If an employee is denied a stress claim by work comp. but still has orig.diag. from her Dr. is FMLA an option?

Saturday, January 30, 2010
By WcrAdmin

I am trying to determine whether or not to allow use of sick time to recapture time loss costs expended by our workers comp provider.

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3 Responses to “If an employee is denied a stress claim by work comp. but still has orig.diag. from her Dr. is FMLA an option?”

  1. FMLA is an option. Depending on your company though, you may not be reimbursed for time you take off for FMLA unless you have accrued vacation or sick leave.

    #12471
  2. My understanding of FMLA is that it entitles an employee to 12 weeks of leave, with the position to be retained for their return, so long as they meet certain requirements. It doesn’t necessarily guarantee payment of wages, but it does provide some provisions for continuance of medical coverage.

    I’m including a link to the actual law (searchable by html links on the page) as well as a link to the Leave Requirement section.

    I hope that helps with information at the very least.

    #12472
  3. FMLA only applies to companies with 50 or more employees within a certain mile radius so you may not even be eligible. You also get time off with your position preserved for you, but no pay while you are on leave :-( You may however, appeal the denial of your claim and win. Most cases that go to hearing resolve in favor of the claimant,not the insurance, although adjusters may not necessarily want you to know that. I strongly suggest getting a worker’s compensation attorney to represent you. You have many many rights and payments are pretty hard to deny, particularly with a diagnosis from your doctor which carries more weight than one from one of their hired MDs (independent medical examiners(IME) )although often times adjusters will and people give up without a fight thinking that the laws are in favor of the insurance. They are not. I worked for the insurances, and specifically worker’s compensation,hence I am truly not steering you wrong. You need an attorney to deal with these people though. They are aggressive, don’t want to pay, and you need a lawyer that will be equally aggresive on your behalf. Many of these attorneys can be found under disability law in your phone book. Fight for your money! If you do, you are likely to get it :-) Best of luck

    #12473

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