Med. benefits

[NewDriver]

Gator can you answer the rest of my questions please?

How many employees total in a 75 mile radius of your work location?

Have you been working full time or at least 1250 hours in the past 12 months?

And a couple of new ones.

What was the first day you were off of work?

Have you used any FMLA time in the past 12 months or since the first of the year?

Thanks in advance. I am going some where with all this that "MIGHT" be of help to you.

[gator76]

NewDriver, Sorry I've not responded until now! Things have been kinda hectic if you know what I mean!!!
We have approx. 80 employees in about a 50 mile radius
I've been working fulltime there since Aug. 24th 2005. 40+ hours a week.
My injury date was 6-21-07, so my first day off would be the 22nd.
I've not used anytime off from the FMLA. I dont know much about that!!! Didnt know I could use time off from that from an injury!!!!

NewDriver, I appreciate all this! Hopefully you can shed some light on this for me!!!
I know for a fact my reg. med.& den. insurance should of at least gone to the end of June, cause it should of been paid up to that.
Called our Gen. Mangr. today and the sec. said he was called out and will not be back till tom.(HOW CONVENIENT), He was'nt in on Friday either!! He is the one that handles all that stuff!!! Gonna try to get some of my 401k money to help cover my girls drugs! Hate to but I may have no choice. Thats another issue....... Our Gen. Mangr. says I cant withdraw it unless I'm terminated or become disabled or quit my job!! I know this cause I tried to get some out at an earlier time!! Thats the way they have it set up,supposedly!!!


Thanks

[Tuffy]

Most employees can not draw on there 401 untill they reach the age of 59, without paying a penality, but I have never heard of you not being able to draw on it, it would probably have to be paid back from your wages when you return to work, I would check into this further.

FMLA and WC can run together, and protect your job for 12 weeks and can also be used intermitently, days , weeks, etc untill used up for that year

[gator76]

Yeh, I was going to draw some out but He said they set it up so we could only get it if we become disabled or leave or get terminated! Which my WC checks say its temp. total disability checks! Wouldnt that qualify me? Oh, and I think I'll be out at least 12 weeks total. Doc. says from surgery to full work duty will be 3 months!!! Unless he releases me earlier!! Going tomorrow to see him.
Thanks!!

[NewDriver]

Gator thank you for answering my questions. I certainly understand when you say things are hectic. And there is no doubt in my mind that you have had your hands full. Provided you are classified as an employee and not classified a sub contractor or the contractor you work for has less than the required 50 employees within a 75 mile radius then the following is TRUE.

Both you and your employer meet the criteria to qualify for FMLA. You need to get the FMLA paperwork from your employer. If they won't give them to you go to this web site to see where else you can get the forms:

http://www.dol.gov/esa/whd/fmla/

While you are at the web site read ALL of the information. Pay special attention to Section 107: Enforcement. This will give you the knowledge you need to GET this very important benefit from your employer. And as you know knowledge is power. You will find that your employer has NO choice but to allow you to take the 12 weeks of FMLA job and benefit protection. FMLA, as stated earlier, certainly CAN run concurrently, (along with) with WC.

During this twelve weeks your employer must, keep your health care insurance or any other benefits, (dental, life, etc), paid as if you were working, (you still pay the part you did when working as well). They can fill your position with a temporary worker but if you are released for duty by or before the end of the 12 week FMLA LOA they MUST reinstate you in the same or equivalent position with the same or better pay and benefits. This is federal law since 1993.

Your state may offer FMLA protections at least as good as federal or better. However any state benefit for time would also run concurrent with Fed FMLA not in addition to.

This will give you at least 12 weeks from the time you go on FMLA that you don't have to be worried about loosing your health insurance for your baby. And your job is protected. If at the end of 12 weeks the doc has not released you then they can at that time terminate you for absenteeism. If this were to happen and you didn't get the IL kids insurance for your daughter they still must offer you the COBRA for your health insurance. COBRA can be used for up to 18 months, sometimes longer under certain circumstances. This is another federal law and they HAVE to do it.

Most employers understand that they are walking on very thin ice if they decide to terminate you after filing a WC claim. Most understand they better have one hell of a good reason to do so. Unfortunately some are ignorant enough to take the chance. Just keep in mind it is ILLEGAL for them to term you because you had the accident or filed a WC claim.

Keep this in mind, if your doc releases you by or before the FMLA 12 weeks is up and by your "own choosing" you do not return to work there for a minimum of 30 days they can, and usually do, charge you the full cost of the insurance premium that they have paid while you were out on FMLA. However if your doc doesn't release you or they refuse to put you back to work they CAN NOT charge you for this. Only if you choose to not return.

Gator it would really be in your best interest to pursue this even IF you got the state coverage for your daughter. You really need to call the Fed DOL and get this going. It will cancel your insurance termination at least for the 12 protected weeks. Also the employer knew you and they were eligible for FMLA and it is their responsibility to give you this information and the forms that you and your doc need to fill out.

