best interest at heart) I would contact the Alaska Division of Workers Compensation. They, like many states, have an Information & Assistance Unit. Their contact information is:
Anchorage Office
3301 Eagle St, Ste 304, Anchorage AK 99503
Tel: (907) 269-4980
Fax: (907) 269-4975

Lou,

Thanks for the advise, that's good advise too.
I called the comp company today after thinking about it for a bit. They've been very civil to deal with (so far) so I thought that may be a good way to start rather than slamming them with being contacted by a lawyer after not hearing anything from me for almost 2-years.

I'm a straight shooting kind of guy and figured that since they'd treated me well so far they deserved a chance to do the right thing on their own before taking it to the next level.
They seem to be kind of a small mom and pop type operation from the impression I'm getting. The claim worker that I'd dealt with in the past was no longer with them they said, and they only have 2 others now.
Both of which were busy, so I have to wait for someone to call me back tomorrow.

 

[Munch69ProTour]

Andy, welcome to the circus. I managed WC programs in California for 35 years. Every state is different so I'll offer only one comment. Before retaining an attorney (who won't always have your best interest at heart) I would contact the Alaska Division of Workers Compensation. They, like many states, have an Information & Assistance Unit. Their contact information is:
Anchorage Office
3301 Eagle St, Ste 304, Anchorage AK 99503
Tel: (907) 269-4980
Fax: (907) 269-4975

Good Job MLou. I have run W/C reinsurance companies for 30 years (basically insurance of insurance companies). Starting with the State of Alaska is the best advice you can get. The settlement you recieved in the past may represent a problem, but if it all depends upon what the settlement agreement says and whether you were capably represented by an attorney.

Any chance your work involved exposure to navigable waters? Any boat/ship repair? If so you may be eligible for USL&H benefits.

I hope you feel better soon.

You also have unemployment compensation to think about.

 

[BACK FROM THE DEAD]

I wasn't involved in any type of marine work, I'm an electrician. I opened an unemployment claim as soon as I was laid off, but from what I understand I'll become ineligible to receive anything from them if I'm on comp.

I did call the comp office yesterday and left a message. I was called back promptly this morning by a nice lady who told me that the case worker I'd previously worked with was no longer with them, so she'd be the one handling me now.

I explained to her my situation and she told me that they'd begin paying me bi-weekly payments for dis-ability compensation as soon as I could provide them with a letter from my Dr stating that I'm currently unable to work due to my injury, and my previous 2-years of income/pay records.
And that if I go back to the place that did my previous PPI and get a new evaluation they'll issue a check for the difference if I'm found to be further disabled than they had previously ruled (when I did my physical evaluation on pain meds).

They really didn't give me any kind of resistance at all and seemed to be very accommodating and willing to help... What gives here? Should I be waiting for the other shoe to drop or what?