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What course of action should I take now? worker's comp.
Anonymous3 views6 answers
Was working for my employer for 10+ years. Production was increased the past few years which lead to a back injury. I'm currently on wmc and I was terminated from my 2nd job because my family leave expired which I took because of the injures incurred from the first job. I was told by the Dr. that I would never be able to do what I used to do even after surgery (if I agree to have it). Due to my refusal to not have surgery I've been sent for a 2nd opinion appt which a Rn case manager called to ask if she could be present for, is that normal? Would it be beneficial to seek a lawyer for lost wages (2nd job)? Should I deny the case manager's request to sit in for my Dr. appt? and also could anyone recommend a lawyer. Thanks!
There are too many specific legal questions here requiring a KY response. There could be many reasons to do various things.
Call a local workers' compensation attorney - most will give you at least some basic answers. Realistically though, you need to hire an attorney. The little money you will pay out of benefits you get will be worth knowing the claim is being handled correctly, and knowing that your rights are being protected.
It is none of your "case manager's" business to sit in on a doctor visit. You're going for treatment and healing and the "case manager's" only goal is to get your case closed as quickly and cheaply for the insurer as possible.
It's true that each state has its own particular regulations which need to be observed in workers comp so your best bet is to locate a worker's compensation attorney ASAP through the state Justice Association, the 'Find A Lawyer' tab above, or a county bar association.
I practice Worker's Compensation in Northern Kentucky (in Florence). To answer your questions in order:
1. The carrier doesn't ask a nurse case manager (NCM) to be present in every case, but it certainly isn't unusual. I can see why they wanted one in your case, since alternate forms of treatment are being recommended.
2. I'm not sure what claim you'd have for lost wages from your second job. It wouldn't be through the worker's compensation system, but you might have a disability policy that would come into play.
3. If you deny the NCM sitting in on the doctor's appointment, you're looking at getting benefits cut off. You have the right to deny it, but it makes the road ahead a little tougher. If the NCM hasn't been a pain in the butt so far, I'd let her sit in. If she's the kind that answers questions for you and triest to get the doctor to release you, then it might be worth refusing to allow her in.
4. I don't know if I'm allowed to recommend myself, but that's who I'd recommend if I were.
My bet is you'll need a lawyer anyway when it comes time to determine your impairment. That's usually the case when you take an alternate course of treatment. If you have any other questions, give me a call at 525-1160.
I've had the issue come up where physical restrictions prevent a worker from doing one of two jobs. That should be part of your workers' comp claim.
Also regarding the case manager, you could ask your doctor to keep her in the waiting area and not talk to her after your appointment.
Use the Find a Lawyer function at this site.
