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deescows · 02-24-2009, 08:44 PM

[/size]Ok I fell at work and dislocated my knee. I was off for about 3 days when the case nurse called me and told me that I was filed for wc. I had already set up an appt. with ortho and told her that. A few days later adjuster called and took recorded statement and told me that she would be surprised if it was covered..I figured as much, since this same thing happened to me 2 years ago and it wasn't...I told her about the MD then and she said ok. She also told me that my employer had an "agressive back to work policy", and that she would let me know by early the next week if it were payable. Well, went to MD appt. and he just put me in a brace (he didn't even touch the messed up leg..only to wrap it back up and put brace on.. kept looking at the one that wasn't a problem) and ordered me back to work as long as I didn't kneel or crawl..I stand all day at work...with no other restrictions. My case nurse called and I told her what MD had done, she was a little perplexed. When I asked her if it was covered by comp she said that she assumed so. I told her that the adjuster had'nt called back and she said that she would find something out for me. Later adjuster called and told me that she had talked to MD before I went to see him. She also told me that she was still trying to get med records from hospital and could I please call them to get them released to her. I called hospital and asked if they had gotten the request, they said no not in system. Called adjuster and left message they weren't sent and to please resend request. Leg still painful and doesn't feel right...took off stupid brace, since it was making leg swell more...called work and told them that I had filed FMLA, they said they didn't know if it was going to be on comp eiither.

Today went to another MD (ortho) and he moved leg all around and really looked at it...was group that took care of other leg problem..ordered MRI..want to see what's going on and why still sore after 14 days. I had call from new case manager, she said that she had notes from MD that I had visited earlier and that she wanted to know how work restrictions werer going and that she told employer that I was able to return to work...no crawling or kneeling..she said that I had told employer that I wanted to get second opinion and that the choice of MD for that would have to be approved from list by adjuster..I know I have to pay for that, I read the state code...I told her I would call adjuster, did and she didn't call back....DO I HAVE TO TAKE WORK COMP????? I live in Indiana, if that makes a difference.

lfoster21 · 02-25-2009, 02:01 AM

I know in VA, you do need to take W/C if it happened at work. Now if they deny it, you can then go where ever you want from that point on. Or you can fight to have then acknowledge it as their fault. I am sure ea. state is different, but that is what I have learned from VA.

Bummer Knees · 02-25-2009, 09:01 AM

The accident has already been reported, filed with the insurance company, and you have been to the doctor.

It is to late to say I don't want this to be work comp.

The employer has a legal responsibility to report the injury and it sounds as if they have done their job.

When I was injury I did not want to file work comp but because their was a witness to my injury and a report had already been made, I had no choice but to continue with work comp.

deescows · 02-25-2009, 10:23 AM

Thank you for your replies. The real problem of the matter is that I know the insurance adjuster is lying about having contacted the hospital..they haven't yet. The best part is that I can't get them to admit or deny the case! They just want me to go back to work with no restrictions and just leave my leg to do whatever it's going to do..no MRI or anything from the comp Dr. And they haven't even paid for anything yet..no wages and I paid the copay to the Dr that I saw on comp. I just can't figure it out, I'm not wanting to go back to work, because something is wrong with leg and I know standing on it all day for 40 hours a week will make it worse...I feel that they are just goofing around to get me fired.

lfoster21 · 02-25-2009, 10:17 PM

This is a tactic that they have used on me, except it was when I was trying to get my surgery approved. They would not deny it or approve it...in hopes that I would give up and go back to work. However, my lawyer said that she was use to them doing this and she asked them to make a decision & on the 2nd request, she sent them a letter stating that if we did not hve a decission by a specific date, she was filing a case with the w/c's court. They did wait until the court issued us a date on the docket and then they accepted the surgery. I understand what you are saying and they don't care if you get well and at this point, you are not getting the treatment that you need. I suggest that if you do not already have a lawyer, that youconsult with a few and ask them what your choices are, to get them to make a decission, one way or the other. If they deny it, at least then you can get the medical treatment that you need.

Good luck and keep us posted.

sparkey · 02-26-2009, 12:39 PM

So your job requires that you stand on your leg all day and they sent you back to work standing on the injured leg????? If I read that right, then something is wrong. You should be sitting if it is your leg and not standing on it all day. If you are , then I would go back to the doctor and tell them that you are standing on it all day and what sort of doctor would tell you to stand on a leg that is injured?????

Get a second opinion and ask for better restrictions or they should take you out of work. Go to your primary doctor to get taken out of work till they find light duty. This is absurd!!!! Man I am getting a short temper with WC lately.

deescows · 02-26-2009, 12:57 PM

Hi, thanks for all of your replies. I just got call from Wc today and they said that it was denied, since they couldn't prove it was work related. I'm so glad, since now even though I will have to pay for it, I can get something done for the leg. I've filed for FMLA, so they can't fire me for being gone for the time that I was..strict attendence policy...just in case I need to be off again. Now I can see another doc and fire the goof that was in comps pocket. YIPPY!!! I hope that everyone here gets the help that they need, I'll be thinking of you!!