My husband has been denied a workman comp claim what do we do?
My husband is in management but is required to be a hands-on worker. Has been employed with this company for 9 1/2 years. Last year their put-up man was permanently laid off and my husband along with his 2 crewmen take turns putting up product which consists of lifting 90 lb rolls. On Jan.25th he was putting up and at first he thought he had just pulled a muscle which happens often with the work he performs so he did not report it just thought it would pass. Feb.11th when still painful and swollen he believed it to be a hernia on his right lower side not just a pulled muscle, he then reported it to the front office to see if he could go to the dr. They sent him to the doctor on Feb.15 and he has a hernia. Insurance has denied claim based on not being filed in a timely manner. Boss told him he’s on his own, to wait a week and file under his medical insurance and tell them he doesn’t know how it happened. That would be a lie and also against the law not to mention our deduct./$2500ea
GET A JOB!!!
Get a lawyer. As soon as you have a lawyer, they listen better.
make a quick call to a local worker comp attorney for this question.
Call a lawyer, and only one that specializes in workers comp cases. Don’t just call any old lawyer, you’ll need some one who knows the ropes. In fact you could try 1-800-complaw to see of they can direct you to someone in your area. I don’t know where you are but try anyway.
You guys need a lawyer, don’t forget to get one with the contingency law(sp?)
make up a story, say he was lifting something at home. We had to do something like this at my work, I wont go into details cuz who knows whos reading this but the hospital or doctors office will repeatedly keep asking are you sure this is not work related and he just has to keep saying the same story that it happened at home and keep telling them the story you make up. it will work as long as he keeps his mind on it and doesnt let it slip that it was work related for any reason.
You should definitely get a lawyer. This definitely sounds like a work related injury due to the fact that one of his duties is to lift heavy objects and he’s been their for over 9 1/2 years. Just becuase he reported the injury late is not a good enough reason to deny claim.
Seems as if he should have reported it earlier or told them he just done it when he did report it. Seems like the company may have a leg to get up on, but would highly recommend the you contact a Workman’s comp lawyer for a consultation.
Every state has an industrial commission that oversees worker comp claims, look them up if you dont want a lawyer and they should have a person to talk too find out you rights, but that time thing you mentioned seems alittle odd to me.
It should not matter how long it took him to report it. The fact that he was sent to their doctor and he has a hernia, is enough to accept the claim as good. The insurance company is trying to get out of paying for the surgery and time off. Have him call the insurance company directly and ask for an appeal. He should not go to his doctor since it is, in fact, a workmen’s comp claim. Does he have witnesses that he hurt himself? Did he mention the injury to anyone, including co-workers? If he does all that and the insurance will not allow him to appeal, have him report it to the State Worker’s Compensation Board. Look them up on the internet. They should be able to help you.
The law requires you report a injury as soon as you know it’s work
related… the time frame is set by statute. The people giving you
information, those that work with him are not the ones who
determine compensability of an injury by the employers WC carrier.
Just because there has been treatment provided does NOT mean this
is a compensable injury/claim (sorry Josie, but you are wrong) And
campy… what you are suggesting is fraud. And may be punishable by
jail time, at least monetary penalties. Not a good idea. Claims
adjusters are trained to find/use any reason necessary to deny a
claim. WC is based on medical evidence, that is provided by your
treating physician. As you did not provide your STATE…it’s
difficult to help you with any further answers. Go to your state WC
web site for additional information… and talk to an attorney. A
message board is not a good substitute for valid legal advice.