I am not positive but I have been told that the employer CAN NOT apply FMLA retroactively. Meaning that they can only start your FMLA leave once you get the information and return the forms to them. Again let me stress I do not know this for fact so it would be a real good idea for you to call the fed DOL and ask them for sure.

Good luck to you with all this Gator. By the way have you contacted an attorney yet in regard to your WC claim? If not it would probably be a very good idea to. Your employer has already broken the law when they failed to inform you of your rights under FMLA. No telling what other laws they may decide to ignore.
If you don't already have an attorney for your WC case you need to at least get a consultation with one or more good WC attorneys. Given that your employer has already ignored the law on the FMLA issue they have proven they are not to be trusted. And certainly not where something as important as your WC claim is concerned.

Are they paying for all of your medical treatment at 100%, including medication, PT, any bandage material you have bought, Permanenet icepack, tens unit and supplies. Any thing and every thing in connection to your injury is to be paid for in full by WC.

How about reimbursement for mileage for trips you make in relation to your WC claim? Currently the rate in IL is $0.48.5/mi. Some states have a minimum number of miles per trip you must meet or exceed before they pay reimbursement. I scanned IL WC web site but did not find a min limit. Be sure an double check this. Your WC adjuster should have told you about his and provided you with any forms you need to use to file for the reimbursement. I would not be surprised to learn that this information was was not given to you.

Here is a web pointer for ILL WC:

http://www.iwcc.il.gov/

As with the FMLA you need to go there and go often. Read as much as you can and if you don't understand something ask someone. Come back here, call your attorney once you have one. But dont just wonder get it clarified if in doubt. You need to be very PRO ACTIVE in your medical care and with all issues involving your WC claim. Arm yourself with all the knowledge you can concerning your WC laws in ILL.

Good Luck to you and be sure and keep us up to date as to how things are going.

ND

[red1030]

New driver...that was an excellent post on FMLA...thank you for writing it all down.. we should use it again in the future...Red

[Bad Boy Bad Boy]

Gator76, and New Driver, the information supplied by New driver is very good. I am from Illinois like Tuffy. FMLA also depends on Company Policy and Hand Books in this State. Meaning you might have to pay your own Insurance payments while on FMLA. Or if in a Union some Union Contracts now state the employer will pay the Insurance up to the 12 weeks has expired. But you then still pay your portion as New Driver then stated. Now also, dep-ending on Company Policy, you may have paid FMLA, or Non Paid FMLA. At the end of 12 weeks, the employer can release you if you had not returned to work. But then you can reapply for employment there, and if they have an opening can rehire you. There is in no real way you have job protection, unless it is proven to be discrimanation for filing a WC claim. When it comes to FMLA being Federal Law, and WC in Illinois being State Law, you must keep in mind, there two different type Laws. Federal Vs State.

[gator76]

Good news! We qualified to get temp. med. card through Illinois' AllKids program. Temp. meaning while they review our case. So we will be able to get our daughters meds. Found out today that all 4 of her meds w/o ins. a month would be right at 1400.00. Thats more than 1 of my bi-weekly W/C checks!! Nuts!!!! Thats like the Cobra, its like 1300.00 a month for family!!
Talked with my gen. mangr. today. He said that legally they can drop me like that, but my coverage should of went through the month of June!! Paper said it ceased on 6-21. He says thats wrong, I should have coverage till the end of month! If I'm not mistaken, we had a prescription or two filled yet in June! We'll see if they get covered. Also he said that the company owners set up our 401k so that its a retirement only plan!! Have to be disabled for 12 mos. b-4 you can draw it out!!!!(no help there, dont have much in it anyway)
I'm not gonna fight'em on the insurance! I've got it now through the state(temp. till they approve us, they said it shouldnt be a problem.) All we needed was our girls meds. I know one of us could get sick and need it but I've taken chances like that b-4!! Besides, Doc said today that I'll go to therapy starting ASAP for 4-6 weeks 3x a week. Then should return to work and the day I go back my ins. kicks back in!
Had a pretty good day! Had trouble with our car! Allignment issue and bad tires! Got 2 new tires and allignment job all for 75.00!! Then gota a call about the temp state ins. So today was a up day!!!!
Does anybody know if I would be entitled to a settlement? Might be a posting on this somewhere, dont know! Heard I was then heard I wasnt!! No biggie.....at least my injury is paid for! Doc says I will probably never be a 100% on my knee again, but close! Kinda sucks cause I'm a vol. fireman and have to be on my knees crawling into houses!!!
Well enough jibber jabber!!!!! Thank you all and GOD Bless!!!!!

[capricorn]

hi Gator...Glad your day was so positive. We need that.

CAP

[1171]

glad one of the links was helpful.